To be upset at A&E fobbing off my toddler?

[IWineAndDontDine]

I hate to be that person. I acknowledge they are overstretched and understaffed but I'm concerned about my daughter. Shes had diarrhoea for 3-4 weeks since covid. Lost her appetite around then, its got to the point she is probably eating 150 calories a day if that. Just a couple of mouthfuls of food. She's not herself, she looks gaunt, her eyes look sunken, she's gagging constantly as if she's going to throw up and occasionally does throw up. She's been warm for over a week. We haven't tested her temp with an actual thermometer but she's been clearly warm to touch and sweating. Just gradually getting worse since covid.

We have been told by everyone covid symptoms drag and drag so we kept thinking she would improve, but I just looked at her this morning and thought, this has gone on too long, you look super poorly and malnourished, so I called gp (my husband gets a private gp line through work). He said he wouldn't wait and get her seen before the day is up.

We took her to a&e as per drs orders and they checked her temp which was, 39.6. Checked to see if her tummy was tender, checked her lungs with stethoscope, and that was it. Said they weren't worried so long as she was drinking. Said the temp was worrying but only if it goes on for 5 days and as we havent tested properly they werent going to count it, despite it being over a week since we could feel she was clearly warm. No tests, no bloods, no advice. Am I being a paranoid mother? Have we been fobbed off or is this all I should expect from an a&e visit?

You are not being unreasonable at all. Have you seen the Jason Watkins documentary on his daughter dying of Sepsis. Ask them to check for this, to put your mind at ease.

Did the private gp say “get her seen today” as per your first post, or explicitly say a&e (as per your second)?

It doesn’t take 4 weeks to die of sepsis. It’s hours.

the o/p’s dd has been like this for 4 weeks.

it’s not sepsis. There’s no deterioration or change in condition.

🙄 yes she is very neglected. Had a brief convo with a gp 2 weeks ago as i had an appt so booked a double just to check her over, but they were very unconcerned (our normal nhs gp) and said to look out for worrying symptoms (ie sepsis/meningitis symptoms). Said they weren't concerned as calpol was bringing down temp to acceptable level

Weigh her today and then every 3/4 says . Write it down .
You say she is gaunt and dark around the eyes so I assume you believe she is continuing to lose weight ? Write a food diary of everything she has eaten and if sick how soon after eating / how much is coming back. What is the colour of her urine ? Make her pee in a potty so you can see the colour and not just in the toilet bowl.
Unless she improves in a few days make an appointment with your actual GPS surgery and don't be fobbed off.

But the back of the calpol pack says if you’re using it for more than 3 days seek medical advice. I’m sorry because you must be very worried but you haven’t been treating it appropriately if all you’ve done for 4 weeks is give some calpol.

I hope your dd is better soon. Have you tried high calorie treats, ice cream etc?

A&e or urgent care. He said he wouldn't be waiting for 111 out of hours gp

Which I did, and was told it was fine

I imagine Emergency did check her for signs of sepsis.... 🙄

OP I do agree with alot of what is said here, however, I don't want you to be put off taking her back to A&E at any point if you think she's getting worse.

Hate for you to think oh well MN told me I was unreasonable, so I will wait till Monday and call our GP - if you have a horrible niggling feeling something is going really wrong.

No matter what anyone says here, we aren't with you.

Monitor the temp, give the calpol but if at say 2am your senses are saying this isn't right, something is getting worse then go back to A&E. If you think she's ticking along sure wait till Monday but I'd just hate for you to think anyone here is in a position to tell you that.

Things change fast with kids. You always have 111 as an option too.

Personally I kinda get it - we muddle along with a grizzly, mildly unwell kid and then one day we go - nah somethings really going wrong now. Happened to me - 3 week of virus type symptoms that very quickly turned into a secondary bacterial infection. I was right to be treating the 3 weeks of snot with calpol but I was also right one night to pick my DC up and run to the hospital. No one could or did say to me - why didn't you bring them sooner, because 'sooner' they weren't as ill as they are right now.

