To say every hospital should have a children’s A&E

[Wouldloveanother]

I know, it’s pie in the sky and won’t happen.
the state of A&E scares me at the moment. It’s one thing adults waiting 12+ hours alongside people high on drugs or in mental distress (our A&E seems to have a lot of both), it’s another thing for a small child to have to wait in such circumstances. I also feel in general children should take priority over adults (perhaps that’s controversial) and they shouldn’t have to queue with us.
Where we lived before had a dedicated children’s A&E and it was fantastic. AIBU?

Our A&E has a system whereby you are seen by a nurse within the first 15 mins and triaged and then the wait begins. Those who shouldn’t be there are sent packing immediately or signposted to the correct service (ie GP/pharmacist). So don’t worry, the service isn’t being swamped by “precious parents”. When I was there it was a string of young adult men who seemed to be swamping the system with blocked ears and ingrowing toenails. The children’s waiting room was virtually empty.

I also feel in general children should take priority over adults (perhaps that’s controversial) and they shouldn’t have to queue with us.

To be fair to posters you originally said this, which is completely different.

That children 'in general' should take priority over adults.

You acknowledged it's a controversial opinion so it can't be too much of a shock people don't like it 🤷🏻‍♀️

Maybe there should be separate waiting, triage, assessment and treatment areas for children, mh issues and adults. Do psychiatric hospitals have the equivalent of their own a&e units or take direct admissions from the mh team and the police.

I think it's important too.
Ours doesn't have Childrens A&E but has a separate waiting room for Walk in Urgent Care (ie not life threatening).

I think it's inevitable that people will have to witness distressing or unpleasant things in any A&E. It's A&E - even if it was kids only, you'd still see some horrible and upsetting things and children will see other children with serious injuries and in a lot of distress. it's just the nature of an emergency unit, really.

YABU

Children shouldn't take priority over adults, triage should be done irrespective of age, unless age makes their condition more serious.

A child with a broken leg is no more important than a 60 year old with a broken leg who might have been sitting there longer

I was the one who mentioned a sore finger. I used that as an example of what the OP was advocating (general priority for children because they’re children, not because of clinical need). I specifically said that A&E triage currently factors childhood into clinical need where relevant and that this is fine. What’s not fine is a child getting priority simply because of their age, when there’s no clinical need for it.

The OP now says that isn’t what she was saying so it’s all irrelevant but please don’t be disingenuous about what has been said.

The local hospitals have multi locked doors separating children from the main waiting room so nobody spends too long with an unwell child or infant in the company of the general population. The door to the left leads to the children's area, one way over to the right leads to the adults, with Resus (I think) in the middle. It's good because it provides safety for the children away from such things as fights, drunkenness, aggressive parents coming in to start a fight with the other parent, a way of keeping an abuser out if something is disclosed by the child, people attempting to get entry to where someone has been admitted with gunshot or stab wounds in order to carry on their attack - that kind of thing.

When you get through the doors, the area itself is all part of the one place, but they are on one side of the department, so it's still quieter and in an emergency, there's nothing impeding staff from Paeds, Majors, Minors, etc, being able to run from one end to another. It wasn't as difficult for them to split up the area for adults into Covid and Not Covid areas either, as it was a case of adding dividers and opening the doors between there and the attached emergency care unit to increase area, rather than completely rebuilding.

It seems to work very well in the great scheme of things - the worst aspects of needing A&E (the waiting room at night where anybody and everybody can get in and do) beyond the actual being ill or injured part are avoided whilst there is nothing restricting the ability of staff to attend a life-threatening emergency, wherever they are in the department.

Why should children go before adults??

A kid with a broken arm shouldn't go before an adult in anaphylactic shock or having a heart attack... the child is unlikely to die compared to an adult with a more endangering condition.

I've always lived in city where there is a separate children's a and e I thought that was the norm.. consider me educated on that now.

I totally agree about having separate waiting area for children as some adults with mh or drug/alcohol can sometimes/have been violent in waiting areas and that's not something children should be exposed to when they are themselves feeling more vulnerable and confused due to their illness its an added stress they dont need. for those who think that's unreasonable then start allowing 5year olds watch 18 plus movies if you think they should be around people having violent breakdowns.

