Should self inflicted wounded people use our A&E departments?

30-10-2018 8:20pm

Andy From Sligo wrote: »

lot of 'experts' on here

Including yourself, I suppose?

El_Duderino 09 · 30-10-2018 8:22pm

Andy From Sligo wrote: »

it dont work properly - I know heard loads of people who say I am not going to A&E I d be in there for hours - if it was working properly they wouldnt even think like that

You know loads of people who don't go to A&E in a genuine emergency because they might be in there for hours? Lol.

I doubt it.

Andy From Sligo · 30-10-2018 8:39pm

SusieBlue wrote: »

If your wife was trained in first aid she would have recognized that she was having an anaphylactic reaction to the kiwi and would have been able to immediately alert the hospital staff to the severity of the situation.
Even with minimal first aid training (which is what I have) she would have known she needed an epipen when her tongue started swelling.
Something here isn’t adding up.

yes i'm making it all up as i go along - if thats what you want to believe . I cant be bothered explaining everything word for word that went on , I would hope people would just believe me and stop being so pedantic ...

Andy From Sligo · 30-10-2018 8:42pm

RaichuMGS wrote: »

If it had “nicked” an atery she would have been dead inside of 3 minutes.

yes , so after 3 minutes if patients havent died , then you know its only just a cut finger - but admittedly even a cut finger with blood pouring out can be quite frightening especially if it looks like its never gonna stop bleeding

30-10-2018 8:44pm

Andy From Sligo wrote: »

yes , so after 3 minutes if patients havent died , then you know its only just a cut finger - but admittedly even a cut finger with blood pouring out can be quite frightening especially if it looks like its never gonna stop bleeding

So I suppose if someone has a heart attack and doesn’t die they should just wait and go see their doctor is it?

El_Duderino 09 · 30-10-2018 8:48pm

RaichuMGS wrote: »

Andy From Sligo wrote: »

yes , so after 3 minutes if patients havent died , then you know its only just a cut finger - but admittedly even a cut finger with blood pouring out can be quite frightening especially if it looks like its never gonna stop bleeding

So I suppose if someone has a heart attack and doesn’t die they should just wait and go see their doctor is it?

It would presumably depend on who was at fault for the heart attack. If it was caused by unhealthy living then they should go to private hospital. If it was caused by genetics then they should be treated quickly. The triage nurse can make that determination when they see the patient.

Andy From Sligo · 30-10-2018 8:49pm

RaichuMGS wrote: »

So I suppose if someone has a heart attack and doesn’t die they should just wait and go see their doctor is it?

you know the answer to that ...

30-10-2018 8:49pm

El_Duderino 09 wrote: »

It would presumably depend on who was at fault for the heart attack. If it was caused by unhealthy living then they should go to private hospital. If it was caused by genetics then they should be treated quickly. The triage nurse can make that determination when they see the patient.

“Have you ever eaten from McDonald’s?”

“Yes nurse”

“FCUK OFF OUTTA HERE YE BOLLOX”

Big Bag of Chips · 30-10-2018 10:51pm

Andy From Sligo wrote: »

I know heard loads of people who say I am not going to A&E I d be in there for hours - if it was working properly they wouldnt even think like that

If they needed to be in A&E they'd go, regardless of how long they thought they'd be there. If "loads of people" could survive alright without being in A&E then they didn't need to be there in the first place, and by staying away helped the overcrowded system be a little less overcrowded.

30-10-2018 11:04pm

Andy From Sligo wrote: »

that is true

just hazarding a guess and jumping to conclusions .. a bit like others on here who think they have me all sussed out and think I am some kind of expert for suggesting/telling people what i think is wrong with A&E departments

No, Andy. I don't think there's any danger anyone thinks you're an expert.

Andy From Sligo · 30-10-2018 11:32pm

Big Bag of Chips wrote: »

If they needed to be in A&E they'd go, regardless of how long they thought they'd be there. If "loads of people" could survive alright without being in A&E then they didn't need to be there in the first place, and by staying away helped the overcrowded system be a little less overcrowded.

indeed - this is what i think too

Big Bag of Chips · 30-10-2018 11:45pm

Andy From Sligo wrote: »

indeed - this is what i think too

But you said

Andy From Sligo wrote: »

if it was working properly they wouldnt even think like that

So which is it.. Do you think if A&E was "working properly" loads of people who didn't need to be there would go there? Because there wouldn't be a long wait?

