[Closed] When to go to A&E

glupton1976 - Member
If I use I_Ache's link to look for my nearest MIU it tells me that the closest one is Crowborough War Memorial MIU in Sussex. I live in Edinburgh....

That was my point. How can anybody in the profession lecture normal people about them going to the correct place if the NHS is giving us the wrong information.

Hmmm checked that link too and it gives me an MIU in Sussex, which admittedly is piss poor as I'm in Durham.

Plenty other avenues to find out that info though.

Judging by some of the replies and advice/crap being spouted on this thread, I'm surprised some of you make it to work on your own or are even able to wipe your own arse!

oooh what a tough guy.. I'm all of a dither 😳

It's homoerotic macho toss like that which has caused irreversible and debilitating damage to my knee..
If you've really hurt yourself, go [i]somewhere[/i] and get it checked out, especially if you're not as young as you used to be like many here..

So my local minor injury unit is [i]within[/i] my local A&E......

Dr Gray's Hospital (Within A&E Department)
Pluscarden Road, Elgin IV30 1SN
Open 24 hours seven days a week

.....so you still have to go to A&E, although NHS Grampian also say this....

TURN TO YOUR MINOR INJURIES UNIT.

If you require urgent care for a minor injury, you should attend your local Minor Injury Unit.
Most are open 24 hours a day.
You can be treated for a range of ailments including sprains, burns and simple fractures.
If your injury happened a few days ago, or if it’s an old injury that has got worse again, please turn to your GP for advice.
To find your local Minor Injury Unit click here

So if you have a sprain, you need to go to A&E...

I didn't even know about these MIUs. My nearest is apparently in Barry about 30 mins drive away from most of the population of this area, whereas the main hospital is quite handy for most of us.

Still, I'm happy to have one - a place you can just walk in, wait and get x-rayed would be fantastic.

A question for the medics then - if I go to A&E at a quiet time, and am prepared to wait until everyone with a serious issue is seen to, is it still a drain on resources?

Paladin it's a unit off the A&E you go the the hospital, book in and it's passed to triage and then they treat you in the relevant department. Many A&E departments are adding on Minor Injuries for those that turn up with small issues that can be dealt with without taking up vital resources.

A question for the medics then - if I go to A&E at a quiet time, and am prepared to wait until everyone with a serious issue is seen to, is it still a drain on resources?

Just because the waiting room is quiet does not mean they are not busy.

effing hell there is some tosh spouted on here (HORA) - go to A&E, and explaine what happened. You must get scaphoid related injuries ruled out ASAP as they can develop nasty side effects. The docs/triage nurse will not mind this. IF a walk in clinic is availble without a weeks notice use this, but make sure there is a doc who can asses fully. Scaphoid injuries cannot wait..

Most are open 24 hours a day.

Nottingham city doesn't have a minor injuries unit that is open 24 hours a day. If the provision is like that in a major city, I can't see it being great in more rural areas.

An injury sustained at 9pm that requires stitches therefore requires a trip to A&E where you sit under the condescending posters asking if you should be somewhere else as if you'd really choose to visit A&E when you had another option!

A ?scaphoid will need an x-ray, and then a cast, and then usually another x-ray, and then usually another cast because they are not sure, it could be the swelling, just to be safe... Mabe another X-ray... They really can be a pain in the arse*. For the record, I'm in the job, and from personal experience I'd go to a decent A&E, with a good book, on a weekday early morning and be relaxed about the wait. (waiting is good, means you aren't that poorly). The exception would be if the local WIC had imaging and I was confident of the quality of the clinicians working there. Either way, you will probably end up with a short arm cast and a fracture clinic referral.

Just because the waiting room is quiet does not mean they are not busy

Of course - but if they are busy, and I've got a minor or old injury, then I'll wait until they aren't busy - surely? Does me sitting in the waiting room cause extra pressure? (Genuine question, not rhetoric!)

For the record, I'm in the job, and from personal experience I'd go to a decent A&E, with a good book, on a weekday early morning and be relaxed about the wait.

That's a decent answer I think, ta.

