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how long should asthmatics sit in triage area??

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had an asthma attack in aberdeen tea time on saturday ...was driven to Aberdeen's main hospital and after giving my details to the receptionist had to sit in the waiting room for 45 mins before being seen by the triage nurse.. on reaching just under 150 on my blow into machine lol i was taken straight into resusc and put on oxygen, nebs and had a line put in...question....is this a normal occurrence ..sitting in a waiting room for 45mins while one's lips are turning a pale shade of blue?? lol

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33 Replies

Ideally you any patient should be seen by a triage nurse within 20mins of arrival. Most hospitals now you are seen by a nurse prior to giving your details to the reception but by the sounds of it this isnt so in aberdeen? they should also state that if any patient has chest pains or difficulties in breathing not to wait and makethemselves known to medical staff, was this not so? if not im sorry you were let down by the hospital and nhs system. maybe though it will put you in good stead to speak up and let the staff know rather than just sitting and getting worse? nurses would much rather you pestered them than them have to deal with a moresevere situation.

Andrea

They can't wait to get me round the corner and into resus, mind you they know me. If you are getting worse and stuck in triage tell someone don;t assume they have noticed you going blue and struggling for air.

TELL SOMEONE!

Bex

This was the first time i've actually had to visit Aberdeen A&E..was actually up there visiting my daughter..I know from experience of visiting Falkirk A&E that asthmatics are treated as a priority and seen immediately ..have written an email to Grampian and Highland NHS asking exactly what the policy is in Aberdeen A&E..ie.. does the receptionist make the triage nurse aware of the patient's condition or is it down to a first come ..first seen policy...after I was seen by the triage nurse ..the treatment i received was first class...but I know for a fact that in Stirling Royal Infirmary and Falkirk Royal Infirmary the receptionist makes medical staff aware immediately if someone suffering from asthma has arrived at A&E

When I have to go to a/e I got to thr reception they usually take me thru straight away to majors straight away I sure other folk who sat waiting for hours must get anoyed that i get wheeled thru straigh away. Past couple of time I gone to a/e by ambulance so go thru straight away anyway.

Only had to wait once and that was years ago when I was at college and I went to a really silly costa that made me sit there for 30mns i think could poss been 45 really stuipid when i couldnt breth

Hey,

I ended up in a similar situation last year in what is apparently one of the UK's top chest hospitals, very disappointing. Maybe it was just bad timing on my part but that obviously isn't my fault, we can't help what time it is when we turn up in A&E. I happened to turn up at the A&E when every dr in the hospital was in hand over and most of the A&E nurses were as well. I know that isn't their fault but it isn't mine either and as a result I was left in a majors cubicle whilst the staff disappeared to hand over. Over half an hour later whilst mum had dashed off to get some help the nursing staff walked passed during their hand over and realised I really wasn't very well. I was then taken to resus and then to the ITU from there. I think that my situation was a one off (or at least I hope it was) and was just bad timing. But still it shouldn't be happening.

tks xxxxx

When I started to go to hossie for my attacks similar happened to me many times!

Im bewildered about Aberdeen as thats where the Prof Ayres is based (or was last time I heard - he ran the HEartlands Brittle asthma clinic)!

Perhaps their A+E recept need somw training in how urgent treatment is for asthmatics!

It happened to me until once they did it for about 60mins and my husband (not anymore) was trying to chase someone to treat me - but nobody did till I collapsed and quit breathing!!

But the paramedics who took me in dumped me in reception and did sod all!

Now if I go in I go via 999 on blues and twos and straight to resus - called into *majax Phone* so they are ready for me as I have nasty habbit of going into resp arrest!

I have a friend who lives in Irvine Scotland and she gets so poor treatment Im surprised shes still alive!

yaf_user681_26410 profile image
yaf_user681_26410

I was taken into A&E via ambulance last week and still took 2 hours to be seen by a doctor even though asthma was triggered by a severe allergfic reaction and had been given adrenaline. A lot of people walkewd past and looked at me coughing incessantly but still didn't get seen any quicker.

KateMoss profile image
KateMoss

Last time I was in A&E in local, I was helped round from OPD, sat on a chair for 2 mins then was dragged straight into resus via Triage!

Even when I have been into A&E for non asthma reasons - usually a snapped needle - they do say if I need a neb to let them know and the will check me over anyway.