Is that not what is happening right now? A&E works fine, it's the people who don't really need to be there, who clog the place up causing it to be over crowded and long waiting times for non-emergencies?

We don't need to send "self inflicted injuries" to private clinics. People who don't need to be in A&E just need to stop turning up in A&E.

Andy From Sligo · 31-10-2018 1:33am

Big Bag of Chips wrote: »

But you said

So which is it.. Do you think if A&E was "working properly" loads of people who didn't need to be there would go there? Because there wouldn't be a long wait?

Is that not what is happening right now? A&E works fine, it's the people who don't really need to be there, who clog the place up causing it to be over crowded and long waiting times for non-emergencies?

We don't need to send "self inflicted injuries" to private clinics. People who don't need to be in A&E just need to stop turning up in A&E.

i know - but they do and they will . some people say people are not in A&E because they want to be - I am not so sure with some people. I still maintain in some circumstances without picking it to pieces that some people do high risk activities and recreation that can potentially end them up in A&E overcrowding the waiting room, causing longer waiting times, making others wait longer than normal and overstretching doctors and nurses and the service over-all .. I dont think I will change my mind on that no matter what anyone says ... if there was a facility to ship (for want of a better word) those certain members of the public outside the HSE accident and emergency departments then it will make it better for other people attending A&E and who need to be seen quicker.

trouble is with people once they have made their mind up that it wouldnt work or would fail you might as well be talking to the wall because Luddites who have made their mind up and cannot even entertain alternative ways of doing things will just stick with the norm - and its really not worth trying to convince them or converse with them any longer.

Big Bag of Chips · 31-10-2018 1:56am

But as somebody pointed out, those people who are involved in high risk activities tend not to be the people filling A&E beds. You can't stop people pursuing interests. A hill walker/mountain climber is not going to end up in A&E on a regular basis. Work place accidents/road accidents will be far more common than climbing accidents for example.

You'd be better suggesting that any "non-emergency" people who think twice about going to A&E because they'll be waiting should be the ones who are shipped off to somewhere else, and leave the custom built facility to do the job it is designed to do - dealing with emergencies, regardless of how they came about. Why would you ship emergencies out of a n emergency department to clear up A&E to run "properly" so non emergencies have less of a wait time?

Just to note, I think hospitals are making a move away from calling it Accident and Emergency now and it is just being called "Emergency Department". So they treat emergencies.

witchgirl26 · 31-10-2018 9:57am

Andy From Sligo wrote: »

dont want to seem heartless but as a matter of fact, was she given a cubicle? ,could a nurse wrap a piece of gauze and hand up to stop the bleeding , was GP around / nurse around anywhere to do stitching - couple of paracetamol for pain, something to stop it bleeding, piece of steralised cotton gauze to clot the blood and keep the dirt out be fine until it got stitches (unless she had a clotting problem) if it stopped bleeding ok then a pop to gp surgery the next day for stitches would have sufficed. - but then again I wasnt there so I didnt see how bad it was. But if it didnt nick a an artery or anything and blood wasnt spurting out it might have been OK to not have to go into A&E with it.

Flipping hell - did you miss the part that I said you could see the bone in her finger from the cut? Yes she got a cubicle. In the 5 mins it took to get to hospital she'd soaked through an entire kitchen roll with blood so a couple of paracetamol and a stitch was not going to cut it. She needed a tournequet in order to reduce the blood flow so they could even examine it. My mam is a nurse and would not have gone unless it actually was an emergency. And not all GP's do stitches.

But exactly - you weren't there and you aren't medically trained so do you know what, if I'm bleeding a large amount I'm going to go to A&E despite the fact that someone on boards think I'm taking up space.