Woody, if you are in Durham I would recommend the minor injuries unit at Shotley Bridge. Excellent.

Has he gone yet?

Is it time to call 'dibs' on his bikes yet?

Does me sitting in the waiting room cause extra pressure? (Genuine question, not rhetoric!)

Of course - but if they are busy, and I've got a minor or old injury, then I'll wait until they aren't busy - surely? Does me sitting in the waiting room cause extra pressure?

Yes, because you're still being treated instead of someone else. The staff treating you could be doing other things with that time. The money spent on the equipment/disposables used to assess and treat you could be spent on something else.

I'm not saying don't go, just saying that the idea of waiting until everything else in the hospital has been done and the staff are sitting around with nothing to do isn't very realistic.

Right, ta. I'm still concerned about my wife's foot.. probably the GP is the best option cos it's round the corner and they have good drop-in sessions, although no X-ray machine!

If I use I_Ache's link to look for my nearest MIU it tells me that the closest one is

If I search for "minor injuries unit" it (correctly) sends me to my local hospital. If I search for "MIU", it sends me to Sheffield (60 miles / an hour and a half away).

When I had suspected scaphoid isues after a monumental OTB at Stainburn I went to Otley minor injuries, got an x-ray, got to speak to a doctor who told me he thought there was nothing to worry about and I'd just sprained something but that he'd get a radiographer to call me the next day. This all took about 20mins.

The phonecall happened, the radiographer agreed, my thumbs haven't fallen off yet so all's good.

If I search for "minor injuries unit" it (correctly) sends me to my local hospital. If I search for "MIU", it sends me to Sheffield (60 miles / an hour and a half away).

The information for my local A&E (major hospital) talks about adults with minor injuries, but it's not listed under MIUs.

The latest comments on MIUs some it up perfectly:

- Many people don't know what or where they are
- The NHS don't seem to know what or where they are
- A+E departments apparently often perform this function. For historical reasons most people only know about docs or A+E so they will continue to go to 'A+E' or whatever the local trust want to window dress it as
- The lack of national strategy and coherence worries me immensely...

And for those who live in an enlightened trust who promote these services, lucky you - don't slam the other posters who like me (Kirklees+Calderdale) have the old suck-it-up/GP/NHS-direct/A+E choice.

The lack of national strategy and coherence worries me immensely

Have you seen the NHS Wales website where you search for them? Awful. And if you search on the main NHS page it redirects you to a different website that does the same thing.

Honestly - wtf?

The latest comments on MIUs some it up perfectly:

- Many people don't know what or where they are
- The NHS don't seem to know what or where they are
- A+E departments apparently often perform this function. For historical reasons most people only know about docs or A+E so they will continue to go to 'A+E' or whatever the local trust want to window dress it as
- The lack of national strategy and coherence worries me immensely...

999, 111, NHS Direct, OOH GP collectives, Walk in centres, Drop in clinics Your own GP... No wonder people are confused. So they put in place a dedicated phone line to help people to decide which health care access point is most appropriate for them and... THEY MAKE A WORSE JOB of it than letting people just make their own decision!!!! (This is a fact; its probably because they always have to make the absolute 'safest' decision for fear of litigation, coupled with not actually being able to see the patient).

You couldn't make it up.

I actually think that the whole lot should be shook up and started again; bin the 'GP' system, The A&Es, the (privately run cherry picking) walk in centres, and replace the whole lot with large primary care access departments. None of this 'ooh you've come to the wrong place' nonsense then, just turn up, let the profesional at the door stream you to the appropriate clinical setting, and you only call an ambulance to get there if you can't get there for a genuine medical reason. And the whole thing costing, say, the price of a prescription at point of contact so that people will engage their brain before costing society a fortune.

and, breathe...

+1 v8ninety

If I've a cough, fever, headache, need jabs etc then the GP (but been a bloke, more likely just roll with it).

Deep cuts/breaks/likely internal damage etc, A&E.

But then I'm old-fashion and ignore all this 'modern' thinking and bo11ocks I hear on the radio/TV.

And what is 111?

And what is 111?

If it's been a week - go to GP and ask for referral to local X-ray department missing out the overstretched A&E department altogether.

