to expect there to be a service in between caring for my sick child at home or phoning for an ambulance?

[beesonmummyshead]

dd is 2.7. For 48 hours she has vomited everything she has eaten or drunk. She now has diarrhoea and is crying/sleeping a lot. I phoned my doctors to speak to the doctor as I'm worried about dehydration.

The duty doctor called back and after a couple of questions sid he'd like to see my dd to ensure she is not dehydrated and asked I take her to the surgery. I have no transport and am about 20 mins walk away, and besides dd is not well enough to be moved, so I requested a home visit. Doctor refused on the grounds that I should get a taxi. I have never had a home visit before btw.

My mum intervenes and complains. Doctor gets told to attend asap, which he does. He walks in, tells me to strip dd to her nappy (which she doesnt have as she is toilet trained) then pinches her toes, fingers and ribs, then, without asking her, tries to prise open her mouth . He doesn't check her for a rash, check her breathing or tell me how to treat her. He told me to bring her down to the surgery if she is the same tomorrow

TBH I am minded never to use the home visit service again . If dd stays the same, I can care for her, if she is worse I will call for an ambulance. Why is there no service available for worried mothers with small children who shouldn't be dragged across town to sit and wait to see a doctor?

sorry to hear your DD is unwell, hope she is better tomorrow.
However, presumably if she was stripped off he could see there was no rash. If he was checking her over he could tell her breathing was normal. He did a check (for dehydration presumably) and told you what to do if she doesn't improve.
If you aren't able to get out with her, what sort of service are you expecting?

tbh I think you should have taken a taxi, probably
(I am often in exactly the same position re transport)
if you think the dr has done an insufficient job of checking her out I would take her to A&E in a taxi if need be (any friends who could give you a lift?)

what were you expecting? we luckily that we have a home visits call-outs, other countries do not have this.

Hopefully your dd will get well soon, and if your worried further call a ambulance.

I think you are overeacting a little. I've carted mine up out of hours in similar circumstances. I'd have stuck her in a buggy and walked her if I didn't want to pay for a taxi. TBH it is pretty much a waste of time too seeign a dr too, unless they really are getting dehydrated.

Sorry meant to say hope she recovers quickly. I think if drs advice is watchful waiting, it is the way to go - if she gets worse or your instinct tells you to, don't hesitate to use out of hours drs or go to a&e

something a bit better than I could have offered myself, with some bedside manners.

I only phoned to ask for advice, he wanted to see her, but then got annoyed with me when I couldn't get down to the surgery.

The practice manager said a home visit should be carrid out so he came begrudgingly. But I am still sat here with my dd who is unwell with no better way to treat her than I am already - I have not been told how to check her myslf for dehydration, how long the bug is likely to last, if it is indeed a bug, or what to do about her temperature, which seems raised, not that the doctor bothered to check, aas she cannot keep calpol down

What SPB said.

There is an in-between - get a taxi. YABU

But hope DD is better soon.

sorry I only answered one poster

Perhaps I am being a bit PFB. We normally have a car but we are inbetween cars this week and even if I had a car I really dont think I should disturb a child who is this poorly just because the doctor wants to check her. I simply wanted advice, which I still don't have

if she cant keep calpol down and has a temp, you strip her down and sponge with tepid water.

check for dehydration by monitoring urine output for amount and colour. check nails by pushing them to see how quickly the blood returns (should be within 2 secs), and pinch the skin to check for elasticity (should bounce straight back in a young child).

I can understand that you are upset as this dr's bedside manners leave something to be desired, but the truth is that there was something between caring for your sick child at home and calling an ambulance: the duty doctor did come out and make a home visit. SO your only reasonable grounds for complaint would be that he wasn't very nice- but that could equally have happened in the hospital (have met some ghastly people in hospitals).

And if he hadn't been able to come, then a 20 minute taxi ride with a small child doesn't seem that much to ask: I have taken an unconscious toddler to A&E in a car before now. A sick baby is actually easier to move than a sick adult.

Ambulances really are for people who either cannot be moved in an ordinary car (e.g. older/bigger people who cannot be lifted by their own family) or for children who are so seriously ill that they need immediate attention from a paramedic.

I have only got home visits twice, once when I was delirious from pleurisy - clearly cheaper to send duty doctor with antiobiotics than an ambulance, and once when dd had a bad asthma attack.

I know it seems hard and you're upset, but the truth is there are only so many ambulances/duty doctors, and you wouldn't want someone else to die because they didn't get the attention.

NHS walk in centres are the in-between service and, in my experience, are excellent although the wait can be tedious. With health funding in this country at a premium I'm not sure what else you expect to be provided. Although it isn't ideal if you don't have private transport then a lift from a friend/neighbour/family member or public transport are your only options and expecting a doctor to come to you because you prefer not to use pubic transport is unreasonable unless the patient is absolutely incapable of using it.

