"Response to uncontrolled bleeding"

Recently, I presented to Joondalup Emergency. This was after speaking with another hospital and confirming I met the medical criteria to present to ED for uncontrolled bleeding while miscarrying our second baby. We are local to Joondalup and I was seriously concerned about the level of bleeding so we presented to the ED.

I bled through a heavy duty pad whilst being asked the COVID-19 questions and despite the kind nurse getting a medical sheet to sit on whilst I ‘took a number and waited my turn’, it seemed I was put into the standard queue which included being triaged as the same priority as a patient who I believe had fallen over, hurt their back and was having a ‘bit of trouble walking’. The other patient who wanted to be checked over just because, and another patient who could laugh and joke with others with their arm already in a sling. First system failure to keep patients who are presenting with acute care requirements safe over your apparent system time wasters, in my opinion.

My spouse then had to justify why they should be allowed to enter the ED and was told they could not sit with me. I was bleeding heavily and I believe at risk of fainting, never mind the fact I was in significant pain and had the whole ED able to see what was happening. My spouse was also informed it was unlikely that they would be able to proceed into the ED with me. I needed them there not only as an emotional support but as a medical support because I feel your ED clearly isn’t sufficiently staffed or able to recognise or respond to emergency care for patients who actually need medical help. I believe this is your second system failure to keep patients safe.

The triage nurse was polite and kind, she noted down my details, what my presenting symptoms were and asked us to take a seat and we would be seen as soon as possible. My spouse asked how long would that be. The response was 1 hour and 45 minutes was the current wait time. Considering my spouse had seen how much blood I had lost at home and their concern that I had already flooded a fresh pad in about 25 minutes, they asked about moving me to a different hospital to which the response was they were unsure on other hospital’s wait times. My spouse and I discussed what I wanted to do, feeling myself flood through again we made the decision to seek appropriate medical care and left for the other hospital.

The outcome: the other hospital was  unable to stop the bleeding, this resulted in an emergency surgery. I lost a unit of blood just in the 3 hours I was at this other hospital, let alone what was lost at home and whilst in your so called ‘care’.

Had I waited at Joondalup Hospital the 1 hour 45 minutes, I believe this could have resulted in a different outcome. I’m frustrated that I wasted and put trust in your team for the 35 minutes that I did. Plus the travel time we could have saved going direct to the other hospital. Why is this time lost so important? Because this could have gotten me to another hospital sooner and different care options taken rather than the trauma of being rushed in for emergency surgery. Being told that, although my vitals were stable, if I continued to lose blood as I was, the situation could change very suddenly and we would be in trouble, is what has pushed me not to stay silent. I wonder how many other miscarrying mums you’ve put in the generic queue and caused both physical and mental harm to. A miscarriage is traumatic enough, let alone during a pandemic where our only support person is frequently removed from us and let alone when you’re bleeding uncontrollably - which is a life-threatening condition.

It’s here where I kindly and respectfully ask, please don’t bother with your generic ‘we’re sorry’, ‘our team is investigating it’ or ‘we’ve reviewed your case and it was a once off communication error’. Based on my experience, uncontrolled internal bleeding is an emergency, your ED and its staff failed to recognise and respond. You can argue that this is a once off case but in my opinion, once off can result in a person’s death.

What I feel you need to do is implement a Obstetrics/Gynaecology Fast Track program. Where if a woman presents with any concerning condition including uncontrolled bleeding, they are seen by your Obstetrics/Gynae team within 10 minutes. Not placed into the standard queue and asked to haemorrhage amongst the crowd. I wonder if I was bleeding that significantly from another part of my body if your team would have responded with more haste?

You need to understand based on my experience, we already feel helpless enough that we’ve lost our babies often without explanation, we feel even more helpless without our partners by our sides thanks to the pandemic and then when we don’t receive the medical care we deserve our helplessness removes hope, dignity and our ability to move forward without trauma.