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!

I always think this when people talk about elderly people waiting in a&e for hours and hours- it’s so miserable and undignified but that doesn’t make it a medical priority

I was able to walk, talk, read, laugh, even eat in the hours before my appendix exploded even though my stomach hurt. You have no idea that their less visible issue wasn’t more life threatening than yours.

A&E is for accidents and emergencies, a lot of accidents are caused by bad decisions and stupidity. In this case it would depend on how bad the burns were, I assume very bad if he was seeking emergency treatment. I did the same thing when I was a teenager but didn’t seek any treatment, I just hobbled on my heels and the sides of my feet for a week - natural consequences of stupidity. But if it was so bad that he had gravel lodged in flesh because the soles of his feet had burned off or something then I think that is quite a serious accident that deserves A&E. But a brief wash, gauze and first aid bandage would only need urgent care or he could’ve done that himself

Yep.

I took my son to A&E because I suspected he was dehydrated due to a tummy bug that he was struggling to shake off. He was in fact dehydrated but the 'tummy bug' was actually an aggressive tumour in his bowel causing an obstruction and he needed emergency surgery.

He was also sat in A&E on his ipad before he was seen and also chatting with me. Not many people look like they have cancer before it is diagnosed.

Right.

My local a&e is inundated on race days with women who have hurt their ankles in their ridiculous heels. I always say they should set up a mobile ankle unit there to bandage up and send on the way!

Our local MIU was closed with the resulting, and completely forseeable, increase in people attending A&E.
It's impossible to get a quick GP appt so people resort to A&E.

We need better access to GPs, more MIUs and maybe A&E will then be just full of people with actual emergencies.

I agree. Who decides and where is the cut off point? We could all do more to be preventative and I'm saying that as a non smoker, non drinker fitness enthusiast who has had cancer three times.

My late father used to always rant about idiots wasting medical time -

One of his friends was a surgeon in a&e and had to waste his precious time operating on some fool who had been in a bar fight. I heard about this probably fifty times.
Specialist heart surgeons should refuse to treat anyone who smokes. But what if they smoked in the past I asked. My dad, an ex smoker, paused.
Similar attitude to alcoholics or any kind of addicts.
Obese people should be put in an entirely different wing of the hospital anyway so nobody has to look at them, the absolute cheek of them inflicting their appearances on us.

When he himself was in hospital for the last 6 months of his life I wondered was the fact he never ate vegetables or any fresh food and had been downing paracetamol and double dosing steroids for at least a decade relevant.

In fairness, if self inflicted injuries were excluded from A&E the waiting times would be a quarter of what they are now. I don’t work for A&E but I would imagine that the overriding priority is ‘risk of imminent death’ and so in spite of having some awful painful conditions, if you’re not going to keel over and die there and then, you’re likely in for a long wait. I once phoned 111 for an extremely painful shoulder and left arm and was told to go to the minor injuries unit within the hour. An appointment had been made for me and I was ushered through and seen almost immediately. I think they suspected a heart attack. It wasn’t, thank goodness, but it demonstrated how well the system works when it’s potentially critical.

I'm in a relatively big city, no miu.

OP, |I saw the clip on the news last night and was shouting at him for being such a moron. I agree with you, in the heat we've been having, to walk across tarmac with no shoes on is the height of stupidity. A&E was the right place for him to be, because those burns looked very nasty, but it was the stupidity of the man that riled. It was certainly not far off being an emergency for him, but accident? No! The man was a complete bellend for having done it to himself. It is why I think there should be a charge for A&E. Genuine cases get refunded, bell-ends go home a bit lighter of pocket.

It is not business as usual in a heatwave with red heat alerts. Bare feet on tarmac! That idiot has a vote. It's scary.

I'm not convinced that access to medical care should be based on IQ.

A&E is not a great place to be for anyone. You (generic you) have to believe that the nurses/doctors are doing their level best prioritising the people coming in through the door.

Many individuals they will recognise as will be there on a regular basis - either because of mental health issues or physical health conditions that require regular A&E trips. You could argue better support for both of these groups in the community would not only help them but also reduce their reliance on attending A&E.