I haven't ever been left in a triage area but sometimes in the past they have nebbed me then abandoned me in a cubicle to await a registrar who then had a wobbly and chucks me into resus.

I alwasy carry my protocol so mostly I go to resus.

All asthmatics going to A&E should be priority and seen to ASAP.

We are told not to worry about going or calling an ambulance as asthma can deteriorate very quickly.

Me too Kate but hastook a few hairy moments, two respiritory attacks and a few cross words to ge it right, now the mere mention of my name and resus is cleared! and as soon as i go to a and e even if with my diabetes the bed manager contats the chest ward andif no beds they move someone out. Im only allowed on chest ward or itu/hdu. Then at my regional lung centre if i rarley make it there the mere mention of my cons name and its straight to resus. The nurses are fab they get a doc in straght away tell em what i need contact med reg ( no little juniours ) and itu team, and all this on my first neb!!!

It makes all the difference to the outcome.

Andrea xxx

Very interesting!!

Really funny this topic came up as I had a triage problem on Moday with my 10 year old son.

Jayden is a severe Asthmatic who has had 8 admissions this year and is in A&E at least once a month. He was ok ish when we left from home but the walk from the entrance to A&E was a bad idea. Our local hospital in central London has a triage system but you have to book in with the receptionist before being seen.

I told them Jayden was having an attack and needed to see a doctor, when asked 'has he been here before?' I replied just about every month this year. For some reason this did not start alarm bells ringing and we were told to take a seat and wait for traige.

After 4 people had gone in (3 of which looked as though there was nothing wrong with them, only my observation I know) I went back to reception to ask how many before Jay as he was really struggling with his breathing. I was told 'don't ask me I don't know, ask the nurse!' so I waited for the next patient to come out and explained the situating said he was struggling and was becoming distressed. The nurse told me she was reading some notes and would let me know when she had finished!!! When she finally emerged from her little room she called someone else and didn't even look at Jayden to see how he was. The lady sitting opposite me jumped up, shouted at the nurse, told her to look at Jayden and that he needed to be seen NOW. She came over, took one look at him at took him through to see a doctor without even triaging him.

I know some parents become anxious when their children are ill and the staff are probably harassed on a regular basis by worried mothers, but you would think that pointing out your son is having breathing difficulties would at least warrant a quick peek. In the end it took a stranger to get her attention. Surely this can't be right.

My son is well known by most of the paediatic nurses in A&E so once we get through his treatment is usually superb. In fact the paeds reg on call saw his name on the system and came to see how he was even though the A&E doc had not requested it at that point. He spoke to the doc looking after Jay and explained that he will pretent to be well so he can go home, and also that he responds well initially but drops back down quite quickly with low sats and needs O2. This was a great help as I have had to fight in the past to see paeds as I know Jay but they think he is Ok and send him home only to be back 2 hours later worse than the first time.

So although I had a little rant about the hospital it comes down to who is good at their job and who is not.

Arniemouse profile image
Arniemouse

I have found this very variable at times however since developing the chest pain with my heart have found service has picked up no end!! Everyone gets scared in spite of my reassurances that its just part of condition so if you want to get through quicker mention some vague chest pain - could just be a pulled muscle - and it could do the trick.

Den

KateMoss profile image
KateMoss

Den, when I mention chest pain from pleurisy etc they come at me with an ECG machine - makes things worse cos you have to lie back & can't bloomin breathe!

LOL!

I used to have similiar probs with Sean in A & E . When he was very small i used to sit politely in triage cos i was asked i did, what is it with us brits! ANyway after a couple of waits in triage watching my son wheezy and coughing non stop and then going straight to resus after triage I decided to stand up and be heard.

I oten wonder now why on earth i didnt cause more of a fuss but i guess it was a learning curve. Unfortunatly Sean has a bad habit of looking amazingly well even when he really struggling so it took a while for staff to realse i wasnt a neurotic mum , i had lots of dont be silly of course his peak flow isnt 50 lets try it again followed by oh dear you were right, he is veryunwell i think we will take him into another room (which i quickly learnt is polite word for resus)

We changed hospitals 2 yrs ago and Sean now has direct admission to ward so any time of day or night i can just ring, tell them he is on his way and a doc is waiting for us when we get there ready to assess. Luckily this route has worked well for us and we dont need AE but if we end up elsewhere there is no way id go back to the sitting waiting politely routine!

julie

I read this while in hosp and was horrified.

