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"A&E visit with a young baby"

About: Borders General Hospital / Accident & Emergency Borders General Hospital / Paediatrics (Ward 15)

(as a parent/guardian),

I brought my young baby up to A&E on the request of NHS24 with a high temp. A&E was extremely busy so I understand there were significant pressures for staff. I was informed on arrival, because of this, they would phone the kids ward and see if we could go straight up. Unfortunately there had been an emergency in SCBU so we were unable to attend straight away.

Waiting in A&E waiting room, I felt forgotten about. We were eventually 'triaged' without any set of observations and a quick run down of what I had already discussed with NHS 24 earlier. This is not triage. There is a lack of confidentiality with your 'triaging' as everyone in the waiting area can hear this. This also adds to other people's annoyance as they start forming their own opinions on who should/should not be seen before themselves/relatives. 

We were eventually taken up to the ward 2.5 hours later and they were also surprised we had not been seen considering the age of my child and a high temp being an obvious red flag. My baby was escalated very quickly as she was dropping her oxygen saturations significantly and her temp remained high. She was given a full septic screen because of this. She was later diagnosed with viral meningitis. Had this been bacterial meningitis we'd have lost precious hours. The night we arrived the staff in the children's ward were brilliant, specifically the 2 Nurses in attendance, Nurse Practitioner and Paediatric Consultant were all fantastic. They took my concerns seriously, escalated promptly and explained everything fully. 

I understand that there are multiple issues within the NHS that are not the fault of those on the floors. However, I have worked in an A&E department and strongly recommend triaging patients on arrival, in a room with privacy and obtaining a full set of observations so that an informed clinical decision can be made. 
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Responses

Response from Lesley Anderson, Senior Charge Nurse, Emergency Department, NHS Borders 15 months ago
Lesley Anderson
Senior Charge Nurse, Emergency Department,
NHS Borders
Submitted on 02/02/2023 at 14:28
Published on Care Opinion at 14:28


Dear GMRR, thanks for taking the time to use Care Opinion. I am sorry to hear that your child has been unwell and sorry about your concerns whilst attending ED. Our current Triage process is not ideal but we have no other suitable area in the Dept and covid guidelines mean we have to screen everyone before the get into the main Dept. Saying that, the nursing staff should be aware of how much detail they go into at Triage and understand not to ask questions of a persona nature but we also need to weight that up about keeping the patients and department safe. We do also have a screen round the waiting which serves as partial sound proofing. I am unable to comment as to why your child did not have a set of observations taken but I would be happy to investigate if you wish to me investigate further. This can be done through the feedback and complaints office. Every patient that attends ED, should have a full set of observations at triage (minor injuries requires temperature and oxygen saturations only). Unwell children or adults would get a full set of observations taken (but not a Blood Pressure on children). I hope your child is making a good recovery and thanks again for using Care Opinion but rest assured, if you want me to investigate this further, I would be happy to do so. It is also worth mentioning, that I am confident our nursing staff are trained in identifying unwell children so I would hope that had your child had Bacterial Meningitis, then symtoms of a child being acutely unwell, would have been identified at triage. We ensure all acutely unwell adults and children are brought into the main Dept as a matter or urgency. Please do not hesitiate to contact me as I am more than happy to investigate further if need be.

Regards

Lesley Anderson

Senior Charge Nurse, Emergency Dept, BGH.

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