dulwich medical centre refuse to see a 4 year old child that was stung by a bee

[lilolil]

Dulwich medical centre have just refused to treat a 4 year old child that had been stung by a bee.Advice given was to take the child to A&E.

This has just been followed up by the admin officer coming to say that one of our first aiders should have been able to deal with it.

It was the opinion of our first aiders that because the surgery was next door, we should go there first to get the fastest treatment.

My acting manager was shocked by the manner in which the admin officer spoke to members of staff in the presence of children

[Pickle]

That's really bad, it's quick action that's needed in those cases, not faffing about trying to get to A&E :(

We are registered there, but have pretty much given up hope of ever being seen when required. It's very frustrating, as they used to be great 9/10 years ago when we first registered there.

[Sue]

Just need to remove the bee sting and take an antihistamine?

Unless the child has a known bad reaction to bee stings, in which case the parents would be aware and carry the necessary items?

There is a pharmacy within five minutes walk of DMC (North Cross Road) who would have been able to advise. I am surprised that anybody thought it was a suitable thing to try to get emergency treatment from a GP surgery for. Where would it end if everybody did that? Even longer waiting times for booked appointments while the GPs (or nurses) dealt with minor issues.

Sorry if that sounds harsh.

ETA: And I'm surprised the advice was to go to A&E. A bee sting is hardly an emergency is it, unless the child is clearly having a bad reaction to it eg abnormal swelling up and airways blocked, which would be a 999 call rather than a trip to A&E I'd have thought.

[JohnL]

Sue Wrote:

-------------------------------------------------------

> Just need to remove the bee sting and take an

> antihistamine?

>

> Unless the child has a known bad reaction to bee

> stings, in which case the parents would be aware

> and carry the necessary items?

>

> There is a pharmacy within five minutes walk of

> DMC (North Cross Road) who would have been able to

> advise. I am surprised that anybody thought it was

> a suitable thing to try to get emergency treatment

> from a GP surgery for. Where would it end if

> everybody did that? Even longer waiting times

> for booked appointments while the GPs (or nurses)

> dealt with minor issues.

>

> Sorry if that sounds harsh.

>

> ETA: And I'm surprised the advice was to go to

> A&E. A bee sting is hardly an emergency is it,

> unless the child is clearly having a bad reaction

> to it eg abnormal swelling up and airways blocked,

> which would be a 999 call rather than a trip to

> A&E I'd have thought.

It's vinegar or lemon or bicarb not sure which - I'll try one next time

I just read WD40 for bee stings works wonders - surely not.

[Carmen22]

I

[jimbo1964]

I don't think I'd put WD40 on a child's (or anyone's) skin. Sue's right. I'm no fan of the DMC but a bee sting is hardly an emergency medical case in most instances.

[keekybreeks]

so we have a situation where a parent is concerned, yet the consensus from the forum stasi - all medically trained of course- that the parent should *man up* and deal with it?

Am I missing something here

Any other tips - wine vinegar will cure your cancer? crystals will sort out your lumbago? how about a course of homeopathy to fix your diabetes?

[Blah Blah]

Well to be fair, most people do not need medical treatment for bee stings apart from the advice given above. In rare occasions an allergic reaction can occur, and it is very obvious when it does, and that is a 999 call. So I'm with the forum stasi here and I AM medically trained.

Edited to add that only 0.8% of stings lead to anaphylaxis and 3% to allergic reaction. So no medical treatment is needed in at least 97% of cases.

[Cora]

But in another thread it is stated that the child had 'A mild allergy to bee stings and Lips and tongue that were tingling slightly' - they were caring for the child and I would definately expect them to get the nearest medical advice immediately, which luckily (or unluckily in their case) was a Drs surgery next door. The Drs should be better placed to decide if it was likely to turn into an emergency or not. Surely a better use of resources to get emergency advice from a nearby Dr before calling an ambulance? If I was in the same situation and was refused a Dr I would call an ambulance - I would not take the risk. This is about an allergy to bee stings not a bee sting per se.

[Blah Blah]

An allergic reaction can only be properly assessed at a hospital to be fair, so the advice of the GP was correct in my opinion.

[DulwichFox]

Yes with a young child who has never been stung before there is no way to tell if a bad reaction

is likely.. Need to be in a place that can deal with any situation that may develop.

Kings A&E only 10 - 15 mins away on a bus.

Some Antihistamines may not be suitable for young children. So professioanal advice is always best.

DulwichFox

[lilolil]

It was not the GP who saw him but the receptionist.

He was not seen by a nurse or GP as this was refused.

It would have taken a matter of minutes for someone medically trained to see a little boy who was trembling and upset. The sting was no longer in his hand.

As far as I can remember, he has a medical condition where if he gets too hot and agitated, he suffers from seizures. This, together with the fact that he was experiencing mild tingling was ignored.

