To think my husband is gravely ill at the wrong time?

[MyOtherCarIsAPorsche]

Masses of confusion.

Husband spoke to GP yesterday morning and described his chest pain. He was advised to call an ambulance. My husband refused because he didn't think he needed one - thought he had chest infection or torn muscle.

He went to A&E - was sat in a corridor from 10.30am - he had ecg, x ray and blood test. He continued to sit on a chair in the corridor all day.

He was told he was waiting for blood test results. These came back at 6pm. Then he had to wait for a CT scan - then rushed to resus.

Dissected aorta from heart level to naval level.

I was called to be allowed to sit with him because I wasn't allowed to be in A&E. Was then told he was being blue lighted to another hospital an hour away for immediate surgery. I asked is this time critical? The answer was - yes life saving.

Paramedics arrived and told me to set off to this other hospital. There were three paramedics. One said 'I'm not taking him because I can't use that bit of kit, I'll lose my job if something goes wrong'. No advanced paramedics available and no doctor available to go in the transfer.

I was 15 min into the journey and then called back to the hospital.

No surgery.

Trying all day today to get him transferred. Nothing available.

He's critically ill.

I'm out of my mind with worry.

There's a saying about not being ill on the weekend. The standard of care is not the same. The 24hr cover appears to not exist.

I feel like we're being fobbed off with poor excuses big style.

This is awful. I'm so sorry you're both going through this.
I've experienced hospital weekend delays and lack of specific staff many years ago. Its was a terrifying time to need help.
Be your husbands voice, ask questions, be polite but assertive.
Good luck. I am thinking of you both.

Can you get someone to bring you a pen and notebook? Then whenever anyone talks to you about your husband's condition, write down what they say, their name and time. When they've finished say, 'just to be clear for the record, you're saying x, y, z'. Ask each person how critical your dh is and how urgently he needs treatment - write it down and let the member of staff see you're writing it down.

With the paramedics for example you could have made a written note and then said, 'so just to be clear, you're refusing to take my dh to another hospital for life-saving treatment because you've not been trained in the necessary kit he might need en route? So he can't get urgent treatment? Is that right?'

Might get more results if people think what they're saying/not doing now might come back to bite them. Also makes it harder for people to deny later what they said and you also have a handy transcript to use as the basis for your official complaint once your dh is better.

Reading this makes me feel so angry and scared.

It's a tragedy what we've allowed to be done to the NHS. It beggars belief

My Dad has had several aortic dissections. It’s very risky. The last one I was told by a consultant there was nothing to be done, and I said not to be ridiculous, to speak to his consultant. I was quite full-on and tracked down the consultant myself when he refused to. Once the consultant rang him he came and - well, he didn’t apologise but he was sheepish.

You need to advocate for him. I agree, this is a terrible time for this to have happened but you have to try your best. Which ICU are they trying to transfer you to?

@7eleven

I wonder if it’s worth trying to get hold of your MP?

The MPs dont give a fig, it's the MPs who cause these issues with their chronic underfunding. I once worked with an MP who led a cut in the Social services disability budget and when a service user complained that he was not provided with certain disability aids, the MP tried to blame social services. Even though it was that bastard who had cut their budget. I really feel for you OP, I hope your DH gets the help he needs swiftly.

I really hope your husband gets treated soon. I have no suggestions apart from shouting on Twitter.

@StrawberryPot

Can you get someone to bring you a pen and notebook? Then whenever anyone talks to you about your husband's condition, write down what they say, their name and time. When they've finished say, 'just to be clear for the record, you're saying x, y, z'. Ask each person how critical your dh is and how urgently he needs treatment - write it down and let the member of staff see you're writing it down.

With the paramedics for example you could have made a written note and then said, 'so just to be clear, you're refusing to take my dh to another hospital for life-saving treatment because you've not been trained in the necessary kit he might need en route? So he can't get urgent treatment? Is that right?'

Might get more results if people think what they're saying/not doing now might come back to bite them. Also makes it harder for people to deny later what they said and you also have a handy transcript to use as the basis for your official complaint once your dh is better.

You're advocating shaming a paramedic who was acting entirely professionally in refusing to act outside their competence? The paramedic is the one person in this story who has acted 100% correctly.

How scary for you both. I hope he can get the surgery soon.

I am absolutely furious on your behalf.

Have they said if it's a type A or B dissection? The latter is usually less urgent for surgery.

I know it is incredibly hard to muster yourself at a time like this, and feels wrong, but if needs be you or your son need to go into that hospital and completely throw your toys out of your pram...

...I had a similar experience with trying to get my dad adequate treatment after he fell and broke his back in multiple places. The only thing that got results was going completely batshit and threatening MRS and going to the media (and I am so far removed from being 'that' type of person, believe me).

I hope your visit goes well and he's soon being treated and on his way to recovery. I know someone who had surgery for a aortic aneurysm and made a full recovery so a positive outcome is very possible even though it's incredibly scary right now.

You're advocating shaming a paramedic who was acting entirely professionally in refusing to act outside their competence? The paramedic is the one person in this story who has acted 100% correctly.

No. I'm advocating that the op compiles a record of all the points at which the NHS has failed her dh. The shame is on the system that means he hadn't been trained properly. It was an example.

*With the paramedics for example you could have made a written note and then said, 'so just to be clear, you're refusing to take my dh to another hospital for life-saving treatment because you've not been trained in the necessary kit he might need en route? So he can't get urgent treatment? Is that right?'

