Your print-out-and-keep guide to avoiding the A&E queues

Stick a plaster on a cut, apply some ice to a nasty sprain — there was a time when minor injuries were dealt with at home after a quick rummage through the medicine cabinet.

A trip to the hospital was left to real emergencies such as broken bones, dislocations and suspected heart attacks. But it seems times have changed.

‘These days, a lack of even basic first aid skills is leading to patients turning up at A&E simply because they are worried,’ says Tracey Taylor, educational development manager at the British Red Cross, which has just published a report on the problem. 

DIY: Health experts say a lack of first aid skills is heaping pressure on doctors and nurses alike 

It found that most people arrive at A&E with minor injuries such as cuts or sprains.

And this means everyone is waiting longer to be seen. According to 2016/17 figures, more than 2.5 million people in English A&E units alone had to wait for over four hours to be seen.

‘The vast majority of people presenting at A&E could easily be treated at home with basic first aid and save a huge amount of NHS time, money and resources,’ says Emma Hammett, former A&E nurse and founder of First Aid for Life, a first aid training school.

Here, with the help of first aid experts, we explain how to deal with common medical mishaps, and help identify when you really should head to hospital.


Usually caused by a burst blood vessel within the nose, this often looks much worse than it is. ‘Serious blood loss is rare and the bleeding is mostly self-limiting,’ says Emma Hammett.

WHAT NOT TO DO: Don’t tilt your head back as this may cause blood to run down your throat which can irritate your stomach and make you sick.

WHAT TO DO: Tilt your head forward and pinch your nose to compress the bleeding vessel. ‘Applying pressure, allow the blood vessel to reseal and stop the bleeding within ten minutes,’ says Alan Weir, clinical director of St John Ambulance.

RED FLAGS: ‘If the bleeding is still heavy 30 minutes after you apply pressure, you are swallowing a large amount of blood that is making you vomit, or the bleeding started after you received a blow to the head, go to A&E,’ says Alan Weir.


A child who is well in himself, but has a high temperature, should not be in casualty a lot of the time, says Emma Hammett. ‘A&E departments are clogged up with sleepy children in pyjamas who really ought to be resting at home.’

WHAT NOT TO DO: Putting children in a lukewarm bath to cool them down is no longer recommended by experts.

Less is more: The vast majority of people presenting at A&E could easily be treated at home saving huge amount of NHS time, money and resources

Less is more: The vast majority of people presenting at A&E could easily be treated at home saving huge amount of NHS time, money and resources

WHAT TO DO: Make sure the child remains well-hydrated and don’t wrap them up as this will encourage their temperature to rise.

RED FLAGS: ‘If a child is floppy with glazed eyes or has a seizure for the first time then take them to A&E, as this could be an indicator of something more serious,’ says Emma Hammett.


Caused by a lack of oxygen to the brain, in the vast majority of cases this is due to simple things like standing up too quickly, says Tracey Taylor.

WHAT NOT TO DO: Don’t bother splashing cold water in their face. ‘It’s a shock to the system and they can end up inhaling water,’ says Alan Weir.

WHAT TO DO: ‘If someone faints, then put them on their back and raise their legs above heart level to restore blood flow to the brain,’ says Alan Weir.

If the patient is diabetic, give them a sugary drink or sweet as the faint may have been caused by a dip in blood sugar levels.

RED FLAGS: People should regaining consciousness within a matter of seconds. ‘If they don’t wake up after a few minutes then call an ambulance,’ says Alan Weir.

Accompanying chest pain, palpitations and light-headedness, a family history of cardiac disorders and a preceding headache are all red flags.


A&E is clogged full of people with suspected broken bones. ‘Unless you are seriously worried that you have broken a bone, treat the problem at home and see if it improves within the next few hours,’ says Emma Hammett.

WHAT NOT TO DO: There’s no real treatment for broken toes other than pain relief and strapping, which you can do at home.

WHAT TO DO: ‘Use a wrapped bag of frozen peas to bring down the swelling in the area and elevate it on a pillow,’ she says.

Time after time: According to 2016/17 figures, more than 2.5 million people in English A&E units alone had to wait for over four hours to be seen

Time after time: According to 2016/17 figures, more than 2.5 million people in English A&E units alone had to wait for over four hours to be seen

RED FLAGS: ‘Don’t assume that because you can wriggle your toes or walk gingerly a bone isn’t broken. People can walk on a broken leg,’ says Emma Hammett.

If the bone is at an odd angle or the joint looks misshapen go to hospital for an X-ray. Older people with a suspected bone fracture should be seen in casualty because they are much more likely to develop complications.


Minor burns can usually be dealt with at home. Even some more serious burns should be treated in a walk-in clinic, rather than an A&E department.

WHAT NOT TO DO: ‘Don’t apply butter — that’s an old wives’ tale and could lead to further damage,’ says Alan Weir.

WHAT TO DO: ‘All burns should be cooled under cool running water for at least ten minutes,’ says Emma Hammett.

‘Minor burns can then be loosely covered with cling film or a clean plastic bag. Take paracetamol for pain relief.’

Cling film stops air movement over the exposed nerve ends, reducing pain. It also provides a barrier which can help to prevent any infection.