And just to clarify, my mam is the last person who'd want to take up space in an A&E having worked in hospitals so much. If she has anything non-serious, she'll go to the GP or to the VHI Swiftcare instead but sometimes you have to go to A&E because it's well an accident or an emergency. Clue's in the name.

Andy From Sligo wrote: »

hmmm.. so just as the staff are chucking out phsically abusive drunks on a weekend night they say "here you wouldnt mind just sticking your signature on this before you go will ye?"

Nope the physically abusive drunks have the Gardai called on them but if they still need medical treatment, they are restrained until they either receive it or they do sign the form.

ohnonotgmail wrote: »

Physically abusive drunks get arrested not chucked out.

Exactly.

Andy From Sligo wrote: »

it dont work properly - I know heard loads of people who say I am not going to A&E I d be in there for hours - if it was working properly they wouldnt even think like that

I meant the system of triage does work. I'm not saying it doesn't lead to long queues. If they'd be there for hours, then maybe under your logic they shouldn't be going as they haven't been assessed as in need or urgent care.

PlaneSpeeking · 31-10-2018 11:43am

witchgirl26 wrote: »

Flipping hell - did you miss the part that I said you could see the bone in her finger from the cut? Yes she got a cubicle. In the 5 mins it took to get to hospital she'd soaked through an entire kitchen roll with blood so a couple of paracetamol and a stitch was not going to cut it. She needed a tournequet in order to reduce the blood flow so they could even examine it. My mam is a nurse and would not have gone unless it actually was an emergency. And not all GP's do stitches.

But exactly - you weren't there and you aren't medically trained so do you know what, if I'm bleeding a large amount I'm going to go to A&E despite the fact that someone on boards think I'm taking up space.

And just to clarify, my mam is the last person who'd want to take up space in an A&E having worked in hospitals so much. If she has anything non-serious, she'll go to the GP or to the VHI Swiftcare instead but sometimes you have to go to A&E because it's well an accident or an emergency. Clue's in the name.

Nope the physically abusive drunks have the Gardai called on them but if they still need medical treatment, they are restrained until they either receive it or they do sign the form.

Exactly.

I meant the system of triage does work. I'm not saying it doesn't lead to long queues. If they'd be there for hours, then maybe under your logic they shouldn't be going as they haven't been assessed as in need or urgent care.

The only time I ever went to the ED for something I didn't think might be an emergency, it turned out to be one!!!

My ankle had swollen up and I was in pain. I thought it was just a sprain and went with ice and rest.

Few dyas of it being red and warm and I thought it best to check it out (my mother died of sepsis so I'm a little gunshy with infection). Turned out it was cellulitis and I needed to be admitted for IV antibiotics!

Oh and the bold part - too true, when I was there there was a lad who had caused a car crash, Gardai were keeping an eye on him but he was seen before anyone. He should have been kicked out

witchgirl26 · 31-10-2018 12:24pm

PlaneSpeeking wrote: »

The only time I ever went to the ED for something I didn't think might be an emergency, it turned out to be one!!!

My ankle had swollen up and I was in pain. I thought it was just a sprain and went with ice and rest.

Few dyas of it being red and warm and I thought it best to check it out (my mother died of sepsis so I'm a little gunshy with infection). Turned out it was cellulitis and I needed to be admitted for IV antibiotics!

See and this is why people are better off to be safe than sorry with something sometimes.

Last time I hurt my foot, I went to VHI as I was pretty sure it wasn't too serious but needed an x-ray. It was fine thankfully but a lot of people don't have access to VHI clinics and GP's don't do x-rays.

PlaneSpeeking wrote: »

Oh and the bold part - too true, when I was there there was a lad who had caused a car crash, Gardai were keeping an eye on him but he was seen before anyone. He should have been kicked out

A couple of people I know use to work in A&E and said that if they could treat the disruptive drunks or a prisoner etc quick and easy first, they would (as long as not putting someone else at risk) as it means they could get them out of the way.