OP however the queue jump is a no.

I'm not being disingenuous, it was very obvious that the OP didn't mean a sore finger should go ahead of a heart attack. Nobody with any amount of common sense would think that but as evidenced by the comments on this thread and many others, there seems to be a hell of a lot of people who don't understand that children often do have a higher clinical priority than adults with the same kind of symptoms. Nobody is saying a child with a minor illness or injury is going to be seen ahead of an adult with a major illness or injury - but when it's a child and an adult both in majors the child will usually be given priority for a number of very legitimate reasons.

A child is less likely to accurately describe what is wrong, they are more likely to go downhill very quickly with no warning - they can be stable for a long time then suddenly become unstable, they often have more serious complications due to their size and how effectively their body works and doctors often less time to fix things when things go badly wrong because again, children have less body fluids, less temperature regulation, and their bodies generally aren't going to be as resilient as a healthy adults.

Children are already given priority in those groups that doesn't change regardless of whether or not its a mixed A&E vs children's and adults. The only thing a separate children's A&E would mean is a calmer, more suitable waiting area for children and possibly slightly shorter waiting times for both children and adults but only if the staff could be found (which given the state of the NHS is unlikely).

@Mariposista I'm sure you don't care since you apparently don't like kids much but the reason families with young kids are given priority boarding is so the kids don't get worked up into a tantrum state in a queue waiting to get on the plane. Its as much for the sake of the other adults on the flight as it is for the kids themselves.

This is not the reason families board first, it's because they take longer to get settled once on the plane, as parents getting kids in seats, bags overhead can take up most of the aisle.

The solution would be to have two separate areas with medical staff dedicated to each.

Well obviously there should be and quite rightly is triage.

But that is not what the OP originally said.

They said they should be prioritised over adults - not that everyone should be triaged based on need.

If that means a child is found to need treatment first then they should of course be treated but that’s based on a medical assessment, not just because of their age

Of course the OP has now said we have all misunderstood what they meant but that’s either because they didn’t explain their thinking fully or they are backtracking

Agree. staffed by paediatric nurses and regular attendance by a paediatrician. So much nicer for children

a totally seperate area and service. so yes they would jump over adults waiting

So by your reckoning a child with a broken finger should be seen ahead of an adult with a heart attack...

This is one of the best examples of parental arrogance I've seen on this forum.

Why would adults be waiting to see a paediatrician?

I'm not being disingenuous, it was very obvious that the OP didn't mean a sore finger should go ahead of a heart attack. Nobody with any amount of common sense would think that but as evidenced by the comments on this thread and many others, there seems to be a hell of a lot of people who don't understand that children often do have a higher clinical priority than adults with the same kind of symptoms

It's just as obvious that A&E departments will prioritise children in circumstances where clinical need dictates that, and so the OP's call for change must be for something beyond that. That something beyond that must, by necessity, be that children have priority over adults for reasons other than clinical need, and posters are using extreme examples to demonstrate how preposterous that would be.

The OP has not clarified what she actually meant by it, which doesn't help.

@rainbowmilk Well then I shall clarify.

what I meant is priority in terms of having their own A&E.

I have actually said this but people don’t read my posts then argue with something I haven’t said.

So you're literally saying there should be two A&E departments in every hospital? Ok. Where does the funding come from?

There'll still only be one X-ray department, one lab etc so do they still get bulked together then?

You did use the word prioritise so what are we prioritising?

I totally agree that children should have a separate room I still remember when I was in a a&e as a child after an accident and the fear as a very drunk man started to attack a nurse and the security not being able to stop it and eventually police running through everyone screaming not nice when your 6 with a concussion. My a&e has a separate room I do not believe children should go first if the adult is more unwell that’s just bonkers.

You said priority over adults. Children having their own A&E has no bearing on adults, because as you say, adults don't need to see paediatricians. Do you mean that if there's a choice between having a general A&E and a childrens' A&E, then the hospital should choose the latter? That would be priority (and also utterly bonkers).

If what you mean is every hospital should have a childrens' A&E as well then just say that. No need to pit children against adults (if anything it might benefit adults by making their queue shorter). But you've specifically referred to children having priority, so that's what I (and half the posters) are trying to understand.