A+E waiting times.

[shadow_boxer]

Anyone who can work ED full time is a bloody hero tbh. It's mostly all locums though as it's such an unnattractive career.

I'll be bobbing in and out of ED for the next 7 nights and that's enough for me.

Spot on. I hated it.

 

[DELETED_83755]

Just woke up after working nights in A&E. Sad that it is very much dependant on locum doctors. The junior doctors work about 12 in 16 weekends

 

[Burnsy2023]

Unfortunately whilst waiting times to see a GP are so long some people will go to A&E. I wouldn't personally but obviously plenty of people do.

This is from my surgery's appointment booking website and the first appointment is 3 weeks away.

That's because you are looking at general appointments not urgent ones. Like has been said, if it's urgent the vast majority of surgeries will give you a same day appointment.

 

[dl8860]

Took my mate get his foot checked

Unless it was being 'checked' for extremely severe pain due to a fracture or infection, you shouldn't have gone to A&E yourselves. You were likely set to the back of the queue due to this, which is the reason for your long wait.

What's that phrase about complaining about traffic...

You aren't stuck in traffic, you are the traffic.

 

[McBain]

I fractured my skull last year, rolled up to A+E and was all over the place, almost passing out, they saw me pretty quick.

 

[RetiredGreyFox]

Anyone who is able to walk into A&E without bleeding from somewhere shouldn't be in A&E.

Ooh, I have a big list incoming including heart attacks, asthma attacks and so on .......................
Bit of a daft post really.

 

[Destination]

Ooh, I have a big list incoming including heart attacks, asthma attacks and so on .......................
Bit of a daft post really.

He did say 'walk', most hearts and asthma will hit a stage where they can't

 

[Xordium]

Ooh, I have a big list incoming including heart attacks, asthma attacks and so on .......................
Bit of a daft post really.

Yes because considering how A+E will prioritise things is:

1/ Airway
2/ Breathing
3/ Circulation < Bleeding comes in here and only if it is impacting perfusion.

So bleeding is actually something that genuinely can wait compared to other things.

Anyone who can work ED full time is a bloody hero tbh.

I loved that kind of work because I like the pace and the adrenaline and challenge of it all. Nothing heroic about that at all just I love that pulling it all out of the fire feeling going to the edge etc.

 

[RetiredGreyFox]

He did say 'walk', most hearts and asthma will hit a stage where they can't

but as you know a lot still walk in so have they got to wait until they reach the non walking phase

And what Xordium says.

 

[Destination]

but as you know a lot still walk in so have they got to wait until they reach the non walking phase

And what Xordium says.

Indeed, it's bets to keep them waiting a few hours to check the heart attack is genuine
Those pesky gastoevents.

 

[Xordium]

Well there are two things there really. Firstly the point the poster that was obviously trying to make - that is unless you are really unwell that you shouldn't be going. And then the other one by using that example that the average person wouldn't have a clue about what is unwell and how things are prioritised so they are not capable of making that decision anyway.

 

[Luke]

Yes because considering how A+E will prioritise things is:

1/ Airway
2/ Breathing
3/ Circulation < Bleeding comes in here and only if it is impacting perfusion.

So bleeding is actually something that genuinely can wait compared to other things.

Not any more. CABC is the current assessment (excluding DR) method:
Catastrophic bleeding
Airway
Breathing
Circulation

It really does have to be classified as a catastrophic bleed to be considered before airway though, although internal catastrophic bleeding may not be obvious.

 

[Minstadave]

I loved that kind of work because I like the pace and the adrenaline and challenge of it all. Nothing heroic about that at all just I love that pulling it all out of the fire feeling going to the edge etc.

Most of ED is dull though, burns/fractures/drunks/attempted suicides/elderly stuff.

Fortunately all the exciting paediatric stuff in ED they call us too and leave us to it.

 

[Xordium]

Not any more. CABC is the current assessment (excluding DR) method:
Catastrophic bleeding
Airway
Breathing
Circulation

It really does have to be classified as a catastrophic bleed to be considered before airway though, although internal catastrophic bleeding may not be obvious.

There are a variety of methods - I just went for the simplistic one. With catastrophic bleeding you'll end up with airway and breathing effected anyway. You'll rarely get anything in isolation with trauma will you eg bleeding causing a tension pneumothorax which will cause airway tracheal shift (airway) and the loss of lung expansion (breathing).

ABC is a good one to explain to people in layman's terms because it is a good method to explain why the priorities are as they are:

The point of circulation is to deliver oxygen to the tissues but there is no point doing that if;
The breathing is not working and you aren't getting the oxygen in the first place, and you can't get the oxygen in the first place if:
The airway is blocked and there is no way for gas to get into the lungs.

Naturally if someone's taken a bullet to the neck you are going to want to do something about the quite sharpish!

Fortunately all the exciting paediatric stuff in ED they call us too and leave us to it.

Yep, well paeds is always exciting because they go so quick but then you can also get them back quick.

 

[Xelene]

Broke my foot a couple of months back, knew that while uncomfortable it wouldn't kill me - so waited for the morning and was in and out in a couple of hours.

 

[RetiredGreyFox]

Broke my foot a couple of months back, knew that while uncomfortable it wouldn't kill me - so waited for the morning and was in and out in a couple of hours.

But you still went to A&E - damn and blast you heathen.

 

[Luke]

The point of circulation is to deliver oxygen to the tissues but there is no point doing that if;
The breathing is not working and you aren't getting the oxygen in the first place, and you can't get the oxygen in the first place if:
The airway is blocked and there is no way for gas to get into the lungs.

Conversely, there is no point securing an airway if there will be no circulating volume to push around the body to make use of the oxygen.
Like you say, different models of assessment and many of the steps take place simultaneously in a team based environment.

 

[heeeed]

A+E to work in a found not much fun at all. I enjoyed the social aspects of it as the department is generally young, and large enough that there were a lot of social nights, but the work was either scary and unpleasant or dull and drudgerous. The hours were long and antisocial as I was doing it in the age of band 3 rotas which have been illegal now for 10 years + I think. I still cannot believe the hours I used to work as a junior, it just scares me.

 

[thedoc46]

I waited for 28hrs once in a Greek Hospital (Corfu island back in 92) to fix a broken foot.... + the greasy beep beep sorry but can't swear even though it would be FULLY justified !!!!!!!! set the damn thing wrong, with no gauze, or a clean up, so the plaster was just slapped all over the road rash, which included gravel and dirt !

So count yourself lucky !

 

[Dolph]

It could be worse, you could be in a welsh A&E, far less likely to be seen promptly than England.