I felt sorry for the Mother who only wanted some reassurance.

[Blah Blah]

Given the medical history of the boy, A & E was the sensible option. To criticise a GP Surgery that gave you the correct advice is unfair. They didn't ignore the child. They correctly told you yo go to A & E.

Also fox, many people are allergic to antihistamines, so they should never be prescribed by anyone but a qualified doctor.

[lilolil]

Even though the doctors was next door??

I would have thought that you would go to the nearest point to get help.

Obviously we have different opinions, but if it was my own child, I would have done the same thing.

[keekybreeks]

lilolil Wrote:

-------------------------------------------------------

> It was not the GP who saw him but the

> receptionist.

>

> He was not seen by a nurse or GP as this was

> refused.

>

> It would have taken a matter of minutes for

> someone medically trained to see a little boy who

> was trembling and upset. The sting was no longer

> in his hand.

>

> As far as I can remember, he has a medical

> condition where if he gets too hot and agitated,

> he suffers from seizures. This, together with the

> fact that he was experiencing mild tingling was

> ignored.

>

> I felt sorry for the Mother who only wanted some

> reassurance.

ignore them. you are right on this.too much oneupmanhip and cock waving going on in the fourm to take most responses seriously.

[Blah Blah]

kbeaks, the issue here is of procedure, so your trolling is misplaced here. Allergic reactions in anything are often a hospital referral for young children, because there they have the equipment to deal with a sudden deterioration. A GP surgery does not. I am sure that if a doctor had looked at the child the advice would have been the same, because apart from monitoring heart rate, temperature and blood pressure, there is little a GP can do in the scenario of a deterioriation. Allergy to bee stings is rare, but can be serious. As a medical professional I think the advice was correct.

I'm not criticising your actions lilo, your concern was naturally for the child, and to get treatment as quickly as possible, and no-one can criticise that. But GP practices are not the same as a hospital A and E. You went there, rightly so and were advised to go to A and E. So you were given advice and correctly so imo. Receptionists are not doctors but they do have a lot of experience in directing patient care. Let's put it this way. If the bee sting had descended into anaphylaxis, or some other complication - the time wasted trying to get a doctor to look at the child instead of calling an ambulance could have made a difference. And Kings does fast track children through A and E too. They would much rather see a false alarm than see a child suffer because they didn't get the right treatment quickly enough.

[keekybreeks]

fuck it.

[KidKruger]

If DMC gave the correct advice, they're due an apology for the criticism they've received in this instance.

[Alex K]

Blah Blah, you surprise me. No "crash cart" at a GP surgery? "Little a GP can do in case of a deterioration" -- intubate the airway, start a drip for administration of inotropes, surely? Can it be that a GP surgery is not equipped with a laryngoscope, endotracheal tube, manual-ventilation equipment...?

Minor surgery is undertaken at GPs' hands routinely. GPs would be sorely remiss not to be able to intervene in case of an adverse reaction to an anaesthetic (even a topical anaesthetic).

If DMC have no such equipment on hand, all the more reason to stay away from them.

[Blah Blah]

But those cases would still require transfer to a hospital Alex. And minor surgery is not routine at GP surgeries either. Pretty much all surgery, even the minor stuff is referred to specialist out patient centres. GP surgeries are not A and E. In an obvious emergency, any doctor would come to the aid of a patient, but this was not the case here.

[JohnL]

Off NHS website

"Dial 999 to request an ambulance if you have swelling or itching anywhere else on your body after being bitten or stung, or if you're wheezing or have difficulty swallowing. You'll need emergency medical treatment."

So what they are saying is monitor carefully and if any signs happen - dial 999. If I found multiple stings on a child I'd ring 999 as well.

http://www.nhs.uk/Conditions/Bites-insect/Pages/Symptoms.aspx

[Mumofone]

Alex K Wrote:

-------------------------------------------------------

> Blah Blah, you surprise me. No "crash cart" at a

> GP surgery? "Little a GP can do in case of a

> deterioration" -- intubate the airway, start a

> drip for administration of inotropes, surely? Can

> it be that a GP surgery is not equipped with a

> laryngoscope, endotracheal tube,

> manual-ventilation equipment...?

>

> Minor surgery is undertaken at GPs' hands

> routinely. GPs would be sorely remiss not to be

> able to intervene in case of an adverse reaction

> to an anaesthetic (even a topical anaesthetic).

>

> If DMC have no such equipment on hand, all the

> more reason to stay away from them.

Not to defend DMC as for the most part I think the way the practice is run is rubbish BUT...

You would be hard pushed to find any GP practice that had any of that equipment to hand - or GPs with up to date training to to use it! Best is some oxygen and basic life support ie CPR.