A&E Fact Checking

YOUR A&E

QUESTIONS ANSWERED!

Dr Kaladerhan Agbontaen (BA Hons, MBBS), an Emergency Medicine Specialty Doctor, answers some of your questions about Accident and Emergency (A&E)

1WHEN SHOULD I GO TO A&E, CONTACT NHS 111 OR CALL MY GP?

Emergency departments in A&E are there to deal with genuine life-threatening emergencies. These include: trouble breathing, loss of consciousness, fitting, chest pain, strokes, severe allergic reactions, severe burns or scalds, and major trauma such as a road traffic accidents. If you experience any of these problems please call 999 immediately.

Most A&Es also have an urgent care centre (walk-in centre or minor-injury unit) that you can attend when you feel you require urgent, but not life-threatening attention. This includes treatment for conditions such as sprains and strains, bites and stings, stomach pain, ear and throat infections, coughs and colds, emergency contraception, etc.

However, for most other health conditions, or if you’re in doubt about the urgency of your problem, or maybe you’re just really unsure where to get the right help, the best thing to do is call the NHS on 111 or go to 111.nhs.uk. This is a free and confidential service, available 24 hours a day, 7 days a week. The NHS 111 service involves you answering questions about your symptoms, either by talking to a fully trained advisor over the phone service, or filling out an online form through the website option. Depending on

the situation, the next steps will involve you: l Being given self-care advice on how to manage your symptoms at home. l Being given advice on what local service is best able to help you, or how you can get the medicine you need (for example you may be advised to contact your GP directly). l Being connected to speak to a nurse, pharmacist, GP or emergency dentist. l Getting booked into a face-to-face appointment if you need one. l Being given an arrival time if you need to go to A&E (which might mean that you spend less time in A&E overall). The NHS 111 “The NHS 111 service is free, confidential, and service can also offer translators as well as a specialist NHS 111 British Sign Language service for deaf people. 2 IF I HAVE AN EMERGENCY WITH MY TEETH IS A&E THE BEST PLACE TO GO? available 24 hours a day, 7 days a week.” If you have any concerns about your teeth, the best health professional to see is a dentist. If you are unable to contact/get an appointment with your dentist or do not have one, you can contact the NHS 111 service and they will provide advice as well as help you to find a local dentist to book an emergency appointment with. You can also visit the www.NHS.uk website which gives a list of dentists near you and provides self-care advice for you to look at whilst you’re waiting to be seen. »

However, A&E do provide treatment for potential dental emergencies, so please go to A&E if in addition to your tooth problem you also have: l Swelling around your eye or neck. l Swelling in your mouth or neck that is making it difficult for you to breathe, swallow or speak. l Heavy bleeding. l An injury to your face, mouth or teeth.

3I THINK I’M EXPERIENCING A MENTAL HEALTH CRISIS, IS A&E THE BEST PLACE TO GO AND WHAT WILL HAPPEN WHEN I GET THERE? Looking after your mental health is just as important as looking after your physical health, and a mental health emergency is just as serious as a physical one.

If you feel unable to keep yourself or someone else safe during a mental health crisis, then please always call 999 or go to A&E immediately. The staff at A&E will first provide any care you need around your immediate mental and physical health needs, and then will refer you to one of their specialist psychiatry teams for further assessment and treatment. You will always be kept safe in A&E whilst you wait to be seen by the psychiatry team. Other services that can provide advice

and support if you think you might be experiencing a mental health crisis include: l Calling a crisis line number. l Calling a 24-hour local NHS urgent mental health helpline (you can find these on the www.NHS.uk website or by calling the NHS 111 service). l Have a look at the advice and information around how to cope and calm down during a crisis, provided by the mental health charity MIND on their website- https://www.mind. org.uk/need-urgent-help/what-can-i-do-tohelp-myself-cope/ l Have a look on “Looking page 34 (mental health services directory) of this booklet after mental for more contact details of useful mental health health is just as organisations and resources. important as looking after physical health.” 4 IS IT SAFE TO COME TO A&E WHILST COVID-19 IS STILL AROUND? If you think that you need medical help, it’s always really important that you get it. For example, the risks associated with you not accessing the healthcare you need will often be much higher than the risk of you getting and becoming seriously ill from Covid-19 whilst visiting an NHS service. So please don’t let Covid-19 stop you from coming to A&E. Despite the ongoing Covid-19 pandemic, the NHS is still open, and the same services are available to you if you feel you need medical help. During the Covid-19

pandemic NHS services are continuing to make specific changes to the way that they work, to ensure that you are as safe as possible whilst you are receiving any medical care or attention. For example, all staff are required to wear the necessary Personal Protective Equipment (PPE) to keep all patients and staff safe. On top of this, often the NHS 111 and 999 services are trying to book hospital arrival times in advance so that strict social distancing between patients is maintained.

The staff at A&E are here to help and will keep you as safe as possible whilst we care for you.

5WHAT HAPPENS WHEN I ARRIVE AT A&E, AND HOW LONG WILL THE WHOLE PROCESS TAKE?

When you first arrive at A&E you’ll be asked to register at reception, where they will record your personal details and the reason for you coming to A&E. After you’ve been registered you’ll be seen by a triage nurse or doctor, who will ask questions about why you’ve come to A&E, and also do a few simple checks such as measure your blood pressure, heart rate and oxygen levels. The triage process helps to identify which part of the A&E department you need to be seen in, and ensures that people with the most serious problems are seen first.

After triage, depending on your particular situation, one of the following will happen: l You’ll be asked to wait for a further assessment and treatment by an A&E nurse or doctor. l You’ll be sent directly to be seen by

another specialist department at the hospital (e.g. the obstetrics department for any problems related to pregnancy, labour or childbirth). l You’ll be sent to an on-site GP at the hospital for further management.

If you’re brought to A&E by an ambulance, the process is very similar but with a few differences. For example, the ambulance crew will provide your details to reception for you, and if you’re seriously ill the ambulance crew will have alerted the hospital staff ahead of your arrival to make sure that you are triaged faster. However, arriving by ambulance doesn’t mean that you will always be seen sooner than if you had walked into A&E by yourself, this all depends on how serious your situation is. Unfortunately, the total time you can expect to spend in A&E varies daily and is impacted by several different factors, including; how busy the A&E department is, how busy the whole hospital is and how many staff are available. The current national waiting time target for patients in A&E is 4 hours from arrival to a decision to either discharge (send you home) or admit (keep you in hospital), and this includes any treatment you may receive in the department. However, every person’s experience of A&E is different, and you may be seen much sooner or later than 4 hours.

We know that it can be very difficult to wait in A&E for long periods of time, especially when you aren’t feeling well, but the A&E staff will always get to you eventually and give you the highest quality of care possible.

Written by Dr Kaladerhan Agbontaen BA Hons, MBBS (GMC 7527156)