Definitely get it looked at though, because if it's borked you'll end up costing the NHS more money with the chronic pain, physio, painkillers, etc you'll need as the years of poor wrist structure take their toll.

Has there been any amputations yet?

As long people ignore advice given in the media or bollocks as BR calls it then we will always have problems because they're old fashioned and it's alway been done that way.

[i]As long people ignore advice given in the media or bollocks as BR calls it then we will always have problems because they're old fashioned and it's alway been done that way. [/i]

Mate. For those of us who don't work in the NHS all that seems to happen is change, constant change. Consequently its easier to just go to where you know you'll get treated; minor issues and questions at the GP and breaks/cuts (large) etc at A&E.

And A&E is always open, available and (for me) only 5 mins away, unlike the GP.

You want to see the changes within the NHS that public don't see. It's not difficult to follow the publications in the media that the NHS sending out, I posted one their campaigns back in the begging of the thread. Then this, Oh it's quicker for me to walk to A&E than the minor injuries is rubbish. It may well be but given that it's pretty much a 4 hour wait in A&E for minor stuff or less than 1 hour in a minor injury unit then it makes no sense. It's sad fact that that A&E are chocker full of minor stuff and I think different to V8 and believe educating the public is the way forward, I do it daily at work and all I've suggested alternatives to save A&E visits or unnecessary call outs of Ambulances have welcomed it.

I do think we need to go back to local GPs being on call though as it would ease a lot of the system.

I work as a Paramedic and get as annoyed as the next health care professional by minor stuff turning up at A&E and inappropriate 999 calls....but then i remember that it is this wonderful country full of hypochondriacs that keeps me in work!....i could work 365 days of the year such is the level of hysteria out there when a baby so much as sneezes or a granny gets a tummy ache....long may it continue, we are so risk averse in this country that i am never going to be short of a pretty penny and if some numpty wants me to reassure them that the achey knee they've had for 3 weeks isnt going to kill them then i'll go into automatic pilot, think of the money and enjoy the cup of tea i'll no doubt have made for me whil i do it!

I rode into a tree. I mashed my thumb back, should I have gone to minor injuries or A + E ?
It definatly needed an X ray , and i was almost certain either it was broken ,or I had snapped the tendons again.
sunday afternoon so was expecting a long wait, Triage in 10 mins, doc in 45 mins, then X ray and on way home in 2hrs. Nothing broken.
Week later letter arrives.
You have a fracture in your thumb, please come back to fracture clinic.
I attend fracture clinic and see a knee specialist. Make new appt for hand specialist. Who sends me home with a ' wait for an ultrasound appoitment' There is a 2 week wait for ultrasound appoitments, then I have to make another appoitment to see hand lady doctor. again.
Maybe if i had gone to MIU and not accidenté I might have some idea what is broken ,or not.

I'm Ambo, and I think all this a&e vs minor injuries vs walk in centre stuff is daft and confusing to the public. Just go where is most convienient, and looks quietest. You'll be triaged and seen in order of need. If you can, choose a quiet time; but don't get stressed about waiting, it's a good sign. Even the biggest major trauma centre is perfectly willing and capable of seeing and treating a minor sprain or fracture. It's kind of their bread and butter, and trust me, you won't be stopping the consultant ortho on call from seeing his multi system trauma alert patient more quickly, because you'll most likely be seen by a very competent Nurse Practitioner or a house officer or senior on their A&E rotation. It's all good, and no one minds.

EDIT; there are plenty of people who take the Micky out of A&E hospitality; minor isolated limb injury patients (especially self presenters) are not amongst them, IMHO.

When to go to A&E
111 posts & 49 voices

@docrobster, 😆 good spot!

I crashed at a SITS on the first corner of the first lap, really hurt my thumb, it was agonious for the entire race and for several days, so I went into A&E just to get a medical opinion. I remember it being very quiet, they had a prod and decided it was just hurt. No hint of any resentment or timewasting accusations, it was all smiles.

