To think drunk teen shouldn't be in paeds A&E?

[Us3r21422]

NC for this in case picked up by the likes the of Daily Fail etc.

Took DD to paeds A&E last night due to concerns about dehydration after 5 days of gastro bug and decreasing tolerance for fluids and no wet nappy for 12 hours. Luckily she is OK and we were allowed home after some anti sickness meant she could tolerate water, but the place was full of really sick babies and toddlers. Dr said 4 cases of D&V/dehydration, plus a query sepsis child, croup etc.

I heard someone approach the nurses station and say they were bringing a drunk 15 year old and his parents round from adult A&E, no particular reason given, so assume this was purely based on his age. He did say dad was struggling to manage said drunk teen.

At this point I knew we were going home, so no real skin in the game, but I thought to myself that if the teen was that drunk, was paeds A&E really the place to bring him when he would have received presumably the same medical care in adult A&E?

As I say, no big deal to me as we were leaving, but I'm not sure I'd have been happy with a drunk/loud/aggressive/silly teen in the cubicle next to us. More so for the other parents and children who were really very very poorly and had clearly been there a long time, were very tired, waiting for a bed on the ward etc.

So - aibu to think drunk teen probably should have stayed in adult A&E and that it's not really desirable for a 15 year old who's had a few too many to be in the same (very small) department as lots of really unwell younger children?

Spoken like a mum of a baby . You’ll feel differently once your baby is 15.

They're a child. They should not be on an adult ward.

If it was my child I would want to be staying overnight with them at that age still and children's wards have fold out beds for parents that adult wards don't.

Paediatric A&E in my hospital is for under 16s so that's where a 15 year old would go. It's categorised by age, not reason for being there.

Clearly I'm giving a vibe that I'm making it up or somehow twisting it to suit an agenda.

Obviously can't prove it's true or what exactly was said.

I thought statting I had no skin in the game inferred it was one of those fleeing thoughts/ponderings that i hadn't really thought through, but clearly not 😳 I'm just lying in bed with DD, thinking about last night and after a week of illness and minimal adult interaction (perhaps unwisely) thought I'd put it out there 🤷‍♀️

YABVVU
an adolescent in any state of intoxication is a vulnerable child and needs specialist skills and knowledge to manage potential idiosyncratic adverse reactions to whatever toxins they have ingested.

A disoriented, possibly disinhibited drunk teen is at risk and the paeds staff have the specialist safeguarding training to assess for those risks and care for the family as a whole.

Adult ED will be as much of a traumatic experience to a teen as it will be to your child. Think of the worry you were experiencing as a parent.
My teen was recently in ED after self inflicted intoxication (in their case an OD). How dare you suggest that children like them should be any less a priority than others?

And the staff reaction in your scenario? As a HCP myself, and someone who teaches HCPs- it's inappropriate, unprofessional and a sign of compassion fatigue. It should be supportively challenged with restorative supervision not tolerated. The same staff WILL have moaned about kids with gi upset being in ED rather than seeing their GP. They will have moaned about a lot, because they're burned out, struggling themselves.

You were tired, frightened for your child and not fully aware of what was going on behind the scenes. Your reaction is understandable, but compassion and empathy are needed for all in the situation.

I hope your little one is on the mend. When they are a teen, I hope outsiders remember that they are a child navigating their way through an adult world, and show them kindness and respect.

I voted YABU because you made this bit up...

but I'm not sure I'd have been happy with a drunk/loud/aggressive/silly teen in the cubicle next to us.

Or did you stick around long enough to actually see the teen, and witness drunk, loud, aggressive and silly behaviour?

This was a child with a poison in their body. Of course they should get medical treatment in a children's ward!

15 is a child. Anyone under 18 is a child.
So sounds like this drunk, vulnerable child was in the right place, regardless of how you judge why he might have got himself there in the first place.

Sounds like the teen was in more need than medical attention than your DD was with a tummy bug. A&E isn’t for stomach bugs.

FFS I was waiting for this.

A baby under one who cannot tolerate fluids and has not passed urine in 12 hours needs to be seen imminently. Read the NHS guidance on dehydration.

Our out of hours GP shuts at 8pm. Where else should I have taken her, or should I have waited until she became unconscious or had a hypo due to low blood sugar? Her sugars were 3 on arrival.

@Us3r21422 Might help if you could clearly state why you believe a child should be treated in an adult ward.

I think the fact that you 'have no skin in the game' makes your pondering even worse actually.
You didn't even see the child or know how they were behaving, but still feel confident in asserting children's a&e was not the place for them!
And yes- when your child gets to 15 you will be horrified if someone suggested they should be treated amongst adults or put in an adult ward.