Andy From Sligo · 02-11-2018 5:57pm

I really really dont know what a solution could be .. but i still really hate the thought of drunks, druggies, prisoners, abusive people sharing the same HSE A&E dept as other people .. am sure there has got to be a better solution out there so they can still get care/medical help if they need it but as I say , when they have to share with others ... and i am still not happy the way even still these days an awful lot of people are choosing to go to A&E which could have been sorted with their GP / local medical centre for one reason or another . and other patients who might be waiting for an MRI scan / CT scan but instead of wating for it want to fast track having one so present themselves to A&E - Then if there was good proper 24hour support of mental health system in Ireland then the people who need help could get it from mental health services and not have to seek it from the A&E (I heard of one instance of a lad who tried to take his life and the GP said if you try to get through to the mental health services and get no answer or any help and still feel suicidal go straight to A&E ?!?)

it all needs sorting out and categorising somehow better than it is now , and then I do believe waiting times could be reduced.

blairbear · 02-11-2018 6:30pm

Honestly, Andy; as someone who IS an expert (Emergency Medicine registrar working in the HSE EDs for the last 7 years), every single point you have made is wrong on several levels. Every criticism you have of the triage system shows grave levels of ignorance. Every rudimentary understanding you have of medical issues is fundamentally flawed.

Drunk patients and drug users are still people deserving of care. Abuse and violence is not tolerated. The sickest, most urgent person is seen first. Our triage system is internationally researched and evidence based. The correct place for a suicidal patient is indeed the ED, as then they can be admitted as an inpatient to the psychiatry unit.

Also EDs haven't been called A&E since 1998.

This thread is painful.

Big Bag of Chips · 02-11-2018 7:20pm

Andy From Sligo wrote: »

(I heard of one instance of a lad who tried to take his life and the GP said if you try to get through to the mental health services and get no answer or any help and still feel suicidal go straight to A&E ?!?)

Where else do you suggest a suicidal person gets emergency care? Do you think they should wait until they can get through to a helpline? Or over the weekend wait until Monday morning to try get an appointment with their GP? Of course a suicidal person should present to A&E. Their need is an emergency.

To be honest, Andy, my biggest shock from the whole of this thread is that you're married. Because from your posting history and your "ideals" I assumed you were a teenager who felt they could take on the world and solve all the problems.. Without actually having clue as to how things work. We've all been there.

Life isn't simple. Society isn't simple. So offering simple solutions to very very complex situations will never work. If it was so simple don't you think the measures would already be in place?

Andy From Sligo · 02-11-2018 8:26pm

blairbear wrote: »

Honestly, Andy; as someone who IS an expert (Emergency Medicine registrar working in the HSE EDs for the last 7 years), every single point you have made is wrong on several levels. Every criticism you have of the triage system shows grave levels of ignorance. Every rudimentary understanding you have of medical issues is fundamentally flawed.

Drunk patients and drug users are still people deserving of care. Abuse and violence is not tolerated. The sickest, most urgent person is seen first. Our triage system is internationally researched and evidence based. The correct place for a suicidal patient is indeed the ED, as then they can be admitted as an inpatient to the psychiatry unit.

Also EDs haven't been called A&E since 1998.

This thread is painful.

ok then i bow to your experience then seeing as your better qualified than i am on the subject then

cant be a bad thing getting a view on the other side of the desk though and get feedback from the public as to what they think can it?

Andy From Sligo · 02-11-2018 8:33pm

Big Bag of Chips wrote: »

Where else do you suggest a suicidal person gets emergency care? Do you think they should wait until they can get through to a helpline? Or over the weekend wait until Monday morning to try get an appointment with their GP? Of course a suicidal person should present to A&E. Their need is an emergency.

To be honest, Andy, my biggest shock from the whole of this thread is that you're married. Because from your posting history and your "ideals" I assumed you were a teenager who felt they could take on the world and solve all the problems.. Without actually having clue as to how things work. We've all been there.

Life isn't simple. Society isn't simple. So offering simple solutions to very very complex situations will never work. If it was so simple don't you think the measures would already be in place?

I can hardly be blamed myself for the failing because this country hasnt got an accessible mental health service available 24hrs all year round.

.. and the staff and everyone in an ED department is experienced to deal with mental health ? - and the surroundings of a busy ED department is suitable yes for someone who needs immediate care?