I also went in for a bandage and an opinion after what was for me a fairly bad crash at Cwmcarn. I was worried I was timewasting, but they all went "oooh!" when I showed them the injuries. I can't imagine why, they must get far far worse. I think that was the time a 10 year old girl came in having stuck a garden fork clean both wellie and foot.. that got some comedy reactions from everyone.

it was agonious

My one recent(ish) experience was very positive. MrsSweam2 fell off in the chilterns and wrist was damaged. Phoned up (can't remember if it was 999 or NHS Direct; think it was NHSDirect) and was given directions to Minor Injuries Unit in High Wycombe (including Sat Nav post-code). Seen within an hour including x-rays and doctor worried that wrist might need pinning a.s.a.p. Living in Hounslow so was told best to get into the system for after care at Houslow A+E so drove from High Wycombe to Hounslow. Arrived at Hounslow A+E expecting a huge wait and to be at the back of the queue only to discover all the x-rays had been sent to the relevant department from the MIU and surgeon called us within the hour straight into surgery.

It's sad fact that that A&E are chocker full of minor stuff

I think we must just be very very lucky in the three hospitals that my family routinely uses..
To be fair though, we only go to the hospital when neccesary, so tend to be dealt with pretty promptly

Ninja edit, I was going to pull you up on using them routinely.

😛

Drac - Moderator
Paladin it's a unit off the A&E you go the the hospital, book in and it's passed to triage and then they treat you in the relevant department. Many A&E departments are adding on Minor Injuries for those that turn up with small issues that can be dealt with without taking up vital resources

So minor injuries department and A&E are seperate departments who both use the same Reception and waiting room which you access via a door with A&E above it...

I don't really get it

No not necessarily.

So minor injuries department and A&E are seperate departments who both use the same Reception and waiting room which you access via a door with A&E above it...

.....but in some places it would seem to be!

Little wonder folk are unsure/confused

Well yes in some places it is but why is it confusing, hospitals have many departments. You report to the reception yes and then you get allocated to right department not hard to comprehend really is it. It's also not daft as it means there's staff dedicated to minors and others to more serious meaning. All very simple.

v8ninety - Member
So minor injuries department and A&E are seperate departments who both use the same Reception and waiting room which you access via a door with A&E above it...

Depends entirely on the hospital. Don't let it worry you, just present yourself at reception and you'll get pointed in the right direction. It is daft though

It doesn't worry me, it annoys me though when folk harp on about people goin to the wrong place or unnecessarily using A&E when it is not always so clear-cut.

In some places, sprain your wrist, you go to A&E. Other places you go elsewhere.

oooh what a tough guy.. I'm all of a dither
It's homoerotic macho toss like that which has caused irreversible and debilitating damage to my knee..

Neil the wheel
I'm at MIU SBH on a regular basis and will refrain from commenting. Glad you are happy with the service.

I think you might have some issues there yunki (homoerotic???? ) and completely misunderstood my reasoning behind the post.

right on all counts 😀

....probably

sorry 😳

So.... Having worked in (actually - I still work there from time to time...!) one of the largest EDs (emergency department) in the south, this is my take on 'it'...

I would say that ED/A&E is now really the place for what I would call medical or trauma emergencies - strokes, heart attacks, severe abdominal pains, major trauma, stabbings, fits, dying kids, and the like. The sort of thing urgent blood tests and scans and immediate medical treatments might be required for. The other thing these departments usually have over the others is [b]Doctors[/b] - this is to say, these departments are likely to be best suited for 'non protocol' medical problems.
However, the larger departments will also have 'minor' areas, which are basically MIU but through other doors...

MIUs are a fairly newish idea - they can deal with things you are unlikely to die from - a broken bone, a moderate cut, a sprain. These are often staffed by only nurses/health care staff, though can have doctors. If you need urgent medication (beyond, I suppose, simple antibiotics) then they aren't suited.

There are also 'walk in centres', which are a combo of GP/MIU departments.

The GP will usually deal with chronic physical and mental health issues, but also deals with acute medical problems that are not obviously life threatening. If it appears life threatening, we usually arrange direct admission, or send to A&E for urgent medical treatment.
We also deal with musculoskeletal issues such as chronic pains, sprains, and other joint problems. If we feel you need an XR then we can request, but if we think you've clearly broken a bone, we will forward on to MIU as the XR units we use generally don't photo requests if we suspect a fracture. This is because the image isn't looked at for a few days.

