The response of A&E to a patient arriving with the possible symptoms of cauda equina syndrome can determine whether that patient has a positive or shockingly-bad long-term outcome.
Red flag symptoms of cauda equina syndrome
Someone attending A&E is likely to be suffering with fairly significant symptoms. It may be that they have been warned of the red flag symptoms of cauda equina syndrome by their GP and they know that the condition can be a medical emergency. It may be that their symptoms have developed suddenly and they are concerned about what is happening to them.
Someone attending A&E with the following symptoms should undergo an MRI scan as a matter of emergency.
- Sciatica symptoms in one or both legs
- Tingling and weakness in both legs
- Pain and tingling in the perineal area – the ‘saddle’ area between the legs and around the anus
- Altered bladder function such as having to strain to empty the bladder or unusually poor flow
If the hospital does not have the facilities to perform such a scan, the medical professionals should organise for the patient to be transferred to another local facility for assessment as soon as possible and definitely within a few hours.
Responding to cauda equina syndrome
If the medical professionals on duty in A&E are unclear as to the implications of these symptoms or are unsure what to do, they should seek advice from a specialist consultant.
If the patient is discharged with these symptoms or if their further investigation is delayed due to disorganisation, uncertainty or misdiagnosis, it is quite possible that the patient’s symptoms will deteriorate before surgery can be carried out.
Where the patient still retains some bladder sensation, it is generally regarded that decompression of the cauda equina nerves needs to take place within a matter of hours in order to try to restore some of the patient’s lost function.
A delay in surgery in these circumstances can leave the patient with a lifetime of bowel and bladder incontinence, as well as mobility and sexual problems.
Medical negligence
If this occurs, it may be considered that the hospital has failed in its duty of care. If the patient’s long-term outcome is significantly worsened by the actions of the hospital, it may be appropriate to make a claim for compensation.
Contact us to talk to a specialist medical negligence solicitor if you or a loved one are suffering the appalling long-term impact of cauda equina syndrome due to a failure to respond urgently to red flag symptoms.