The top 10 conditions A&E risk missing in winter onslaught

Winter is closing in and the additional pressures of the cold weather, viruses and flu will have an impact on all A&E departments across the UK.

In the lead up to last Christmas (2014), the country’s A&E units saw an unprecedented peak of 446,473 attendances and throughout the winter emergency departments came close to breaking point.

The winter strain on already busy, underfunded and short staffed emergency units inevitably lead to errors and missed diagnosis. A&E staff also need to communicate with often intoxicated patients (alcohol and drugs) or sometimes people with learning difficulties, which can lead to ‘missed’ conditions in a high pressure environment.

As the country heads into winter, we are warning of the top 10 conditions that can be missed in an overstretched and busy A&E department.

Spinal injury caused by compression – Cauda equina syndrome involves pressure and swelling on the nerves at the end of the spinal cord and can result in paralysis, double incontinence and other neurological and physical problems. There is a window of 24 to 48 hours in which surgery must take place to avoid permanent damage. The syndrome is extremely rare, and medical professionals often dismiss cauda equina and diagnose back pain.

Appendicitis – Appendicitis is a painful swelling of the appendix, a small pouch connected to the large intestine. If allowed to rupture it can cause a serious infection known as peritonitis, which is life-threatening. Classic symptoms including a stomach ache, fever and pains along one side of the body but the condition has been misdiagnosis as constipation, flu and stomach bug.

Heart attacks – Heart attacks happen when the blood supply to the heart muscle is severely reduced or stopped. Most heart attacks start slowly, with only mild pain or discomfort and symptoms are confused with indigestion, heartburn or a chest infection. Guidelines and procedures mean that it is unacceptable for a doctor or nurse to determine that the patient with chest pain is not having a heart attack and send them home.

Hip joint fracture – Fractured neck of femur is cracks or breaks at the top of the thigh bone close to the hip joint. Then can occur after physical trauma, usually a fall but can be caused by a history of long-distance running or simply a sudden increase in physical activity. Patients may only complain of vague hip, groin or knee pain but it can have a life changing effect on mobility if left untreated. Inexperienced medical professionals often misread X-rays and a full diagnosis often requires a CT or MRI scan.

Wrist fracture – Scaphoid fractures are usually caused by a fall on to an outstretched hand. The scaphoid bone is found in the hand around the area of the wrist. Standard X-rays may not pick up all scaphoid fractures and a CT or MRI scan may be required. If not recognised and treated, painful and debilitating complications can develop.


Hand injury – Flexor tendon injuries and nerve injuries in the hand are caused by a deep cut or if the finger are pulled violently so the tendons detach from the bone. A patient will experience tenderness, inflammation, swelling or numbness in the hand, and damaged tendons require emergency surgery within 24 hours for a successful recovery. A missed flexor injury or any delay may result in long term disability in the hand.

Brain bleed – A subarachnoid haemorrhage is a type of stroke caused by bleeding on the surface of the brain. It can lead to serious brain injuries and death. The main symptom is a sudden and painful headache. Other symptoms include a stiff neck, vomiting, light sensitivity, blurred or double vision, seizures or unconsciousness. If a patient shows signs of a suspected subarachnoid haemorrhage an urgent CT scan is required to check for bleeding around the brain.

Build-up of blood in the skull – Intracranial bleeds within the skull following a physical trauma – such as a traffic accident, fall or sport’s concussion – can be missed because they can occur after even minor head traumas. The build-up of blood from the ruptured blood vessels causes pressure on the brain tissue or limits its blood supply. The condition can result in a severe brain injury or death if not diagnosed quickly with a CT scan and treated.

Blood clot – A pulmonary embolism usually happens when a blood clot called a deep vein thrombosis (DVT), often in the leg, travels to the lungs and blocks a blood vessel. Usually associated with age and inactivity, a DVT needs careful diagnosis and lives can be saved if found early and treated properly.