Oh you want a pop too do you?

As I said to pp, a baby under one who cannot tolerate fluids and has not passed urine in 12 hours needs to be seen imminently. Read the NHS guidance on dehydration.

Our out of hours GP shuts at 8pm. Where else should I have taken her, or should I have waited until she became unconscious or had a hypo due to low blood sugar? Her sugars were 3 on arrival.

YABU
I'm a paeds nurse and looked after a few intoxicated teens in my time. They are still children and entitled to access care from staff that are trained to look after them.
Generally easy admissions as well, get them on a drip, sleep it off and home in the morning. Bliss.

I'm sure if it was your teen you wouldn't want them in adult A&E.

YABU. Children belong in the paeds ward.

You don’t get medical treatment for ‘a few too many’ or for being silly or loud. If the medical professionals deem he needed to be monitored then it’s not up to you to minimise the situation because you don’t approve.

A 15yo is a child. You might be a bit less judgy when your kid gets to that age but of course I’m sure your child will be perfect 🤨

At 14 I had a severe head injury, and appeared completely intoxicated, vomiting and aggressive.

should I have gone to adult A&E? Or do you think children should be in adult A&E only if if they were “drunk”.

Or is 14 ok, but 15 not?

Where is your line- many things can look like intoxication, do you only want children treated as adults if it is “their fault”?

He is a child so it’s totally legitimate for him to be in paeds A&E. But I would also have found a loud, drunk teenager exceptionally annoying if I was in there with a sick child. I loathe drunks.

In all fairness - it’s absolutely impossible to get appropriate care for a child at times.

My son was 8 months and had a fairly routine respiratory infection, no big deal, we managed at home with vapour run, calpol, increased fluids and so on. After about a week he wasn’t getting better, his temp was hovering in the 38s, with occasional spikes to 40 which came down quickly. He was decreasing on milk by this point, down to about half his normal, and not taking solids. I took him to the GP. They wrote it off as normal and told it’s fine as long as he did one pee per day (!!!) but to come back if I was still concerned. Two days later he was worse again, by this point he was only taking fluids in a syringe and barely peeing.

It took four visits to my GP where absolutely nothing happened. Phoned out of hours because by this point he had barely peed in 8 days, he couldn’t even cry (no noise, no tears) - the nurse heard his cough and told us to go straight to A&E where he was sent to paeds and given steroids, fluids and antibiotics.

Had he been treated appropriately earlier there would have been no need to go to a&e.

He’s a child and needs safeguarding from the potential risks in an adult a and e, and needs to be in an environment designed for children and young people. He needs staff who are trained to care for young people.
dont be so callous and judgemental. You have no idea of the circumstances or what happened.
one day your child will grow up and make a mistake of some sort.
when you have a teenager you wouldn’t them exposed to unnecessary risk because the mother of a toddler doesn’t want to share resources.

This is actually a really helpful response, thank you flamingoes.

What you say about compassion fatigue makes a lot of sense, I hadn't thought about it like that at all.

To clarify, I didn't overtly think he should be any less of a medical priority, but completely appreciate it came off that way by suggesting/wondering if paeds A&E was the right place for him. I hadn't considered the specialist skills and knowledge required to treat a child for the effects of intoxication.

I suppose i was a bit surprised and maybe inadvertently led by the response of the doctors I heard and it was one of those moments where you think "blimey, I'm pleased we're going home now". They were really quite casual and I heard the male handing over saying "oh yes, he's definitely had a few". He did open with "intoxicated 15 year old male", but his tone quickly changed to a much more blasé one and I suppose that led my train of thought.

I'm sorry about your DD and hope she's okay.

It wasn’t a criticism of you - more of the fact there are no other options - no wonder A&Es have huge waiting times if they have to be used like this

the parents would have been worried,
awful situation
hopefully he is ok today and there are no repurcussions.
my own ds came home drunk one years eve, it was very worrying

When I was in children's a&e we had a mother in also she was under 18 and vulnerable so she was in the children's department but she was also a mother in her own right no-one batted an eye at her need is need

As a medic I’m pretty horrified about how much information you were given about other patients in the department and that the staff were discussing in front of patients that they were irritated about having to see a drunk child.

A 15yr old has every right to be in a paeds A&e. And who knows what was actually happening- a lot of things can look like drunkenness- head injury, hypoglycaemia , overdose etc . I worked in a A&E where every child presenting because of alcohol/ substances was treated as a safeguarding issue.

Focus on your own child - not who else is there and why.
And stop being so judgemental