Advice for Families Leaving before Complete Assessment

Information for parents and carers

Advice for Families Leaving before Complete Assessment – PIAG 229 (241kB pdf)

Introduction

You have decided that your child does not need urgent assessment at Alder Hey Emergency Department today.

There may be many reasons for this decision. Your child’s condition may have improved and you are no longer worried or you may have received some advice and reassurance or have been informed of an alternative service that might better suit your child’s needs.
We realise that sometimes, the wait to see an Emergency Clinician may be very long and you may decide to use another healthcare service such as 111, your GP or a Walk-in Centre.

If you are taking your child from the department please let us know as we may be able to provide you with some guidance on alternative healthcare services. If your child’s condition changes and you are concerned please do seek help urgently.

You should call 999 or take your child to the nearest Emergency Department that sees children if your child is:

Difficult to wake (lethargic) or confused
Very agitated and restless and you cannot calm them
Pale, mottled or has abnormally cold hands or feet
Blue around the lips
Too breathless to talk or feed
Using their neck muscles when breathing
Develops a rash that does not fade with pressure (Glass Test)

If your child has a fit or convulsion then you should bring them to the Emergency Department or call 999.

If you have other concerns about your child’s health please call 111 or contact your GP or local Walk-in Centre.

Useful Websites

Healthier Together
NHS website with lots of useful advice about looking after your child’s health and when to get help.
https://what0-18.nhs.uk/parentscarers

Please note, this website has been developed by colleagues in Dorset, Hampshire and the Isle of Wight. While the general information contained is correct, specific services may not be available In Cheshire and Merseyside.

When should I worry?

Booklet developed by GPs in Wales with advice and information about common childhood illnesses.
http://www.whenshouldiworry.com/resources/When%20should%20I%20worry-Booklet_England-with%20111%20service_2016.pdf
Versions are available in different languages from the website: http://www.whenshouldiworry.com/

What to do if your child is unwell

Prevent dehydration – Give small children their usual diet along with some extra fluid such as diluted squash or water. Regular small amounts given often are best. Homemade ice-lollies are a great way to stay cool and give fluid.

Where a baby or child is breastfed, the most appropriate fluid is breastmilk.
If you find any signs of dehydration such as a dry mouth or fewer wet nappies than usual, encourage your child to drink more fluids and seek further advice if you are worried.

Useful weblink: https://www.nhs.uk/conditions/dehydration/

It is not necessary to give medicines (paracetamol or ibuprofen) to treat your child’s temperature if they appear settled. But if your child has a fever and is distressed or very unwell, you can help to make them feel more comfortable by giving them either paracetamol or ibuprofen (please read the instructions on the bottle first and do not exceed the maximum daily doses). Don’t give the medicines at the same time. If your child has not improved after 1 hour, you may want to try giving the other medicine.
Do not sponge your child with water. This does not help to reduce fever.

Useful weblink: https://www.nhs.uk/conditions/fever-in-children/

The Glass Test:

Look out for a rash that does not fade with pressure using the Glass (or Tumbler) Test:
Press the side of a clear glass firmly against the skin. If you can see the spots through the glass and they do not fade then seek medical advice immediately.

On dark skin, the spots/rash can be more difficult to see – look in light skinned areas such as palms of hands and soles of feet.

Spots/rash may fade at first so keep checking
Fever with spots/rash that do not fade under pressure may be a medical emergency
A rash is not the only sign of serious illness. If someone is ill and getting worse, get medical help immediately

Check your child during the night for rashes and to see if they are getting better. If a rash appears, do the Glass test. If you are concerned that your child is not improving ring 111.
Useful weblink:
https://www.meningitisnow.org/meningitis-explained/signs-and-symptoms/glass-test/

For updates on children’s health matters and what’s going on locally follow us on Twitter @alderheyED

This leaflet only gives general information about possible signs of serious illness in children.

This leaflet only gives general information. You must always discuss the individual treatment of your child with the appropriate member of staff. Do not rely on this leaflet alone for information about your child’s treatment.

This information can be made available in other languages and formats if requested.