02-11-2018 8:34pm

I avoided this for weeks but I'm sorry I did. OP, you are clinically retarded. Ban me if you like mods but my God, that is the most inane crap I've ever read in my life.

Mod-Banned

02-11-2018 8:34pm

Andy From Sligo wrote: »

ok then i bow to your experience then seeing as your better qualified than i am on the subject then

cant be a bad thing getting a view on the other side of the desk though and get feedback from the public as to what they think can it?

Well, yeah it can. When you’re saying ridiculous stuff like a suicidal person shouldn’t go to A&E. If emergency depts started turning patients away following your ideas I’d be afraid to witness the outcome.

blairbear · 02-11-2018 8:40pm

Yes. We are indeed trained to deal with patients with psychiatric issues, and then we refer to the psychiatry team on call, who are available in house 24/7.

I'm afraid I see very little value in your feedback, Andy. You have no real experience of EDs or of the patient experience and have a poor command of logic and reason, it would appear.

Andy From Sligo · 02-11-2018 8:40pm

Deleted User wrote: »

I avoided this for weeks but I'm sorry I did. OP, you are clinically retarded. Ban me if you like mods but my God, that is the most inane crap I've ever read in my life.

well dont read it and why join in then, just so you can call me a retard for having a different view to others? - we cannot all have the same opinions on everything just because you and others dont like it

02-11-2018 8:41pm

[Deleted User] wrote: »

I avoided this for weeks but I'm sorry I did. OP, you are clinically retarded. Ban me if you like mods but my God, that is the most inane crap I've ever read in my life.

I agree this thread is ridiculous but that’s a bit too far I think.

Andy From Sligo · 02-11-2018 8:48pm

RaichuMGS wrote: »

Well, yeah it can. When you’re saying ridiculous stuff like a suicidal person shouldn’t go to A&E. If emergency depts started turning patients away following your ideas I’d be afraid to witness the outcome.

ah see - putting words in my mouth and twisting my words - just for the record I have not said patients should be turned away - i am saying the current situation is not sufficient , it is putting a sticking plaster on a larger problem that A&E (or ED if thats what they are called now) seem to be a onestop shop solution for people that want to go to ED than see GP, to jump the queue and get MRI quicker and to pick up drunks and druggies among other things.

Foweva Awone · 02-11-2018 8:50pm

As someone who's ended up in emergency departments after fairly serious suicide attempts, this thread is very sad to read.

Were my complex and serious psychiatric issues going to be solved there and then by the emergency department staff - of course not; however I'm glad they stitched up my slashed artery and saved my life instead of wasting critical minutes arguing over whether they should help me because the wound was absolutely self-inflicted and because I was drunk at the time.

I mightn't have particularly cared whether I lived or died at the time, but over a year since that particular incident, I'm very grateful to the hard-working medical staff, on behalf of both myself and my four-year-old son, who isn't growing up without a mammy.

I suppose the OP would have wanted me to be sent "somewhere else" - I didn't have the luxury of time; I'm just lucky the ambulance journey to the hospital was only a couple of minutes from my house. And yeah I was probably put ahead of other patients and treated immediately - if I hadn't been, I probably wouldn't be alive today.

Would I do it now today, now that I'm mentally stable and have been for quite a while? Of course not. But I'm very happy and relieved that the help was there when I needed it.

Andy From Sligo · 02-11-2018 8:55pm

blairbear wrote: »

Yes. We are indeed trained to deal with patients with psychiatric issues, and then we refer to the psychiatry team on call, who are available in house 24/7.

I'm afraid I see very little value in your feedback, Andy. You have no real experience of EDs or of the patient experience and have a poor command of logic and reason, it would appear.

I understand - but what are you saying that only people who post on boards then cannot have an opinion or a suggestion or different outlook on life if they are not qualified in the subject in what they are posting about - i bet i can find a plethora of posts on boards started or contributed by people with an opinion on a subject that they are not qualified in . what do you want? everyone to stop posting/contributing or just me?

Should self inflicted wounded people use our A&E departments?

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