I have had difficulty getting A+E to take me seriously on a couple of occasions as I don't tend to wheeze. My asthma can quickly become brittle and reading about the problems some people have been having I realise how very fortunate I am with my local hosp. To avoid problems in A+E my consultant has told me exactly what I have to say and what to explian to A+E doctors. I cant comment on triage as I have never had to go through that but I think the main thing is not just to sit there letting things get worse but keep making the point to the receptionist. After all the worse things get the harder the job for the medics to put them right.

If you do have problems is there a patient advice and liason service for the hospital concerned? They can be very helpful at resolving problems and ensuring they do not happen again.

hi molly :)

i've actually emailed the NHS Trust for the hospital and asked what the Trust policy is regarding the treating of asthmatics when they come into A&E..was actually up in Aberdeen visiting my daughter and this was my first ""visit"" to Aberdeen Infirmary..I have to stress that I have no complaint regarding the treatment I received when I was eventually seen.....the docs and nurses were first class...my email enquiry is solely regarding hospital policy when it comes to treating asthmatics who attend the A&E department..and whether the information given to the receptionist is correctly passed on to the triage nurse. I have had an initial response from the trust apologising for any distress caused and a promise that further enquiries will be made and that I will be notified shortly

I've experienced this too.Two weeks ago when Chloe was admitted the receptionist didn't have a clue when I tried to explain how quickly Chloe detioriates.We got told to sit in triage room eventually after I protested about how ill she was. We were told someone would be with us shortly after 10 mins no one had arrived so I went to pester and they couldn't find her notes the receptionist had put them in the discharge box. They must of took note because we were admitted again on sunday but this time we went straight to ressus.

asthmatics shudnt av 2 wait in triage at all,when i go i go str8 thru cus ive gt history of respiratory n cardiac arrests due 2 my asthma x

For me it's quite normal to wait 15 mins or less, often I get brought through straight away though. A couple of times I've waited max 30 mins.

I don't usually see a doctor right away, maybe takes about an hour. But the nurses always initiate treatment straight away (nebs, o2 etc) before I see a doctor.

Sorry you had such a bad experience. :-(

triage

i was in the a&e with my son on friday Broken bone in hand a girl came in with asthma she was obviously in distress coughing and wheezing she could hardly speak,she came in about 5 min after us and was still sitting in the waiting room when we left an hour later,she still had not been taken through to triage it was a disgrace, anne

Anne.....what kind of hospital leaves someone sitting for over an hour who is obviously having great difficulties breathing??? which hospital was it?

I don't want to rub it in...but my local hospital is VERY good, I have never waited more than 5mins, even when full. I am always taken to recuss and seen by a doc asap.

I completely agree asthma attacks should be seen to immediately, if not make an official complaint.

May x

it was hairmyers in glasgow,in there defence i must say that this is the first time i have seen this happen,as they are normally very quick to react with something like this anne

Hi Scottish mum,

I am living in Aberdeen just now and have ahd variable experiences with A+E - the first time took a while to get through to triage but yesterday I was straight into resus (although arriving with one of the consultant anaesthetists made a huge difference!) - the SpR was fantastic and I was up to the ward within an hour and a half having barely been left by him (I think he was a little concerned re the state I was in though!)

I must admit I amn't very impressed with triage here, having worked in a fab a+e where the triage girls were really on the ball I see the difference big time. The problem is that the whole idea of triage is to see people on a first-comefirst-served basis to identify who is sick, and some nurses are so protocol driven that they can't see past that. The better ones will eyeball those waiting to be seen and take in the sicker ones first, but as I say, that isn't what the protocol says!

Hope you get a decent response from NHS Grumpian as we call them! Do let us know what they say.

Sarah

Asthmatics should not have to wait for any length at all. What I can't work out is why aren't we nebulised and,if that works, then we wait. That seems like a fair system to me!

Hi there.

I had an attack earlier today and went to casualty at derriford hospital in Plymouth and had to get my mum to book me in as I couldn't speak at all by the time I got there. I was sat there for a good 10 minutes and my mum had to go back to reception and ask them if anyone was coming as I was starting to get blue fingernails and lips. The reception staff didn't seem too concerned and said someone was on their way! I have to say the nurses and doctors were A1 as always though but I'd recommend the reception staff have a kick up the a** though!!!