It's not so much the availablility of servce that's the problem here, as the quality of the service. It doesn't sound like the dr gave a good service: poor bedside manner and no advice on how to care for the child.

Did you ask questions? If you know what you want to know, then you have to ask if you're not told. Though of course he should have told you un-asked.

Complain....why would you take a child vomiting in a taxi, you're basically asking to pay the cleaning charge. Personally I wouldn't have bothered a GP about this as I have four dcs and am well practised with D&V. However the GP said they wanted to see your child and should have come to your house with good grace. Tax payers pay his wages and without patients he wouldn't get paid, and I'm sure they get extra cash for coming out.

The reason we have surgeries nearby is to make it easier to visit a doctor. Dehydration means no tears, no wees and dry mouth...without these your child is fine(I think). I follow the rule of %ml fluid every five minutes, if they can keep this down then try 10ml.....

good luck. D&V is not life threatening unless your child becomes lifeless and dry.

oh and my parents have a car and will be around later or if I ned them tomorrow. I am reluctant to involve them as dad is immunocompromised and his mother (who is 93) is staying with them this week, so I wanted them kept away if possible.

To keep the temp down, keep her stripped and use cool damp flannels - we all know that already?

A "normally well" child can survive for a couple of days without much to eat or drink, so hopefully tonight will see the turning point and she will start to take fluids tomorrow?

The doc has done the right things checking for rashes etc. If you think your dd is rapidly deteriorating and needs a hospital bed, IV fluids, IV AB's etc, that's when you go to walk-in or A&E.

Expecting a doctor to come out just so your sick child doesn't have to be disturbed really is expecting too much. The doctors would be constantly going on duty calls and people who were dying would be missed. Speaking as someone who has spent many miserable hours waiting in A&E with children. But I wouldn't want even one person to be put at risk just so that they could be more comfortable.

i was told to pinch the skin toghether gently between your fingers on chest area, if skin wrinkles shes fine if not she is dehydrated, to lower her temp cool her wrists (let her play in a cool bowl of water and splash about or cool flannel to the wrist.

thats what i was advised over the phone when Dd was ill and i couldnt get to docs

if you can get anything down her try some dirolyte to rehydrate her

theres no service between doctors and ambulance except a taxi to either im afraid out doctors would never do a home visit

or ring nhs direct?

just get a taxi
what does to ill to move mean exactly

its not ike she would have had to walk

you bundle her up warm, take her fave cuddly and some water, wrap her in snuggly bankie, talk calmy and lovingly in her ear and take a taxi with her on your lap and fine

cory I I agree with your post, however I have never asked for a doctor to come out to visit my dd (or me for that matter) nor have I ever called an ambulance. Our local hospital is a 30 minute drive away and if I were worried enough to take dd to A&E for D&V then I certanly would call an ambulance. We have no drop in centre in this town either.

Mrsforhowlong thank you. my dd has never been seriously unwell before, and I realise this isnt serious, but she is not a lifeless child and for 2 days ahs not moved from my lap, save to puke or use the potty . Thankyou for your advice.

Well I don't think YABU.

I wouldn't have taken my 2yr old very unwell, vomiting child out to see a doctor so I would expect them to do a home visit and I would expect them to do it with some decent manners.

Of course you should make the effort to take your own child to the doctor if they are unwell but if they are so unwell that they can't keep any food or liquids or even calpol down then I don;t think you are being unresonable in asking for a home visit.

As a side note, It's all very well saying "You should've got a taxi" but what happens if you don't have money for a taxi and don't drive?

I hope your dd is better soon.

Whilst it may be a scary situation, YABU - the time the doctor was out of the surgery meant that they weren't available for other duty cases, and they will have had to do your DD's notes after as well.

Self-care advice can be found in a number of places, including the NHS Direct website.

As far as your comment of 'if I were worried enough to take dd to A&E for D&V then I certanly would call an ambulance.' goes, then that's not really the best plan either - your dd would probably end up waiting a lot longer for an ambulance than if you took her in a taxi/a friend or relative's car.

A doctor will not want to visit a child with V&D unless it is to assess whether the child needs hospitalisation due to excessive dehydration (unlikely in only 48 hours) and to rule out certain other infections.

Doctors do not do home visits on a whim!

thank you lifeas3plus1 I could have afforded the taxi, but had no cash here, so it would have meant stopping at a cash point on the way and then at the doctors. I just thought it was too much for my dd given her level of illness.

It wasn't me who wanted to see the doctore, I just wanted advice, he asked to see her. But I do accept that health resources have a limit and of course I wouldn't want someone to die just so my dd gets seen in the cmfort of her own home. It is just a shame that is all. Perhaps I would have been beter if my mum could have seen dd and offered some wise words to me, rather than speaking to me over the phone.

I have never had a home visit for me or my three children
ever

the only home visits I have heard of was for my friends elderly mum who could barely move

I think I mean that I wouldn't even think of it as an option