A+Es seeing record numbers of children

A+Es seeing record numbers of children

A&E departments are being flooded with children with often mild fevers, creating a “winter in June” for the NHS, experts are warning.

Three royal colleges have joined forces to issue new guidance for parents worried about fevers, after seeing a large rise in the numbers seeking emergency help for conditions that are not Covid.

As lockdown eases, more children are mixing and coming into contact with viruses that are usually seen in the winter months.

These include a range of respiratory infections, bronchiolitis, paraflu and rhinovirus, all of which produce symptoms of cough, runny nose and fever.

The Royal College of Paediatrics and Child Health (RCPCH) said the conditions are usually mild, but it has heard from paediatric emergency medicine doctors around the country describing pressures on their departments from an increase in children being brought in by anxious parents.

It said many parents have not seen fever in their child – particularly if they were born during lockdown – and are taking them to A&E rather than seeking help at pharmacies, their GP, NHS 111 or online.

Dr Camilla Kingdon, president of the RCPCH, said: “Many emergency departments are currently overwhelmed and there has been a particularly steep rise in the number of young children presenting.

“Some have seen the highest ever numbers of children in their department and waiting times can be huge.

“The biggest increase we’re seeing is in children with mild fever. Fevers are very common in young children and usually aren’t serious.

“But many parents haven’t seen fever in their child before and are worried, particularly if they don’t have their usual sources of support to turn to, such as parent groups.”

One emergency paediatrician described the situation as “winter in June”, with data from four hospitals showing May attendances for those aged 15 and under rose from 15,954 in 2018 to 23,661 this year.

Dr Dan Magnus, consultant in paediatric emergency medicine at the Bristol Royal Hospital, said: “We had an incredibly busy week last week – in fact on Monday we set a new record for the number of children seen in 24hrs in our department ever, and that’s in the middle of summer.

“We are effectively running a winter-level ED (emergency department) response in the summertime.”

Dr Richard Burridge, consultant paediatrician and lead for the children’s emergency department at Watford General, said: “We’re seeing three times the number of children with fevers for early June than in 2020 – which was lower because of Covid – and twice the number of children we saw in June 2019, significantly higher than we’ve ever seen before in children’s ED.”

The RCPCH, the Royal College of Emergency Medicine (RCEM) and the Royal College of GPs have issued advice on how parents can treat children with mild fever and when to seek help.

They say that, for most children, treatment with children’s paracetamol or ibuprofen (but not both at the same time) is usually enough to reduce the fever and the child will start to feel better after a few days.

Parents should also ensure children stay hydrated by drinking clear fluids like water or squash.

Those who are concerned about fever in their child should call their GP practice or 111 outside of normal hours, or seek advice from a pharmacist.

The colleges stress that parents should always seek medical advice or take the child to A&E if:

  • The baby is under three months old and has a temperature of 38C (101F) or higher.
  • The baby is three to six months old and has a temperature of 39C (102F) or higher.
  • The child is not drinking well or is dehydrated. For a baby, this means that they are taking less than half of their normal feeds and having less than two wet nappies a day.
  • A child develops a red rash that does not fade when a glass is rolled over it, has a fit or is crying constantly and cannot be consoled or distracted. If the cry does not sound normal (such as high pitched), advice should also be sought.
  • The fever lasts for more than five days or the child is becoming more unwell.

Dr Michelle Jacobs, from the RCEM paediatric emergency medicine professional advisory group, said: “Emergency departments are currently under intense pressures, with many sites reporting record-breaking numbers of patients, crowded departments and long delays, putting patient safety at risk.

“We know there has been a sharp increase in children under five presenting.. The majority of these young children are mostly well, but with a mild fever.

“We absolutely understand and recognise that parents may be concerned, especially if their child is young and this is the first time that they have been unwell.

“But if they take their child to the emergency department there may be a long delay, potentially over four hours, before being seen, which may be difficult and distressing for both parents and children.”

Professor Martin Marshall, chair of the Royal College of GPs, said A&E is the appropriate place to take a child in an emergency but a GP, pharmacist or 111 can help if parents are worried about mild fevers.

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