Rupture of main blood vessel – An aortic aneurysms and an aortic dissection can lead to a rupture in the largest blood vessel in the body, the aorta. It carries blood from the heart to the major organs. If a rupture occurs, it is life threatening. Symptoms vary widely from limb paralysis to back and neck pain and the conditions are sometimes misdiagnosed as a stroke. A CT scan will reveal both conditions and emergency surgery is usually required.

The aftermath of clinical negligence can be devastating and expert support is necessary because clinical negligence is complicated. Compensation is important in cases of clinical negligence because it can help assist with rehabilitation, adaptations of the home and car, purchasing aids and equipment, care and assistance, cover loss of earnings, and private medical treatment.

Contact us on 0800 230 0573 to speak to our Clinical Negligence specialists.


What is World Sepsis Day?

This week is the annual World Sepsis Day (13th September) with the hope that the event would raise awareness of this serious infection, which is said to be responsible for thousands of deaths in the UK annually.

Sepsis is a potentially life-threatening condition triggered by an infection. It is the most common cause of death from infection despite advances in medicine. Sepsis is normally caused by an infection such as pneumonia or flu. Notably, some people are more susceptible to developing sepsis than others, for instance the elderly, young or individuals who have undergone surgical procedures.

In sepsis, the body’s immune system goes into overdrive following an infection, which can lead to damage of tissue and organs. It can cause inflammation, swelling and blood clotting. This can lead to a significant drop in blood pressure, which means the blood supply to vital organs such as the brain, heart and kidneys is reduced. If sepsis is not treated in a timely manner, it can lead to organ failure and even death. It is estimated that, in the UK, more than 100,000 people are admitted to hospital with sepsis and around 37,000 will be fatal cases.

Symptoms of sepsis

There are a number of common symptoms that are visible during the early stages of sepsis and these include:

  • High temperature
  • Shivering
  • Rapid heartbeat
  • Rapid breathing

In cases of more severe sepsis symptoms may include:

  • Feeling dizzy or faint
  • Confusion or disorientation
  • Nausea and vomiting
  • Diarrhoea
  • Cold, clammy and pale or mottled skin


An early diagnosis of sepsis is essential in order to obtain the correct treatment. It is claimed that around 13,000 lives could be saved each year by better treatment methods. Treatment of sepsis varies depending on the site and cause of the initial infection, the organs affected and the extent of any damage.

If your sepsis is detected at an early stage and has not affected your vital organs then it is possible to receive treatment at home by way of antibiotics. Most people will make a full recovery from sepsis following this.

If the sepsis is severe or you develop septic shock (when your blood pressure drops to a dangerously low level), you will need emergency hospital treatment and may require admission to an intensive care unit (ICU). ICUs are able to support any affected body functions, such as breathing or blood circulation, while the medical staff focus on treating the infection.

As a result of problems with vital organs, people with severe sepsis are likely to be very ill and up to four in every 10 people with the condition will die. Septic shock is even more serious, with an estimated six in every 10 cases proving fatal.

However, if identified and treated quickly, sepsis is treatable and in most cases leads to full recovery with no lasting problems.

Management of sepsis

Management of sepsis after admission to hospital is popularly known as the ‘sepsis six’. This involves six elements, three treatments and three tests, which should be initiated by the medical team within an hour of diagnosis.


  • Giving antibiotics
  • Giving fluids intravenously
  • Giving oxygen if levels are low


  • Taking blood cultures to identify the type of bacteria causing sepsis
  • Taking a blood sample to assess the severity of sepsis
  • Monitoring your urine output to assess severity and kidney function

How we can help

At the Serious Injury Helpline, we understand the impact a sepsis diagnosis can have on patients and their families. We also know how important obtaining compensation can be to help with rehabilitation of those who survive and the financial worries of those that are bereaved as a result of sepsis.

If you believe that you or a loved one has had a late diagnosis of sepsis or was poorly treated, you may be eligible to pursue a claim for clinical negligence.

Please feel at ease to contact us on 0800 230 0573 to see whether you have a viable claim for medical negligence.

Further reading: World Sepsis Day