"emergency for children"

About: Lincoln County Hospital

From my mom's experience a child could develop serious complications from a more serious cold. It happened with my son, he got into pneumonia. I went to hospital with my son who was coughing for one month, about 2 weeks ago. He still is coughing very bad, has many secretions, my other baby son got that too and now myself. We were given nothing to get at hospital but calpol which has nothing to do with a bad cough. In some cases, I would dare to suggest that children should be taken tests from throat or nose in order to make sure it's not something as a bacteria. It is very disturbing for a child to cough really badly for two months and nothing to be done in such cases. You can't just look at a patient and know he is fine without to make a simple test. I would like for all medical personnel to be more involved and helpful even with these kind of cases even if there are much more severe ones to take care of. Just paracetamol can't fix everything.

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Response from United Lincolnshire Hospitals NHS Trust

Dear anonymous

Thank you for getting in contact through NHS Choices. It is very difficult to provide a response to you without knowing more specific detail about your son. I am sorry that you feel he has not had the investigations that you feel are warranted and that you are still concerned about him.

At this time of year, there is a very specific viral illness that affects babies called bronchiolitis which is prevalent in babies and children up until the age of 2. From your comments, I think this is probably the age group your son falls into.

We follow something called the NICE (national institute for health and care excellence) guidance which is considered national best practice based on the current available evidence for the management of different conditions. There is one of these for bronchiolitis which can be found online here https://www.nice.org.uk/guidance/ng9.

Bronchiolitis is normally diagnosed in a baby when they have had cold like symptoms with persistent coughing, by looking at the breathing and how hard they are working and by listening to the chest with a stethoscope.

The NICE guidance suggest that pneumonia, which you have mentioned in your comments, should be considered in babies where there is a high temperature of above 39 degrees centigrade and a very specific sound heard when listening to baby’s chest. Your comments do not indicate whether your son did have such a high temperature or what the doctors heard when listening to the chest.

The medical team will normally check the oxygen saturations using a monitor with a red light that is placed on the foot or hand (finger with older children and adults) and this will determine if the patient is managing to maintain normal oxygen levels in their blood and thus does not require additional oxygen.

Babies with bronchiolitis are usually only admitted if they require additional oxygen, if they are not maintaining adequate feed and fluids, or have severe respiratory distress.

In terms of treatment of bronchiolitis the only thing that can be done is to give paracetamol (Calpol) which will help with any soreness from the coughing and help reduce any irritability. Giving any antibiotics or any type of inhaled medication will not help bronchiolitis and it is specifically advised not to in the NICE guidelines.

If there was a bacteria present within the lungs, say in pneumonia for example, this could not be detected by doing a swab of the nose or throat as suggested.

You have said that your child has continued to cough for 2 months and in the absence of any other symptoms it is likely to be caused by a virus for which there is no treatment providing he continues to take fluids and feeds OK. No one can develop a pneumonia from having a cold or any other virus alone, but a pneumonia or other bacterial illness would have to be introduced by being exposed to a very specific bacteria in addition to the virus.

As such a long time has passed, I would suggest that it would be advisable to arrange an appointment to see your GP and to discuss your concerns with the GP.

If you would like me to investigate any specific concern or issues about your child, I would need to know more details and be able to identify your son. You can do this by contacting the Patient Advice and Liaison Service (PALS) on (01522) 707071 or by email on pals@ulh.nhs.uk. I would not be able to make any recommendations or make a clinical diagnosis from this information and this must be done through your GP as advised above, but I would be able to review your son’s care to ensure that he was given the appropriate treatment and care at Lincoln County Hospital with the information available at the time.

Thank you for getting in touch.

Terry Vine, Paediatric Matron