AIBU - friends ooh GP apt

[Studentnursesos12e]

Hey

So I chummed my friend to out of hour GP just now.

She has very painful sinuses, breathless, feels awful, cough.

Obs wise her sats were fine, her temp was 38.9, her Heart rate was 160 (very tachycardic), her BP was 180/100 (quite high as she’s a slim 19 yo female), she has passed 10ml of urine in the past 48 hours and drank 250 ml of water in the same period of time. She’s pale clammy and exhausted.

She is also a student nurse working on ITU which increases exposure to pathogens.

The doctor was very dismissive, said it was a mild virus but probably influenza (?)

If she was an inpatient her NEWS2 score would be 8 which requires immediate escalation. This doctor told her to go to bed for a day or two.

In my and all our other final year student nurses opinions this wasn’t the best advice but don’t know what her options are other than going to a normal GP apt or A&E.

Any options considered

Acute medical nurse here. I would take her to A&E definitely, and immediately. She has a very high NEWS score, sepsis red flags, she will be at high risk of AKI with that fluid intake and output too. She may need IV fluids +/- antibiotics. Could be flu, I have seen young and generally fit patients hospitalised and very sick indeed with influenza.
Wishing you all the best.

What does chummed mean?

Obviously not antibiotics if she has the flu - doh! Still think she needs assessment by an acute clincian with that tachycardia and fluid status.

@onthecoins accompanied

It's a Scottish term AFAIK

Yes, you ignore the OOH GP and go to A&E for this one. The red flags are meant to be, well, red flags... they should prompt further investigation. At the very least she needs kidney function and lactate checking out.

Thanks all for your replies.

I agree it could be influenza. There is a very severe strain working it’s way through the hospitals here.

She’s trying her best to drink.

I spoke to my friends (registrar and CT2) who agreed she needs attention so will take her to A+E

Hope she feels better soon, I agree A&E!

Yep, A&E
Influenza or secondary infection. She's showing very worrying signs. Worrying that the doctor was so dismissive, she's v tachy and probably dehydrated

What's her resp rate?

Hope you don’t have too long a wait at a and e, make sure you bring fluids with you and wrap her up warm

His is your friend now? With all those factors A&E sounds like a sensible option.

Hi all

Long story short she’s now at home, with prescriptions including co-codamol, amoxicillin and some sinusitis drugs.

She had a bag of IV fluid in ambulatory care and lots of bloods done.

She’s at home (rather than uni) with her mum (ICU SCN) so doing much better

You sound like a great friend. She’s lucky to have you.