To think some things should just be turned away from A&E?

[ifallinlove]

I saw a channel 4 video about a day in a&e during the heatwave.

The first guy seen was a bloke who had decided to walk across hot tarmac to get food while at the beach and now had burns on the bottom of his feet.

He said he had “forgotten to get shoes”. I’m sorry but it’s been 35 degrees for at least two weeks now. There is no way on earth that you “forget” to put shoes on. He made the decision to do it and now sought emergency care.

AIBU to say things like this should be redirected to minor injuries and the appropriate referrals made from there? It’s his own stupidity taking up a bed in a&e!

Path of least resistance. They will be seen in case it's something more serious. If they were turned away there is a risk when triaged by an albeit qualified expert that something important was missed. And anyway they are here anyway and "it's fackin free innit?". ( Yes free at point of access blah blah).
Wasting time? Yes. Lack of common sense? Yes. Then again choosing to go and wait at an ED is pretty dumb.

No. It's a slippery slope. Who gets to decide who is ill enough/important enough to be seen?

What about people who engage in risky/dangerous sports? If they get hurt, should they be turned away, because it's their 'own fault?' What about people who are very fat and get obesity related illnesses/conditions? Their 'own fault' for getting fat right? Drug addicts have a nasty turn... Should never have indulged in drugs!!!

Nope. No pecking order. Won't work...

It's impossible to implement.

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This was a minor injury that was entirely self inflicted. Surely an MIU that can then refer on if needs be is best?

I didnt watch it, but presumably he didn't anticipate that it was going to be hot enough to burn him and then make a conscious decision to do it anyway. Truly baffling that suffering burns and a wait in A&E was more convenient than just getting his shoes but people do stupid things. Many people who end up in A&E could have made better choices or taken a safer route so where would you draw the line?

For full disclosure I also went running over hot tarmac on Monday when a gate was left open and my dog escaped. I didn't stop to think, I just chased her!

I was in A&E about four weeks. I was in absolute agony, kidney stone that had to be removed with surgery and then got a kidney stent put in to. Anybody who has had kidney stones will understand the pain.

I waited 9 hours to be seen, obviously no proper triage, just waiting time. I was disgusted at the amount of time wasters. So many laughing, chatting, eating,smoking while I was on my hands and knees in pain vomiting into a bag. There were at least five names called that left before they were seen, so obviously not that unwell.One woman was with her husband and was told she could be waiting another four hours. Husband asked her if she wanted to wait and she said " no ,we will go home and I will just take a motilium ".

Don't get be started on the drug users and drunks who get seen before everyone because they are brought in by the police.

My local an and e has a triage nurse on the door before you even get in. If another service is more appropriate you get sent there before you can even get in the door.

Friday night a and e is full of drunks who have fallen over

Not everywhere has minor injuries; my nearest big town only has A&E.

I was sent to A & E by the practice nurse. I had, what I thought was fairly mild breathlessness. The receptionist at A & E took one look at me and asked if my GP was closed.

I was subsequently admitted to hospital with multiple blood clots in both lungs.

This is the difficulty with turning people away. Who wants to take that risk?

A&e isn’t about disciplining people for poor behaviour, the only factor is whether their medical need requires a&e (blistered burned feet likely does)

my brother is in charge of an a&e and in reality they turn people away to other sources of help every day.

Have you never heard of triage in hospital? This is literally what they do! Even if someone goes to A & E. If it's a minor injury, they will be triaged to the minor injures clinic. Every hospital that has an A & E will have one. Or something similar.

This is already happening! Minor injuries being dealt with out of A & E, so I don't see the point of your thread.

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I don't hink people with low IQ's, reasoning skills or poor risk assessment skills should be turned away from help. However, a front door triaging system that could redirect folks to urgent care centres, or anything else appropriate, would be useful, and then for those who remain, a brief explanation (could be a video link or handout) explaining what the next steps are would be helpful.

I think there should be a simple way to direct some people to a more appropriate place to get help, except that very often that doesn't exist or you can't get appointments.

If your example means he can't get any medical treatment, surely most accidents would also mean no treatment. DH lost a finger larking about with a piano lid as a child, I stood on a rusty nail in inappropriate shoes for the task I was performing, fell off a ladder that wasn't adequately secured? accident with a strimmer when not wearing eye protection, didn't look properly when crossing the road etc etc, all pure stupidity so not entitled to treatment?

I agree that referring people to a more appropriate service might be beneficial.

But the fact it’s self inflicted is irrelevant. He did something silly that he, presumably, did not think would end in injury, and it did. Could happen to anyone (not that specific injury, but a lapse in judgement over something that ends up hurting you).

You don't know what people are dealing with.

I am pretty good at putting on a brave face and chatting even when I am in a bad state. A school mum I know is similar. We both bumped into each other in a &e recently and so chatted away until we were seen . Both of us very definitely needed to be there for very different reasons. Both of us agreed afterwards that chatting had been a wonderful distraction /pain reliever .

It's just a bit grim to sit in judgment on others when you don't know why they are there.

They don’t necessarily get seen before anyone else, they just get taken away so they don’t cause trouble in a busy waiting room

Well done for putting on a brave face. 👏

It's just who I am. A consequence of abuse. I don't need congratulations. I just need recognition that you can't see how ill someone is

Burns are a perfectly adequate reason to go to A&E, they need to be treated quickly and he can’t exactly hobble away to another clinic.

I know of people going to A&E for sore throats and earwax in ears, that’s when it becomes a problem.

The thing is, for every time wasting cockwomble who should have just bought a packet or paracetamol or plasters at Asda, there could also be someone with a “pulled muscle” that’s actually lung cancer, or a headache that’s actually meningitis. If someone presents to A&E we need to triage them regardless of how obvious it might seem that they’re absolutely fine.

What would help is more access to same day GP appointments and more minor injury centres so people don’t feel they need to take minor issues to a&e in the first place.

Hmm, but if you don't know until you've triaged them, how are they supposed to know the headache isn't meningitis etc. People worry, and it's really difficult to get help elsewhere.

Not all areas have an MIU. In our city you’ve got your GP, a walk-in with no doctor and a nurse-prescriber (which is ironic given that they can’t prescribe anything you’ve ever had before, they just send tell you to see your GP or go to A&E), or A&E.

Oh don't be silly. It'd take more resources to triage rapidly, send elsewhere and defend against the lawsuits for the inevitable deaths when the wrong call is made.

If someone has burnt their feet, A&E is an ok place to go.

I spent 12 hours in A&E with my husband a few months ago as his stomach and feet swelled up massively all of a sudden.

We laughed, we chatted, we did crosswords, we people watched.

Turned out he had heart failure and liver cancer.

He died 4 months later.

Laughing and chatting is absolutely no marker of how ill someone is.

Indeed. Patients have been turned away, or at least failed to be admitted for the treatment they actually needed rather than seen and sent home, with terrible consequences.

Aren't sport injuries self inflicted as well?

On thread about cough - a poster was saying asthma patients with difficult breathing shouldn't go to A &E - persuably we should ignore our asthma plans and NHS websits advice and just die.

Plus there can be conditions where judgement is impared - so daft things are done because of underlying reasons or becuase they didn't realise the dangers so risk assessed poorly.

Many A&E do triage or re-direct now - last area there was a minor injuries unit right by A&E.

I image the pain of the burns will be a lesson all by itself.

Drunks at weekend have been an issue for decades - but main reason NHS is under pressue is aging population they need more healthcare.