A and E question

[Yabayabadoo]

Is it right to not run blood tests if a young person turns up with shortness of breath and palpatations, had an ECG and was told we were wasting resources by being there

Those the exact words they used?
Palpitations isn't a diagnosis, so presumably the ECG ruled out anything sinister.
People say palpitations when they are having ectopics -harmless, panic attacks -harmless, had too much exercise - harmless etc etc. So yes it is quite normal not to do bloods. How is your person now?

Yes that what what was told, explained symptoms had been getting worse and had an appt to see GP but it was 3 weeks away hence visit to A and E. After visit to A and E put in new request for new GP appt, which was then a wait time of 7 days. Bloods taken and returned v quickly from a different hospital and told to get to A and E immediately for emergency transfusions and medical teams words were you shouldn’t even be standing

Sorry I’m confused, which hospital did bloods? Why did that hospital tell you to go to A&E rather than refer you to a service for a transfusion themselves? Why didn’t they contact A&E if that was the right dept to send you to so that A&E would have access to the blood tests results that showed an issue?

The 1st A and E visit was in a different town, with symptoms of palpatations, shortness of breath etc, they did an ECG and sent on our way. Because DC then went back to GP explaining they had visted A and E in another town they gave appt in 7 days instead of 3 weeks which was the original appt time they had given.
Blood tests taken by GP and sent to hospital who came back v quickly with results and request for urgent action needed. GP contacted DC to go to A and E which we did this was a different A and E dept in our home city.

My original question was it right that she was basically dismissed by the 1st hospital and should have also ordered blood tests as would have shown the severity of the situation

I think should have had more investigation first time. Worsening breathlessness in any age needs investigation. The list of causes of breathlessness covers several body systems so should have had more than an ECG.
One of my breathlessness cases, a young man in his 20s...had a pneumothorax.
So with a good history I would say more investigations were needed. I'm surprised, they usually do bloods, ECG and cxr as routine

My ECG flagged up problems and they took it incredibly seriously. I was admitted and then had tons of testing.

You likely have anxiety if clear ecg.

You can have a normal ecg despite having other health problems, who took the ecg, did they see a doctor at all, I'm surprised bloods weren't taken.

Unfortunately, this is not uncommon. I was recently in hospital and the woman across from me had come in recently with horrific pain, she was so nice to me, and they just sent her home a week earlier - she said the doctor didn’t even touch her to examine her. A week later, she was back again, moaning in agony, and after a CT, it turns out part of her pancreas had died off (I think this was it??) so she now had low blood supply to her spleen. They were actually going to keep her in for a few days just to keep her pain under control, because no tablets would do it.

My point though, is that sometimes you just get really shit, too-basic treatment at an A&E - maybe they have five people who all came in bleeding out at the same time, or something like that; I know it doesn’t make it okay, but every person who works at the hospital is only human, too. If they screwed up by not taking blood tests and your person was in actual danger as a result, report it - they obviously need to know of and learn from the almost-accident.

The woman I met was having a much, much better second A&E visit, BUT it was the same exact hospital! So it can just be luck of the draw.

It wasn’t a Doctor, a senior nurse chatted with us after the ECG, I raised my concerns and mentioned bloods and even suggested possibility of anaemia. If she had not been so dismissive and run these tests which she told me wasn’t an A and E issue, when they’re having to deal with people having cardiac arrests then it would have been much less of a drain on the resouces she was referring to

Yes I agree it can be luck of the draw, we went to this A and E as generally alot quieter, I think I will raise it so maybe they can re look at how they do things as a def risk to life

"....and was told we were wasting resources by being there"

For a patient who was later told they shouldn't be standing?

The NHS stands a good chance of being sued for the inaction of that A&E if the patient takes a turn for the worst. All you need to do is get what they said in writing or recorded on your phone.

Sounds like heavily rationed resources to me. Very normal in this country.

I'm glad you're DC is getting the help they need.

If it was a nurse who dismissed your concerns and didn't run the appropriate tests then I would request a copy of the a& admission notes, plus the GP and 2nd hospital notes, you can also,write to the a&e matron to ask for an investigation although you probably won't near the outcome. I would also look at the nice guidelines around the management of shortness of breath and palpitations in emergency settings.

What reason were you given for the GP’s referral to A and E?

I had bloods done with those symptoms. My CRP was over 120. They also suggested anxiety, menopause, alcohol, caffeine, stress etc then concluded it was costochondritis and sent me home. I went into fast AF the following day and ended up in resus.

The hospital rang through to the GP practice with blood test results, that had been taken less than 24 hours earlier, telling the GP practice saying urgent action needed.
My DC was told by the GP that she shouldn’t even be standing upright and needed to go to A and E immediately.

The GP was shocked that she was even standing upright

So what's up with your dc OP?

Was that due to anaemia?

Yes

I don’t really get what the AIBU is but you were clearly very unlucky in the first A&E with poor care - I guess the only upside is you were seen by the GP two weeks faster. Hope DD is doing better now…

That’s not life threatening. What was her level? Did they assume internal bleeding as that’s the only logical reason for being told to go to A&E. I say this as someone who is anaemic right now and I’ve been told they’re amazed I’m functioning… but I have 3 dc so have to.

Severe anaemia can be life threatening, there's not enough oxygen for the muscles to work, do you know what her Hb was, was she eventually treated.

The info she was given at hospital was she had a dangerously low level of 40 and anything below 100 is considered low, she was told she should have been 140. She has had 2 blood transfusions and an iron transfusion at hospital

I'd be more concerned about the significant anaemia and it's cause than moaning about AE?? Cancer? Bleeding?