On the night DC's cold turned into an A&E dash was the day/night a respiratory virus turned into a chest infection.

You had her checked 2 weeks ago then continued to give her calpo for a further 2 weeks?

Keep a log of symptoms and fevers. It is very difficult to get blood out of a toddler and many toddler illnesses tend to be viral so most Dr's avoid it.
If she gets any worse before Monday take her back.

Call your GP on Monday, they can see her but they can also provide a letter which can get you into a paediatrics assessment section most hospitals have them if they have a children's A&E section.

Then call on a Saturday?

Right .:. But two weeks have passed since then, and you haven’t so much as waved a thermometer in their direction?

My son had a similar type of illness; we took his temp every 2 hours when he was awake, and during the night if we were up. We dosed him alternating calpol and ibuprofen.

When we contacted the GP we could say his temp is xx dropping to yy after calpol, he is consuming a, b and c each day and is passing urine d times per day and having a bowel movement at e intervals.

We saw the GP four times within a week before eventually taking him to a&e on the doctors advice.

None of your reaction makes any sense.

Yes! Because I was explicitly told it wasn't a problem as her temp was coming down and shes drinking! No one told me to "come back in a week if nothings improved"! Just that her symptoms weren't concerning!

It doesn’t sound to me like she has been fobbed off though?

Shes had a set of physical
observations, a full history and examination from a doctor. They’ve checked for the most serious stuff that needs emergency treatment and reassured you about that.

Thats what A&E is for, to triage urgency. If a person is well enough to be at home they’re better at home with their GP sorting out any further investigations they might need.

I don’t think you were wrong to take her based on the advice you were given but I don’t think you’re being fair to the staff who saw her.

You have done all you could by taking her to A&E. Was she seen by a paediatrician? Have they not given her antibiotics? 39.5 is a very high temperature, I can't believe they just sent her home. I would go back to A&E if she's.not better tomorrow

Good luck OP, it's so worrying when they're little.

Yes because we pay for it so we will use it

But you have no idea if her temp was coming down given that you haven’t checked her temperature?

The story now has the addition that your daughter saw a GP two weeks ago, of course it does after the unanimous responses that she should have been seen sooner.

Why would they give antibiotics for what is probably a virus? They don’t just give out antibiotics for a high temp 😂

Exactly! Don’t believe her for a minute and the fact she can roll her eyes as if it’s so trivial says it all really.

So you didn't call a proper GP, but you thought a private 'gp line' consultation would be better?
All they could do is tell you to see a real doctor, partly because they don't want to be sued if it turns out your child is seriously ill.

This is what happens with private medical services. You get consultations or scans and tests as per the adverts, but then become an extra burden on NHS services, either because you didn't get seen during GP surgery hours, or the tests are inconclusive and end up creating extra work and expense for the real services.

A child with D&V doesn't belong in A&E unless it's sudden and accompanied by fever, floppiness or rash. You are risking passing on D&V to vulnerable emergency patients or NHS staff who cannot afford to become sick themselves.

Suggest you continue to give her fluids and paediatric paracetamol, monitor her condition AND TEMPERATURE, and give your proper GP surgery a call on Monday morning.

In the meantime, Google symptoms for meningitis and Staph infections so you know what serious symptoms look like.

Hope she's better soon OP.

If it’s waited four weeks, it can wait another 36 hours.

Do you not think that after taking her history in A+E the doctor would have checked for sepsis if the indicators were present?
Jason Watkins daughter tragically died 12 years ago. One of the outcomes of her death was that awareness and training in the signs of and treatment for sepsis has been overhauled massively since then.
Sepsis in itself isn’t a disease, it’s a condition that occurs when certain diseases are affecting the body. The OP said the dr didn’t find anything of concern. For possible sepsis there would have been clear signs of infection somewhere in the body.
please don’t scare the OP witless. Here’s what the NHS tell you to look out for. The child had only 1 of these symptoms. https://www.nhs.uk/conditions/sepsis/