What to expect at the emergency department with a sick child
During our recent experiences in hospital with O, I realised that nobody took anytime to explain what to expect from the process or to let us know what would happen next. I took some time to document our experiences. This will be a little bit different for every patient as it totally depends on the hospital and how ill you child is.
Our patient journey
The Emergency Department
23:25 Check-in
We arrived and checked in at reception. This was a purely administrative step documenting name, date of birth, address, billing details etc.
Note: emergency department visits in Ireland are free for children with a referral letter from your GP
Wait.
23:45 Triage
We were seen by a triage nurse, we gave the story of the illness (known as a medical history) and the nurse checked his vital signs (temperature, blood pressure, heart rate and breathing rate). Based on these, we were assigned a priority for assessment by a doctor.
Transfer to cubicle and wait.
Depending on the delay to see a doctor, the child may be given some medication (like calpol or nurofen) and have their vitals checked again.
00:20 Medical Review
We were seen by a doctor (seniority varies). They normally ask to hear the full story of the illness again and ask probing questions before examining the child. We asked for a summary of what they thought and what the next steps were. The doctor ordered some tests, including blood tests, a urine test and also said we would need an IV line.
00: 30 Urine Sample
A nurse returned with a cup for collecting a urine sample and showed me how to collect it.
Wait
01:03 IV line Inserted
Two nurses came and put in the IV line. They were able to take some of the blood tests from this and start the IV fluids.
Wait
02:33 Decision
Based on the combination of the vitals, the history, the examination and the results of these tests, a decision is made to either observe the child in the ED, to admit the child to a ward or to send you home. The doctor came to let us know we would be admitted and that they needed to take a further blood test and give antibiotics.
Wait
02:45 Blood Cultures & Antibiotics
Two nurses came to take additional blood samples for culture, this was to check for an infection in the blood. They also gave him the first dose of antibiotics through his IV line.
The Inpatient Ward
03:20 Moved to Ward
If you are admitted to the ward, there is usually a delay whilst you wait for a bed to be made up/come available on the ward. (This is what is known as a trolley wait). For us it was the middle of the night, so the bed manager helped me to move all our stuff to the ward.
03:30 Admitted to Ward by Nursing Team
When we arrived on Maple ward, the nurse that admitted us there checked his vital signs again and asked you the whole medical story again.
Wait
03:45 Admitted to Medical Team
The admitting doctor/doctor on call came to review and admit him under the admitting consultant. We had to tell the medical story all over again and get examined again.
The medical consultant (most senior doctor) and their team of doctors that takes new patients admitted to the wards from the emergency department changes every 24hrs; they are called the "admitting team". Depending on the hospital and the diagnosis, you will either stay under their care or be transferred to another consultant.
04:11 Time to Sleep
When all the nurses and doctors had gone and hooked O up to IV fluids, it was time for me to make up my (incredible!) camp bed and get a bit of sleep.
We were lucky, after a few days of terrific care, we were discharged home with no follow up. Our overall experience was great, the whole process was so efficient, but still managed to feel safe and caring.
