"Far more care and attention should have been given."

My 18 month old son was brought into A&E via ambulance due to pyrexia which caused febrile convulsions. 

The paramedic who first saw over a video call that our son was limp and unresponsive decided their most urgent response was necessary. They arrived at our house quickly. He was then quickly taken into the ambulance to be assessed enroute. Thankfully, he became responsive and more alert whilst in the ambulance. 

We arrived at A&E and he was taken into resus to be closely observed as the A&E staff felt he was too unstable for their general area due to his continued high heart rate, temperature, and recent convulsions.

Over an hour after being in A&E it was identified that it was best for him to be assessed by a paediatric doctor however there were no beds in paediatric assessment. We waited for a further 2 and half hours to be moved to the Paediatric Assessment Unit. 

Once there, a Health Care Support Worker took his observations and stated he had a high heart rate (170) and temperature (39.6). It was also noted at this point that the red side of his face was red, swollen and hot to the touch. We requested Paracetamol as he was already overdue having had his first and only one of the day at home a couple of hours before we got to A&E. It took over an hour, and ourselves requesting on a total of 3 occasions, to get Paracetamol for a toddler whose temperature was 39.6 and who was actively rigoring. When the Paracetamol was finally given the nurse handing it to us said that it was only prescribed 25 minutes ago. I would have thought it would be a priority to give him Paracetamol as the reason he was in hospital was due to pyrexia and febrile convulsion. 

We then got seen by a junior doctor who did a very brief assessment. During the assessment they asked my toddler to open his mouth while they pointed a wooden stick at him. His response was to shut his mouth so they gave up despite me requesting to help. They ended their assessment stating they would report to a more senior doctor their findings and they would formulate a plan.

Half an hour later we asked if he would be reviewed soon and were told the doctor was cannulating a patient on the ward and would see us after that. It was also around this time we saw and heard the junior doctor who had reviewed our son talking loudly and with a nurse about another patient.

After what had now been a 1 hour wait from anyone last laying eyes on our son, with an ill and tired toddler, and it being near midnight, we decided it would be best to go home and manage his fever at home as his pyrexia was resolving and we could hopefully manage this better with regular Paracetamol at home. 

When we told the nurses we were going home they said the doctor will be shortly. There is an ill patient being seen currently. We explained our reasons for wanting to go home - that we had been in hospital for just under 6 hours and no test, swab, bloods or anything meaningful had been done except a quick examination by a junior doctor who we felt was incompetent at examining a toddler - and asked what their opinion was from their assessment and they said they had wrote "query viral infection." When we asked how they had decided it was viral and not bacterial without a proper review or any tests at all the senior charge nurse answered that he "looks viral" and they were happy for us to go. Adding that if the doctor felt he had needed seen then he would have been seen by now.

The next day we took our son to the GP. Within a matter of minutes of laying eyes on our son he diagnosed him with having tonsillitis, and prescribed him antibiotics. He was so apologetic about our experience and said if anyone had carried out a proper assessment, or simply bothered to look in his mouth, it would have been very obvious he had tonsillitis.

He stated he had very visible large white spots on both tonsils. The fever, and red, swollen, hot left cheek should have been a clear indicator also. With tonsillitis normally being caused due to Strep-A bacteria which it is being widely reported that many children are currently suffering from this should have been diagnosed much, much earlier. 

If we had not taken it upon ourselves to go and see the GP the next day our son would have still never received any antibiotics. 

We are vastly disappointed by his care in the Paediatric Assessment Unit. We feel that the medical and nursing staff should have given far more care and attention to our son.

They should be more vigilant of the Strep-A outbreak and realise how detrimental it can be to misdiagnose a bacterial infection as viral on a toddler.