Hi all!
We are just driving down the A1 and saw a sign for Northumbria Hospital that has an A&E and another hospital that has no A&E.
This randomly reminded me about an episode of 24 hours in A&E where a lad walked in with a knife in his head… So my question is what happens if an actual emergency walks into / is deposited into a hospital with no A&E?
34 comments
You get sent to a hospital with an A&E?
They ring an ambulance to try and get them to the correct one
I imagine they would provide first aid and call an ambulance to take you to where you should be going.
Exactly what you would do in the community. Do whatever you can to keep the patient alive until someone can take over.
In this case call an ambulance for a transfer to another hospital with an A&E, and while you’re waiting for them to arrive, do whatever needs to be done to try to keep them alive.
I think the medical staff would do their best to keep the patient stable until an ambulance could come to take the patient to A&E?
They just have to deal with it as best as they can until (depending on the severity of the emergency) something like a helicopter can arrive to help out. I know a dentist in London who had to medically manage a man with a gunshot wound because he was the closest clinic of any kind
You get told to move your ass quickly to an A&E hospital. A relative insisted they were fine a few months ago after a bad accident. After being repeatedly told to go checked out by everyone, they decided to go to their nearest hospital that was without an A&E department. They were not fine. Thankfully they are now.
Depending on the severity they would direct you to one with A&E or ambulance you there
So I once went to a hospital like that after I smashed my face on my mountain bike. There was “only” a nurse on duty, she cleaned me up the best she could and sent me to the nearest A&E.
They wouldn’t have the facilities to treat you, so would send you to a hospital that does have an A&E department. Without the appropriate staff or equipment, there’s not much else they could do, except maybe call an ambulance depending on your condition.
I’d imagine they’d help as much as they could with what and who they had available, but I know my nearest small hospital doesn’t have any nurses in the minor injuries department after 8pm. They won’t even give stitches, so I doubt they’re equipped for anything major even if it was during opening hours.
I was on holiday and needed to get to hospital. No idea where the nearest a & e was so my frantic dad asked the locals who sent him to the nearest hospital. They then directed us to the correct place which thankfully was only 10 mins away (apparently, I’d passed out by this point so dont know if my dad just told me that to try and reassure me!) I would hope if there wasnt a close by a & e, the first hospital would have offered some first aid!
They would attempt to keep the patient alive whilst arranging for transport to a suitable hospital. They will most likely have a resus trolley available and do their best until the ambulance arrives.
In this scenario I would argue that if you’re conscious, coherent, mobile and not bleeding all over the floor it doesn’t count as an emergency.
Same thing that happens to the patients already in that hospital. If their condition decorates or something goes wrong they call an ambulance to move you to the nearest A&E.
I know a fella who had a heart attack in the Spire hospital car park while visiting his wife there.
Staff stabilised him and provided immediate first aid whilst calling an ambulance to arrange transport to the main hospital.
It’s not exactly the same scenario but I spent some time in various psychiatric wards where there was fairly regularly A&E type injuries.
I remember one which was on a large hospital campus but right at the other end from where the A&E was. A bloke slit his wrists and basically, the staff did nothing. I called 999 and an ambulance came in the usual fashion and a couple of us did what we could naively to halt the blood loss but unfortunately the poor fellow died.
I imagine at any non A&E place, they would similarly call 999. Same with e.g. at a GP surgery. I’d expect someone to offer first aid in the meanwhile.
We had an emergency and got an urgent care unit without A&E next door. They planted us in waiting room and told us to either drive ourselves to A&E or wait two hours for an ambulance.
A relative of mine was shot and went to a non a&e hospital in the first instance… they tried to stabilise him and blue light drove him in an ambulance to an a&e hospital for further treatment.
I’ve been in this situation. I work in a psychiatric hospital, and we got a buzz in the middle of the night by someone saying his back was in terrible pain. I had to say “I’m sorry, we are a psychiatric hospital. All we have is psychiatric nurses.” I just had to guide him towards the nearest hospital with an A&E.
Our town hospital isn’t an a&e out of hours but has a GP clinic covering, I took my wife there for a late night prescription as she was getting unwell, anyway she collapsed so the doctor tells me to sort out an ambulance.
So I rang 999 to ask for priority ambulance from hospital a to hospital b with an a&e. The call handler warned me that prank calls are serious.
I still had to flag the ambulance down.
Other answers cover the general case well, but in this specific case, you’d be OK
I suspect the two hospitals you saw signs for are Wansbeck (which has ED) and Cramlington (which does not) – I live less than a mile from Cramlington hospital.
Cramlington is the specialist emergency hospital – they don’t take walk-ins but if you get picked up by paramedics, that’s where the ambulance is likely taking you.
They aren’t supposed to take anybody except by ambulance transfer or 111 referral (if you live nearby and decide not wait for the van), but if you walk in with a knife in your skull you’re already in the best place in the area. If you went to ED at Wansbeck they’d be trying to stabilise you then get you down to crammy anyway.
It really depends on the hospital.
My mum unfortunately went to MIU with blood pressure of over 210. She was seen promptly as there’s a cardiology ward there and they dealt with all her treatment.
Likewise my father has severe urology issues and he’s gone there as a medical emergency as not been able to urinate and they’ve promptly sent him to the urology ward and had a catheter put in to drain his bladder.
In other cases, they’ve called an ambulance to ferry you straight to a&e.