And as for MIU - ours only opens on a Tuesday! Any other time you have no option but to go to A&E! And so far, my kids have resolutely refused to tie in their injuries with Tuesdays...

Tbh if you’re prepared to go to A&E with a mild headache (that turns out to be meningitis as per earlier example) you’re not likely to be satisfied with a GP visit either

He may have inflicted the burns on himself, but they still needed to be treated in case they got infected or became worse.

No, terrible idea and just creating more work for a&e departments and would just encourage people to lie. It's an accident with burns, the how that came to be, shouldnt factor into it.

Also not all areas have a minor injuries.

Just because it’s self inflicted and a bit idiotic doesn’t mean they should be denied medical care. Jesus.

I thought that this was what was done anyway?

Reception takes the reason, then the system ranks it based on injury type?

But common sense does seem to be lacking. Even my own OH is an idiot when it comes to this - like recently, in pain in left leg all day.. decides at 18:10 to call someone about it - 40 mins AFTER the doctors closed. Of course it is triaged as non emergency, and a 12am gdoc appointment that muggins had to take him to as he could not wait until the morning.

I didn’t say denied medical care.

I said denied a&e treatment.

And yes I feel the same about drunken falls and injuries. They’re not a&e matters.

What matters are they then?

I think the problem is that once you get into
not treating people with self-inflicted injuries you wouldn’t treat obesity-caused cancer/diabetes/heart problem, drunks, drug addicts, sports injuries, people who injure themselves with power tools etc.

I knew someone who went to Africa and fell in a ditch, their leg got infected and they had six months of treatment. Should they have been left to die? (Actually I personally believe they should have been made to pay the cost of their care but many people won’t agree with that.)

Maybe health insurers do not cover these self-inflicted things so if we changed systems we’d take the costs these people incur out?

In most countries you have to pay to give birth which probably sorts out the social problem of the 5-6 child problem family? I don’t recall such families when I lived in Germany but maybe they just keep quiet.

My dad walked barefoot across a hot dark surface a couple of years ago. He's a sensible man, he just had an absent moment where he forgot the surface would be hot. Because of judgey idiots like the OP on this thread, he refused to go to A and E even though the flesh was burnt off down to the bone. My mother ended up cleaning and bandaging it for weeks and thank god it didn't get infected. The only stupid thing in that story is the fact that they didn't go to the hospital. If you are injured, no matter how that injury occurred, you should seek medical care. Burns are especially dangerous. The specific advice is that if you have a burn greater than three inches across in size you should go to A and E and you should always go to A and E if a burn is located on the face, hands, feet, genitals, buttocks, or over a major joint.

Total morons with no medical training should not comment on things they know nothing about.

It’s not hard to put shoes on?

Are you a bot or stupid?

Genuine accidents and emergencies. If people didn’t run to a&e every time they got a paper cut we wouldn’t have people waiting in the back of an ambulance for 7 hours!

But A&E do turn away people who don't need to be treated ASAP. I saw someone told to go to the GP for her cold. (The nurse was sympathetic and said she understood why so many people turned up for similar things at A&E - it was because it was impossible to get a GP appointment. It's irrational to be ticked off at people seeking medical help. What's necessary is a joined up, functional health service. If people had viable alternatives, they would use them rather than chance A&E.)

I also agree that medical care (including A&E treatment, when necessary) shouldn't be declined because the illness or injury is self inflicted. Many ailments are self inflected. Most cancers are caused by diet and lifestyle. The same for heart disease, joint issues etc. Your argument about sport can easily be countered by saying benefits achieved through sports you're most likely to be injured in can also be achieved through less risky exercise like tai chi, pilates, swimming etc.

Not everyone has a minor injuries unit they can go to. The last problem is referrals take months, and in some cases years. Again, people in pain go where they think they will receive treatment. They don't think, 'god I'm in so much pain, but I'm going to wait 2 weeks for a GP call, then 2-4 weeks for an appointment, then 7+ months for the referral.' The problem is not people. It is the broken system supposed to support them.