RED FLAGS: Burns to the hands, feet, genitals, neck or face should always be seen in A&E.

So should any burns that go all around a limb, because the swelling can cut off the blood flow to the extremities. For a baby or a toddler a burn bigger than a 50p piece is considered serious because that represents one per cent of their body surface. Any burn that has blistered or broken the skin should be seen and dressed by a health professional, advises Emma Hammett.

‘A chemical burn (caused by acid) should be washed with cold water for 20 minutes minimum, any contaminated clothing should be removed and the patient should be taken to casualty as soon as possible,’ says Alan Weir.

You should also go to A&E if you have any third degree burns. This is when the injury extends very deep into the skin — it’s frequently painless because the nerves have been destroyed. The area often looks very pale and waxy, or very dark red.


A common cause of visits to the emergency department, these are often not a reason to go to hospital.

WHAT NOT TO DO: ‘Never scrape or prod the eyeball surface to try and get something out,’ says Alan Weir. This can increase the redness.

WHAT TO DO: A contact lens that is stuck or lost at the back of the eye should be washed out with eyewash — available from pharmacies and supermarkets — or cooled boiled water.

An irritated eye or eye infection should be treated with over-the-counter eye drops or sterile saline that you can prepare yourself at home.

RED FLAGS: If the eyeball is damaged in any way — either cut or bruised by blunt trauma — head to A&E. Lid laceration, chemical injuries and non-accidental injuries should also be treated in A&E.


Even a pigeon egg-sized bruise can be dealt with at home with pain killers and rest.

‘Most head injuries won’t cause any long-term effects,’ says Tracey Taylor.

WHAT NOT TO DO: Don’t leave someone on their own for 48 hours after they have had a head injury, as they can suddenly deteriorate due to undetected bleeding and brain swelling.

Don’t drink alcohol and avoid contact sports for at least three weeks as repeated head injuries, before the original injury has had time to fully heal, can lead to permanent damage.

WHAT TO DO: ‘If a child has hurt their head, sit them down and use a bag of frozen peas wrapped in a tea towel as a compress to reduce swelling,’ says Tracey Taylor. An adult should rest for 48 hours and take paracetamol for a mild headache.

RED FLAGS: If dizziness and any headache get worse, seek medical advice.

A baby or child who sustains a bump on the head and appears to be unconscious for a second or two should always be checked out by a health professional, says Emma Hammett.

For an adult the emergency services should be called if they show any signs of brain injury. ‘Repeated vomiting can be an early warning sign,’ says Alan Weir.

‘Other signs include one pupil being bigger than the other or dilation of both pupils.’

Other red flags are seizures, a change of mood, persistent headache and weakness down one side.


A fish bone stuck in the throat isn’t something that normally needs to be dealt with in A&E.

‘A chicken bone stuck in the throat can be more serious because they are harder and bigger and can tear the lining of the oesophagus which may cause bleeding,’ says Alan Weir.

Choking is a life-threatening emergency which should be dealt with immediately by first aid on the scene and also by calling 999 or going straight to A&E.

WHAT NOT TO DO: Don’t poke fingers down someone’s throat or try and make them sick.

WHAT TO DO: ‘There is some evidence that eating mushy rice, white bread or something sticky may help to push the fish bone down the throat,’ says Alan Weir.

RED FLAGS: A fish bone or other bone that won’t budge after 24 hours can cause infection and a visit to casualty may be necessary to remove it.


Beads, buttons, sweets, nuts and toys all end up in children’s noses and ears and are a common reason for them being brought into A&E.

WHAT NOT TO DO: Do not let a child with something stuck in its nose sleep since it could be aspirated into the lungs —instead go to a minor injury centre or a GP.

‘Do not try to remove any object from the ear unless you can easily grasp it with your fingers or tweezers,’ says Alan Weir. ‘There is a chance of pushing it in further, rupturing the eardrum.’

WHAT TO DO: ‘Try to get the child to sneeze or blow the object out of their nose,’ says Tracey Taylor.

RED FLAGS: ‘If you suspect that your child has got a button battery in their nose or ear (the kind that is used in talking birthday cards and watches, for instance), then take them to A&E immediately,’ says Emma Hammett.

Button batteries can leak acid and burn through delicate tissues in a matter of hours.


Bleeding from small cuts and grazes should be treated at home.

More serious cuts may need to be treated at a minor injuries clinic instead.

WHAT NOT TO DO: Don’t use antiseptic to clean a fresh wound. ‘This removes good bacteria from the area as well as the bad, which could make infection more likely,’ says Emma Hammett.

WHAT TO DO: Bleeding can be staunched by applying pressure with a clean towel or dressing.

Once the bleeding has stopped, clean the cut using cool tap water without soap, says Alan Weir.

Wrap a dressing around it to stop it getting infected, making sure it is secure without being tight.

Press the nail bed on the foot or hand. If the colour comes back immediately, then this suggests that the bandage is not too tight.

RED FLAGS: Go to A&E if there is anything embedded in the cut as this can rapidly lead to infection, says Emma Hammett.

‘Cuts on the head and face should also be dealt with in A&E to make sure they heal properly and aren’t disfiguring,’ she adds.