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NHS Walk In Centre Didn’t Know How To Use Nebuliser

Posted on 24th August 2012 in Asthma/ doctors/ NHS

I sat in the waiting room of an NHS walk in centre this week and watched as a frightening series of events played out in front of me.

It was the usual scenario; I’d been there for 20 minutes, constantly checking my watch as minutes ticked by knowing that I was getting later and later for work, knowing that although I was next to be seen it had been 15 minutes since the last patient had left and yet the doctor hadn’t called anyone else.

Then a woman and young lad came in went up the desk, the woman was obviously struggling for breath and the lad had soaking wet hair. My mind pictured the scene at their house that morning with mum feeling unwell but still frantically trying to get her son showered before heading off to seek help. The receptionist asked her name, she couldn’t say it so the boy said it for her. She was then given a form to complete which she did before sitting in the nearest chair.

I was sat behind them. She was heaving for breath. The boy kept looking at her, “are you alright mummy?” he asked quietly. The mum gave him a hug and a lovely smile then turned and gasped for breath. A man and young girl came in and sat with them, I felt immediately relieved as I’d been worried that her and the boy were here on their own.

I checked the time on my phone and rummaged in my bag for something then it occurred to me that the lady had now been sitting for over 5 minutes – struggling to breathe. Why hadn’t she been seen immediately?!

I asked the man if his wife was asthmatic and needing a nebuliser? He said yes. I said, sorry to interfere but it might be worth asking the receptionist to ring through to the doctor as he hasn’t called in any patients for ages. He asked the receptionist and she rang through to the doctor.

Five more minutes past. The mum’s breathing was getting more and more laboured, the little girl was crying and the boy was determinedly trying not to. He asked his mum again if she was alright and she gave him that same, wonderful, brave smile. Except that this time when she turned away there were silent tears streaming down her face.

My eyes prickled with tears and I had to step outside to get a grip. There is a shop opposite so I went in and bought some water for myself and a drink for the children.

The mum had finally gone in with the doctor when I got back so I gave the drink to the dad and said it might help distract the children. They both had some and then the little girl clutched the cold bottle against herself.

The man told me they were on holiday here and hadn’t known where else to go. We chatted for a bit as it turned out that they lived not far from where I’ve just moved. Small world and all that. The children started to calm down and chatted about their holiday.

About 5 minutes later the mum came bursting through the doors followed by the doctor. She was crying and really struggling to walk and breath. The man jumped up ‘What’s wrong?’ he asked her, she angrily brushed him off and went outside.

“I can’t treat her” said the doctor “you’ll have to phone an ambulance”

The whole waiting room looked on in stunned silence.

The children were now both crying.

I spoke to the doctor, “She just needs a nebuliser,” I said, “you must have one here surely?”

“We don’t have one.” he said.

I looked at the receptionist. “We do have one.” she said.

“I don’t know how it works” said the doctor “and the nurse isn’t here.”

So we now had a desperately ill lady, the thing she needed to get better and a doctor who didn’t know how to use it.

The man got his wife back in from outside and got her to sit down again and shouted for the receptionist to call an ambulance, which she did. The doctor asked her to come and lie down in his room, she got really agitated and struggled to say “No!”, the man pleaded with her.

“Is mummy going to be ok daddy?” said the little boy between sobs.

Again I had to step outside. I don’t cry especially easily but this was breaking my heart. I pulled myself back together and went back inside.

The receptionist and the doctor were talking to the couple, trying to convince them that they’d found someone who knew how to use the nebuliser. The woman was violently shaking her head, clearly not feeling she could trust the treatment. It turned out that they’d found some oxygen and they wanted her to use that. After much discussion the doctor said “So she is refusing my treatment, ok.” and went to walk back to his room “No, the man cried, you aren’t able to treat her, there’s a difference! You don’t know how to use the machine and she doesn’t feel confident that you can help her, we’ll wait for the ambulance.” The doctor repeated again, “She is refusing my treatment”. Call me cynical but it felt like it was for the benefit of covering himself, we’d all witnessed the fact that he hadn’t been able to treat her.

The man asked the receptionist to chase up the ambulance, he asked me how far away A&E was, I told him and it was obvious the ambulance should have been here by now. The woman’s breathing was so bad now that she finally agreed to go and lay down and receive oxygen. The receptionist came off the phone and said quietly to the man that there’d been a problem with the ambulance and that another one should be here within 5 minutes.

He looked frantic. He ruffled the boys hair and went off to sit with his wife.

The children were sitting huddled together on their own, they had been 4 chairs apart but were now next to each other. I figured that I wasn’t going to have time to be seen today but didn’t want to leave the children on their own in there waiting.