Might get more results if people think what they're saying/not doing now might come back to bite them. *

The paramedic has said and done exactly the right thing, even the way you've worded it sounds entirely reasonable. They'd have far more to worry about if they'd agreed to take DH and something had gone wrong on route which they weren't trained to deal with.

@VeryMuchFlaggingMinty

I am absolutely furious on your behalf.

Have they said if it's a type A or B dissection? The latter is usually less urgent for surgery.

I know it is incredibly hard to muster yourself at a time like this, and feels wrong, but if needs be you or your son need to go into that hospital and completely throw your toys out of your pram...

...I had a similar experience with trying to get my dad adequate treatment after he fell and broke his back in multiple places. The only thing that got results was going completely batshit and threatening MRS and going to the media (and I am so far removed from being 'that' type of person, believe me).

I hope your visit goes well and he's soon being treated and on his way to recovery. I know someone who had surgery for a aortic aneurysm and made a full recovery so a positive outcome is very possible even though it's incredibly scary right now.

Maybe we can give you a list of questions to ask?

1. Who is his named consultant and how do I contact them?

With the paramedics for example you could have made a written note and then said, 'so just to be clear, you're refusing to take my dh to another hospital for life-saving treatment because you've not been trained in the necessary kit he might need en route? So he can't get urgent treatment? Is that right?'

Well yes the paramedic would say yes, as a duty of care and professionalism I am not willing to try and administer medication I have not been trained in and can not legally administer which could kill your husband and lose me my job or worse.

@StrawberryPot

You're advocating shaming a paramedic who was acting entirely professionally in refusing to act outside their competence? The paramedic is the one person in this story who has acted 100% correctly.

No. I'm advocating that the op compiles a record of all the points at which the NHS has failed her dh. The shame is on the system that means he hadn't been trained properly. It was an example.

I really don't want to derail the thread, but the paramedic hasn't "not beet trained properly". We don't use that type of hospital- based equipment or those kind of drugs. It's not a lack of training, it's outside of our scope of practice. It is actually illegal for us to act outside of our scope of practice.

It works both ways too- an A&E nurse or doctor would not be able to use our specialist ambulance-based equipment as it isn't in their scope of practice.

The paramedic would have been able to convey OPs husband if the hospital provided an escort.

The paramedic has said and done exactly the right thing, even the way you've worded it sounds entirely reasonable. They'd have far more to worry about if they'd agreed to take DH and something had gone wrong on route which they weren't trained to deal with.

Yes of course the paramedic said and did the right thing. And what he said is evidence that the op's dh couldn't be transported because nobody properly trained was available. I'm criticising the system not the paramedic!

Consultant Anaesthetist here. I am so sorry you are having to face this. I would suggest speaking to the Consultant in charge on the ICU. It sounds like it needs an icu nurse, junior icu doctor or junior anaesthetist to go on the transfer so they can change the pump as needed to control his blood pressure. The icu consultant can identify one of those from his team or by speaking to the on call consultant anaesthetist if they are different teams (as they are in some hospitals like mine).
Either way, the icu consultant should be able to identify someone appropriate to do the transfer.
I hope you get it sorted very shortly.

OP although it is the weekend, the hospital will have on call staff (clinical and managers) who should be managing this. I suggest you ask to speak to the consultant (who may be on call), or ask that they be called. Suggested questions are:

1. Can they outline the treatment plan (ie transfer)
2. Can they explain the reasons for the delay
3. Has this been escalated, and to whom has it been escalated

Keep a note of who you speak to.

The NHS is all smoke and mirrors.

@FannylovesDick

Tell them you want the on call Cardiac Consultant, the Clinical Director and the Chief Executive contacted and brought in to speak to you both. This is appalling.

For a dissected abdominal aorta, the person to deal with it would be a vascular surgeon, not a heart specialist.

OP, are you sure they said he’s got a dissected aorta? That is usually critical. It sounds more like he has an AAA, and depending on the size, the treatment will differ.
I hope he’s being seen now.

@FluffyLion

I work for the ambulance service. For an intensive care transfer we always have hospital staff travel with us. Intensive care patients are transferred on the hospital trolley with all of the hospital equipment attached. We aren't trained to use the equipment, it is different to ours, we always have a doctor come with us and usually a nurse too incase anything happens on the journey. I can't understand why they don't have staff available to go on the transfer, it is critical that they make staff available. It just doesn't seem acceptable at all.

Perhaps there just isn’t the staff available? They can’t magic staff out of thin air.

@Soontobe60 I once did a critical maternity transfer in the middle of the night with the head of midwifery for that particular hospital as an escort. There was literally no one else so she came in from home. When its life or death, someone senior needs to step up. There is always a way.

🙏for you. Can this be escalated further?to local MP or so...? Please let him be OK.

[quote TheUnexpectedPickle]@Soontobe60 I once did a critical maternity transfer in the middle of the night with the head of midwifery for that particular hospital as an escort. There was literally no one else so she came in from home. When its life or death, someone senior needs to step up. There is always a way.[/quote]
And what if the senior staff are dealing with other, equally life-or-death cases?
Sometimes, very hard decisions have to be made when there’s a staffing crisis. There isn’t ALWAYS a way.

They need a critical care ambulance for the transfer if the receiving hospital have said yes, then that seems to be the hold up. And get onto SATS as well.

Get onto your ambulance service and ask them for documentation as to why they have refused the transfer.

www.sats.uk.com/our-services

Link and contact details for SATS. I don't know where you are though.