Stay well everyone.

Love Fluffy. x x x

Hi All, I'm new here, only diagnosed about 3 weeks ago...

I went to Aberdeen A&E at about 4am at the start of December, having a real hard time breathing, wheezing, tight chest. It was hard to even tell the receptionist who I was, but once I was booked in I was taken through within a couple of minutes - though it seemed longer to me at the time!

The treatment was fantastic, was put on O2 and nebs straight away, which helped immensely. Since I didn't know I was asthmatic, I had a chest X-Ray, heart trace and blood tests. My Peak Flow was about 250 (should be about 650, and since then my best has been 570).

After 3 hours, and eventually feeling better I got sent over to see my GP. Now on Becotide and Ventolin, and finding that I feel better than I have for a few years! My GP initially considered Bronchitis, as that runs in the family, but after a week on regular inhalers and seeing improvements, diagnosed Asthma.

Anyhow, perhaps it was the time of day, or perhaps Aberdeen A&E have taken notice of your letter, but I was very impressed with the treatment I received.

Hi there,

I remember my very first experience with our son and A&E when he was only 3 months old. He was having real trouble breathing (His entire stomach and neck where heaving with the effort) and slightly blue around the lips, we took him to A & E and spent 35 minutes waiting to be seen by the triage nurse (Even with my other half pestering them), it was one of the scariest 35 minutes of my life.

Admittedly, the triage nurse was very good and took one look at him and rushed us through to resuss where he was plugged in to dozens of different machines (Which was pretty scary too!)

We finally found out that the breathlessness had been brought on by bronchiolitis, and after spending 3 days in hospital we were sent home.

Surely the should prioritise anyone who is having obvious breathing difficulty!?

Sarah

slightly off topic but surely along with priotising breathing probs they should priotise anyone with severe pain. i managed to sit in a&e for 5 hrs a few yrs ago b4 being seen by triage nurse then rushed through and was in theatre 1 hr later having appendix removed.

they need to assess you as soon as you go in really rather than thje receponist doing what they think!

re to sitting in triage

i weas admitted to a hospital in buckinghamshire with an asthma attack and was seen within 10 min but then was left alone with neb and oxygen with my mum and a trainee nurse who was cleaning sheets ect checking i was okay!if anything happens again i'd make yourself known to them or go to the desk and ask how long its going to be!they usually speed up if you get on their cases!

I think the pain thing depends. I get the odd kidney stone and am always seen very quickly as these are known to cause dreadful pain. I guess they get lots of people with ""tummy pain"" and unless you make a fuss I guess they assume you can wait. If I were being rushed in with an asthma attack I would be mightly hacked off if even a kidney stone patient got seen before and I know how they feel.

Bex

received a reply from Grampian NHS Trust a couple of weeks ago...they apologised and wrote that the triage nurse was needed in resusc and that in future they would make sure that a triage nurse was always available...but dont think that actually answered my query about the queuing system that seemed to operate that night...they reiterated that they did not employ a queuing system but there were only 3 of us in the waiting room during that 45mins. I came into the waiting room and the following patients were already waiting....a gentleman who seemed worse the wear for drink who was lying asleep in a wheelchair , he was taken first and walked out on his own without any help about 10 mins later..a lady who seemed to have some abdominal pain ..she was seen and came back into the waiting room after about 25 mins and i was finally taken at the end...but according to NHS grampian...they dont operate a queuing system ;) and they also reiterated that asthmatics are not expected to wait in a queuing system...now can anyone make any sense out of that?? lol

When me and my girlfriend take her little girl to the hospital she gets seen very quickly no more than five mins as they run a passport system where all the details about her and her asthma are in a folder and they know that they need to start treatment asap, as it could mean differnece between having a few nebs then home and 3 days on aminopholin.

I had a very severe asthma attack yesterday, and i was supposed to stay in over night, but i refused! I had 12 nebs and 8 pred tablets, and i know have to take 8 pred tablets a day. I got to hopsital, and i was so wheezy, and i we had to stand in the que for about 20 mins, and then sit in waiting room for 15 mins, before i was seen by a doctor, i was moved all around the hospital, my attack lasted 10 hours, i think i should have been seen earlier!

Holly- May x

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