However, as many of you point out, at the face of all this are [b]Humans[/b], who have different levels of training skill, and caring.
If you go to an MiU you [b]Are[/b]More likely to get an XR because when following a pathway/protocol, the system is often very risk averse I.e. you are more likely to get 'over investigated', but this isn't always best.

DrP

We had a wonderful queue of ambulances stacked outside of our a&e at the weekend, but since it appears we may explode in the next 6 months i guess that's the least of my worries. In truth, we did get those who needed us most through as quickly as we could, and everyone else just had to wait. Personally, i don't care who i treat at work; be it proper serious or repeat time waster. I won't show huge interest in you, other than the medicine, it's not casualty or holby. But i get paid to respectfully patch up punters, and that's what i do to the best of my ability.

[img] [/img]

UPDATE: It is not sorted.

Phoned GP and spoke to receptionist who advised I go down to A&E. I was a bit unsure that she understood the accident had happened a week or so back.

Thought I'd try the MIU/walk in centre route first. Went down there waited for 20 minutes was assessed and assessor agreed I need an X-Ray. BUT for some reason I do not understand he cannot analyse the X-Ray, my GP has to do this.

He phoned GP to ask them to give me a radiology referral which the receptionist agreed to I was then all set to go to radiology this afternoon.

Ten minutes ago my GP phoned. He is not happy with all of this or me for going to the walk in centre. I have to go and see him at 3pm to get the referral done proper. He told me that A&E would not see me if the injury had been done more than 72 hours previously.

Now I am sure that I've been an utter hampton in all of this. The upside is I've done loads of extra exercise through walking around the place. But I feel I've cost the NHS more than if I'd simply bumbled into A&E in the first place.

To make matters worse, today is my wife's birthday. We've been married 17 years and together for 20. How the f***k could I have forgotten it?

I think ^ explains a lot.

[i]How the f***k could I have forgotten it? [/i]

possible broken bone is going to be the least of your worries (quite rightly!).

My GP has referred me to a local x-ray centre for bike related injuries a couple of times. It's just a drop in place and you get seen pretty much the day of the referral and they do tend to give a 'well it looks alright but a radiologist will have a look and confirm' verdict on the spot.

So, lots of faffing and the total acheived is the square root of bugger all!

Sounds like when I broke my ankle:

Walk in centre - Go to A&E now
A&E - pah, tis but a strain, couple of weeks and it'll be OK (no X-ray)
GP 3 months later (still buggered ankle!) - Hmm, probably physio, but have an X-ray just in case, it's not broken, but the physio will want a picture
X-Ray dept - Hmm, we'll put this through as an urgent referral, the fracture clinic will deal with you directly - go home, you'll hear from us
Week goes by and ends up with Mrs Feet creating a scene in docs, get an appointment
GP - it's broken, you need to go to the fracture clinic - phone for an appointment
Fracture clinic (couple of days later) - it's broken in 3 places, but luckily for you it's all setting back in the right place - physio for you

I knew it bloody hurt!

^^^^^^^

Sounds Familiar with Royal Blackburn A&E.

Me: I think I've torn my Knee Ligaments again, especially the lateral side.
A&E: We will X Ray your Tibia
Radiologist: Doesn't seem like anythings broke.
A&E: Just a Sprain heres Some pain Killers, try not to walk on it for a couple of days.

Gp two weeks later, its still hurting. Does a Valgus stress test, Right Urgent MRI Referal.
Week Later MRI scan done. Few days after results.
Proximal Fibula Fracture, LCL, ACL and MCL all Partially torn. Cartilage partially torn.

See Fracture clinic, it seems to be healing but you will need Physio.

12 weeks later I think Im ready to go back to work. Still have a very wobbly knee and a Throbbing ache where my Fibula head is. So we shall see what happens when i go back to work.

The OP has gone very quiet since admitting to forgetting his wife's birthday...