The boy turned round and asked my how long it would take for the ambulance to get here. I glanced at the clock, it had already been 15 minutes. “Well,” I said, as I wiped away a tear and tried to control my voice “the A&E department is about 20 minutes away from here, so they should be here really soon.” We then chatted about his holiday and what they’d been up to, it turns out he was almost exactly 1 year younger than my youngest and his sister was 6. He started telling me about their morning then added that they hadn’t had time for breakfast. I searched through my bag and found a bag of chocolate animals (there are benefits to being a mum!) which they then shared.

Finally, finally, the ambulance appeared and we all breathed a sigh of relief. I was getting ready to leave when the man burst back into the reception area looking livid. “The paramedics have found your nebuliser,” he said loudly to the receptionist “they want to know where exactly the medicine is that should be with it!” I watched in disbelief as it took a further five minutes for a key to the medicine cabinet to be found.

It took 45 minutes from walking through the door to the ambulance arriving yet the means to treat the lady had been on the premises the whole time.

This is the same health centre who wouldn’t send a doctor out to treat a patient who was having a heart attack in the car park. That man sadly died: http://www.cambridge-news.co.uk/Home/Shoppers-horror-as-man-dies-yards-away-from-surgery-19042012.htm

I hope they will learn from this and immediately retrain all relevant staff in the use of nebulisers. My son has asthma, would he be able to last 45 minutes without treatment?

What Do You Know About Triple A?

Posted on 23rd March 2012 in Asthma/ Avoid Asthma Attacks/ Triple A Test

When I picked my 12 year old up from school last night he was feeling very unwell.

His eyes were red and puffy, the skin around his mouth looked puffy and he couldn’t speak more than a couple of words at a time without struggling for breath.

It was terrifying.

We saw the doctor and he now has a regime of inhalers, steroid creams and antihistamine tablets to take in the hope that we can get in control of it all.

He has suffered with eczema since he was a few weeks old; he is allergic (yes allergic) to apples, among other things, and the hayfever season sends his eczema off the chart so he is very uncomfortable right now.

He has suffered with hayfever to a worsening degree for the past few years, but this year is seems to have hit particularly hard.

In addition, we now have the asthma to contend with.

ASTHMA SCARES ME.

It really, really scares me.

When I went into his room last night I could hear him wheezing in his sleep; should I have woken him up? I don’t know. When I suddenly woke up at 3am to hear him in the bathroom struggling to catch his breath, I felt guilty for the fact that I’d fallen asleep. What if he’d had an asthma attack and I hadn’t heard him?

I feel desperately un-equipped to deal with this. I feel out of my depth.

I went on the asthma uk website. A headline smacked me across the face ‘Three People A Day Die From Asthma‘ it told me.

However I’m really glad that I visited the website as I’ve ordered some free publications that will hopefully help me understand the condition a bit more. I’ve also ordered some things for my son: an asthma attack card, a personal action plan and an asthma calendar. These should help him feel a little bit more in control of it all and will also mean that he can carry the attack card in case he falls ill so that someone will know he has asthma.

Also on the website you can take the Triple A Test – it will help you determine how at risk you are of having an attack. The triple A stands for: Avoid Asthma Attacks.

I would like to praise Asthma UK for their site, I found it incredibly informative, clear and easy to use. I can see that I’ll be referring back to it often!

I found the following information, taken directly from the asthma uk website, particularly useful:

What to do in an asthma attack

attack cardThe following guidelines are suitable for both children and adults and are the recommended steps to follow in an asthma attack:

  1. Take one to two puffs of your reliever inhaler (usually blue), immediately.
  2. Sit down and try to take slow, steady breaths.
  3. If you do not start to feel better, take two puffs of your reliever inhaler (one puff at a time) every two minutes. You can take up to ten puffs.
  4. If you do not feel better after taking your inhaler as above, or if you are worried at any time, call 999.
  5. If an ambulance does not arrive within 10 minutes and you are still feeling unwell, repeat step 3.

If your symptoms improve and you do not need to call 999, you still need to see a doctor or asthma nurse within 24 hours. You can order a free, pocket size ‘What to do in an asthma attack’ card to carry with you here.

You’re having an asthma attack if any of the following happens:

  • Your reliever inhaler does not help.
  • Your symptoms are getting worse (cough, breathlessness, wheeze or tight chest).
  • You are too breathless to speak, eat or sleep.

Do not be afraid of causing a fuss, even at night. If you go to A&E (accident and emergency) or are admitted to hospital, take details of your medicines with you if possible.

After an emergency asthma attack:

  • Make an appointment with your doctor or asthma nurse for an asthma review, within 48 hours of your attack.
  • You will also need another review within one or two weeks to review your current asthma treatment and ensure your asthma is well controlled.

Do not ignore worsening symptoms

Asthma attacks are the result of gradual worsening of symptoms over a few days that you may not have noticed.

Needing to use your reliever inhaler more than three times a week may suggest that your asthma is not as well controlled as it could be.

Think about it – if your asthma symptoms are getting worse or you’re using your reliever inhaler more, don’t ignore it.

If your symptoms continue to get worse, make an urgent appointment to see your doctor or asthma nurse within 24 hours.

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