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"It would save time and money and potential harm if hospitals listened to parents more."

About: Perth Children's Hospital / Emergency Department

(as a parent/guardian),

My toddler started having 39°C+ fevers on a Sunday morning. We went to their GP on the Monday. A swab was collected to be tested as the GP suspected a possible case of Influenza. Instead it came back positive for Adenovirus. We were unsure specifically what illness the Adenovirus was causing as the symptoms only involved fever, rigor, lethargy, loss of appetite and irritability. My child wasn’t getting better and on Wednesday night woke up in the middle of the night with a fever, rigor and vomiting. They were unable to keep liquids or nurofen down and because of this we were unable to treat the fever.

We contacted Health Direct for advice who advised us to go to Perth Children's Hospital (PCH). The triage nurse made a comment about how hot our little one was to the touch, they listened to my child's chest and observed the respiratory rate but didn't take their temperature. We waited for 2.5 hours in the waiting room which I understand completely as it was obviously a busy night however my baby was still feverish and we didn't have a nurse come and check in on them once during the time we were situated in the waiting room despite children around us getting checked.

My toddler was asking for a drink and getting quite distressed however the TVs in the waiting area have scrolling text that states to seek permission prior to providing your child with food or drinks, we were situated in the A+B waiting area but my spouse was unable to find anyone to ask when they got up and went searching at waiting area C reception desk. While my spouse was standing at the C reception desk they had 3 medical staff members walk past them but no one stopped to ask if my spouse was okay.

Everyone we tried to ask that came into our line of sight in the waiting room avoided eye contact. We were eventually taken through into emergency and had their obs taken. They had a temp of 39.5°C and was administered nurofen orally which was vomited straight up. I was then asked if I would be okay with them having paracetamol rectally which I consented to - while undoing the nappy I made a comment to the nurse that there had been very strong smelling nappies and my child was finding changing uncomfortable but it seemed to me I was ignored and instead the subject was changed and I was asked if I was a nurse. We were given a fluid balance sheet to complete and hydrolyte to administer, as my child was tolerating fluids with one other episode of vomiting so we were given an information sheet about Gastroenteritis by the doctor who made the comment, even though it's not gastro take this anyway and take the fluid balance sheet to follow, and we were told to continue fluids and nurofen for fever at home and go to the doctor if the fever continued past 5 days or come back to PCH if symptoms worsen or if new symptoms appeared like skin peeling.

We were then sent home without any further questioning/testing. At the hospital I had suspected a possible UTI but when I had tried to point out possible indications I don't feel I wasn't listened to and we were sent home. After over a week of being unwell, with fevers, irritability and lethargy I felt like I needed to take matters into my own hands.  I was able to get a midstream urine sample and luckily happened to have dipstick tests at home so I performed a urinalysis myself. The urinalysis showed blood in the urine and high levels of white blood cells, indicating a UTI. I took my child to Urgent Care along with the sample, where a doctor confirmed that my child had a fever and that the urine was positive for blood and white blood cells and sent it to the lab for confirmation. Finally, my child was properly diagnosed and started treatment on a strong course of antibiotics. 

I'm feeling extremely frustrated given PCH clinical guidelines on paediatric UTIs 

https://pch.health.wa.gov.au/For-health-professionals/Emergency-Department-Guidelines/Urinary-tract-infection

"The diagnosis of UTI should be considered in all febrile infants and young children, and in all infants with fever without focus."

Had this been followed, the UTI would have been picked up on the Wednesday and treatment would have been started right away. I know emergency departments get clogged up with non-emergencies and my child was a non-emergency case and they were very busy but we were referred there as indicated by Health Direct and I feel like we weren't listened to when all I was trying to do was advocate for my child. I'm also a bit annoyed/worried about the fact that not every parent has the basic medical knowledge to recognize the symptoms, capture a sample, test it and show it to a doctor so had that been the case in this situation then that child would go undiagnosed and untreated potentially causing serious complications like renal scarring.