A&E - referred us to paediatric services? What does it mean?

[Ethina]

Took my dd to the a&e as she fainted, and from what she described I was worried about what had caused it. It didn’t sound like what I experienced the handful of times I have fainted so I wanted to have it looked at.

initially the visit went well, and all staff and nurses were helpful and pleasant. They run a few tests such as an ecg, bloods, a neurological check. Dd described the event once to a nurse and once to the doctor, separately. Ten minutes later they return together and begin to question her in detail about the event, and they confront her about points where they feel that she told them different things. They really press her on some of the details, particularly about exactly where the incident happened. They tell dd that she has told them different versions of the story, and they are wondering why. I can only assume that they wanted to establish if she lost consciousness, or something like that, but it began to feel almost hostile at one point. Extraordinary situation.

The next intervention is that they ask her for a urine sample. A nurse asks to speak to dd without me but dd asks that I join, so I do. The nurse conducts a ‘headsss’ assessment with questions about drug use, happiness at home, mental health, does she have friends and so on. This is brief.

The visit ends with us being told that there is nothing wrong physically but we are being referred to ‘paediatric services’. I didn’t know what to say so I just said ok but I realise I have no idea what this means? Does anyone know?

It means they didn't find anything emergent and so are referring you to paediatrics so they can do diagnostics.

She will just see a paediatric consultant - actually probably a registrar - who will ask the same questions and then probably sign her off.

If you have a good Dr, they may suggest further tests but in our experience, unlikely unless she has more fainting episodes.

I should add that the doctor asked about drug use, friendships, stress etc during the examination, so the fact that he asked the nurse to conduct a more in depth questioning on the same topics in my absence clearly means he wanted to dig deeper. We are home schooling so I can see that they want to make sure everything is ok in the friendship department etc, but it all felt really odd

I can’t help but think he just referred us to social services. Is that what paediatric services means?

I understand why you are questioning it and feel worried but they are literally just doing their job. That's all.

I hope your DD is ok.

Thanks, that sounds reassuring

We were referred to social services when my son overdosed and the hospital was totally upfront and told us so.

He hasn’t referred you to social services.

Paediatrics is the healthcare department for children and teens up to 18yo.

She’s fine, thank you. I’m less worried now that head and heart have been looked at, I was worried about things like epilepsy

I appreciate that it is part of their job to look at the bigger picture, and I’m grateful that they do, it just felt unsettling that they didn’t share any concerns along the way, they were being so indirect about it

Oh if you're homeschooling they're likely to do a much more intensive job on the safeguarding piece, because it's so easy for abuse in homeschoolers to go unnoticed.

Also, if your child was giving them inconsistent information, that would be a huge red flag, on top of the homeschooling, so there is a chance that there's a social service referral.

That in and of itself isn't the end of the world, it happens a lot for standard childhood injuries - my kid was in A&E twice in one year and we got a call, it's standard safeguarding if there's any red flags. Inconsistent narrative after loss of consciousness could be a sign of something being wrong medically, but they checked and didn't find anything, so now they need to explore the other possibilities, which might involve a social services referral.

If I were you I'd call the a&e reception and ask for the details of the referral, what dept you're being referred to, etc.

How old is she? The older she is the more conscious they will be of confidentiality for someone who is likely to be considered able to consent to treatment etc.

That must have been incredibly painful. I hope all is better now

This is what 'referral to paediatric services' brings up on my local healthboard...

It is a specialist child health assessment and diagnostic service staffed by specialist child health doctors, in conjunction with therapy and nursing staff. We work in partnership with families, allied health professionals, education, social services and voluntary organisations

Sounds like light touch SS to me tbh, so I suspect something concerned them beyond just the fainting.

Thank you. That’s kind of what I was thinking. I will call and ask about the referral

It was very difficult but social services just made a telephone call to me and that was all.

Paediatrics is health, so they are referring her to a specialist in children's health.

If it was social services they would call it that, or maybe children's services.

How old is she? Is pregnancy a possibility?

Hope your daughter is OK. Try not to worry. I work in Paediatrics.
Paediatrics is Children's health within the hospital. Not Social services.
A Paediatrician is a Children's doctor.
A&E have found nothing obvious that caused the fainting. If she gave 2 different accounts they would need to check her story, it sounds like they were thorough.
Your daughter will see a Paediatric consultant or a doctor in their team, they will likely ask lots of questions - medical, psychological and social to try and work out what is wrong, likely order more blood tests etc.
This is all pretty normal practice.

It's not unusual for a referral to go to paediatric services from A and E . I think it's an additional mechanism of safety, to make sure that someone who specialises in that age group have also completed an assessment.

It's routine to ask those questions in A&E, particularly if there are different accounts of what happened & no, she's been referred to a paediatric team (as explained by others), not social services. It's reassuring that no urgent problems were found, but it also means the A&E team don't know why she fainted. She'll be seen in paediatric outpatients where they'll decide if other investigations are needed

They are completely different one is a medical service the other a social service of course tge medical service may work with childrens services sometimes eg for children with a disability.

Thanks everyone. I was worried about the fainting but very reassured by all the checks she had.

I understand the need to ask questions but at one point it started to feel
like something out of a true crime documentary, like a proper cross examination regarding the circumstances of her episode with the nurse and the doctor saying she told them different stories. I also reacted to the repeated safeguarding questions, first by the doctor who also asked about her social life, drug use, vaping, boyfriends, then they had a nurse ask to see her in private to repeat these questions meaning they must have had additional concerns.

I realise this reads as normal levels of concern from the staff but I have four children and have been to a&e a number of times and it’s never been like this before. Dd is my only home schooled child, perhaps that’s why

And to the poster who asked, no my daughter is not pregnant, they tested

Please ignore comments saying this a light touch SS or variation on SS. Paediatrics is a medical specialty dept. It's the equivalent of being referred on to e.g. Neurology, Orthopedics, Dermatology for a specific issue. Any issue in a minor that doesn't require urgent admission or treatment in A+E but would benefit from further follow up investigation or monitoring would be referred on to Paeds to be followed up as an outpatient. No healthcare professional would secretly refer you to social services without discussing it.

You are over reacting here. Most people would see a specialist referral as a positive outcome when taking a child to A&E. Usually we walk away without answers and it’s put down as ‘viral’ or ‘one of those things’ - your child has been referred for further investigation. Paediatrics just means child. You seem so concerned with the worry of social services you are overlooking the fact that your child had a medical episode and the medics want it investigated. I think the vast majority of parents would be pleased with that, surely that’s why you took her to hospital, to find out what’s going on?

Paediatric services means a doctor that is specialist in children. Not social services!

I remember when I had a seizure as a young teen they asked me loads of questions about drugs etc. This was years ago. Don't worry, they're not saying you've done anything wrong.

You are absolutely right, I can see how my posts would come across that way as I’ve mainly posted about the interactions which felt a bit jarring on the day. Aside from this aspect they were very kind and thorough and we felt very relieved that nothing sinister was found, and we are appreciative that they are following this up.