My local miu has everything a normal a&e hospital has from operating theatres to all the major specialists.
What it can’t deal with though is train wreck cases needed major trauma responses or immediate surgery as not all specialists are available at a given time. For example, even though it has all of the departments, there isn’t always a on call surgeon or consultant available at all times. A lot of is largely run by extremely brilliant senior and advanced nurses and doctors for the biggest part of the day with consultants and surgeons only doing day hours.
Still though, MIU is my first port of call if I need to go into hospital as you can get rapidly triaged, if you’re lucky there’s a person available that can deal with you, if not, there’s a lovely fast track letter you can take straight to the surgical assessment unit at a&e to bypass the a&e waiting room. It’s all about going through the correct steps to avoid a&e if you can.
My health board is pretty good though at turning people away from a&e and redirecting to miu for gp services and minor injuries.
They’ll call an ambulance to take them where they can be seen.
If you walk in they’ll tell you to go to the hospital with the A&E. I know this because when I was a teenager my mother rushed me to the nearest hospital who didn’t have an A&E department (she didn’t know that) and they sent us to the big hospital the next town over. About a 10/15 minute drive further.
However, I don’t think any ambulance would take someone to a hospital that couldn’t administer aid. If an ambulance has been called, they’re taking you where you need to go and that means in most cases bypassing A&E anyway. When they blue lighted me several years ago I was taken from the ambulance straight to a room labelled “resuscitation” which was hardly reassuring let me tell you.
When I went in to the urgent care hospital for a cyst on my leg that was looking pretty nasty they also told me to go to the A&E hospital. Took one look and went “nah that’s not something we can deal with.”. They did ring ahead though and let them know we were coming. Turned out it had gone septic and I was admitted pretty quick.
So yeah, they send you to the bigger hospital. If you have a car/someone can drive you then they prefer that.
Depends on the emergency.
But they probably treat as well as they can to stabilise an emergency case whilst getting an ambulance for them.
If it’s just urgent (say a bad cut that isn’t life threatening/life altering/would have you wait at A&E anyway) they might stablise your injury and direct you to A&E / Urgent Care / Minor Injuries.
They will be able to do first aid (and advanced first aid at that…) and should be able to provide clear and accurate information to 999 whilst doing so.
Taking your knife example, they’d bandage the injury, immobilise the knife, and call an ambulance, not necessarily in that order. They’d also be looking to have the patient sit down and stay calm and still.
I have worked at a hospital that has no A&E but people will still turn up in extremis (seizures, floppy babies). We provide first aid as best we can and dial 999 and pray
I once tripped and fell right outside a private hospital (with no A&E)
Luckily there were staff who saw me and rushed over to help. They put me in a wheelchair and took me inside to an examination room. They checked me over, gave me basic first aid. Then called an ambulance (they were worried that I hit my head and might have concussion)
The ambulance arrived and took me to a different hospital with A&E. Luckily I was all fine (no concussion) but very grateful that the staff took good care of me and made sure I was properly checked out at A&E.
The entire time I was worried that I would receive a bill in the post from the private hospital. But fortunately I didn’t. The hospital has a duty of care to offer basic first aid just like any other business. And the staff just wanted to make sure I was ok.
We have a local hospital like this – minor injuries but no a&e. My sister was taken there once after a fall from a horse. They put her in a neck brace and called an ambulance. The slight downside to this was that the hospital was 15 miles from the ambulance station, which was 20 miles from the hospital, so was a 70 mile, 3-4 hour round trip for the ambulance, so as there were medical staff there and crew changeover was just under an hour away, they waited for that before dispatching the ambulance (I still want to know why they couldn’t have picked her up and then done a quick stop for the crew change en route to the hospital!). If the call had been made from the riding school, they would have been sent straight away.
They call an ambulance, if they put you in a taxi they have to discharge you, which they won’t do if you still actively need care. Going by ambulance keeps the continuity of care.
I’m a paramedic and I’ve been called to a hospital to help with a cardiac arrest which was quite odd
It has happened to me before, I walked into the out of hours clinic at one hospital (where I had been told to go by 111) the doctor there took one look at me & called 999. An ambulance blue lighted me to the closest hospital with an A&E & admission capabilities.
Many small hospitals are only open for outpatient appointments during office hours so you’d be lucky to find anyone but the cleaners.
You’ve had answers, but it also depends what sort of hospital – if it was Northgate Hospital you saw signs for, this is a psychiatric hospital so probably even less equipped than a regular community or private hospital
Someone turned up to Moorfields eye hospital a few years ago with their hand cut off. They were stabilised and sent to St Thomas a&e.
I used to work in a hospital that had a clear sign saying no A+E, but the area was very touristy, so locals knew to go to the nearest district hospital, but tourists.
It depended completely on the situation. If the patient was stable enough to go with family, we would direct them to the nearest hospital.
If not, we would phone an ambulance and do what we could to keep them comfortable.
In the event of an absolute emergency, I.e a patient having severe pain or had a cardiac arrest , we would act in line with emergency protocol and get the defibs ready. We were a hospital for patients undergoing rehabilitation, but we still had basic emergency equipment such as a defibrillator.
I once turned up to minor injuries after injuring my head. A& E felt like overkill. I was a tad sore but otherwise ok
I mentioned that I had no idea whether I should be here or A&E to which I was told they can send me to A&E if I need to be there