Your child has just eaten a wild mushroom? Don’t bother calling the NHS.

19/07/2019

At least once a week during the summer, much more frequently in the autumn, I am contacted by desperate parents worried about their child (or dog) having eaten a wild mushroom. Quite a few of these people have already tried phoning 999 or 111, and got an inappropriate and unhelpful response. I’m not talking about the situation where a child is showing worrying symptoms and the parents think they might have eaten a mushroom. These people know this has happened, and they’ve got a photograph of the offending fungus.

Taking a photograph is exactly the right thing to do, because in the unfortunate case where the mushroom in question in one of the really dangerous ones then responding quickly with the correct medical procedure is crucial to minimising the damage. Unfortunately, the NHS response is the wrong one. I’ve tried googling it myself, and this page illustrates the problem. I’ve also phoned 111. The person I spoke to tried to help, but was only able to quote/follow the same inadequate procedure.

The problem is that the NHS responds by asking questions about symptoms of poisoning instead of attempting to visually identify the fungus from the photo. The worried parents are often making this call immediately after consumption has taken place, but even the most fast-acting mycotoxins take at least thirty minutes to kick in. The most lethal of all can take several hours, even though those toxins are being absorbed into the bloodstream. If you wait until the victim is displaying symptoms of poisoning, or even worse, until there has been positive result in a toxicology test, then damage may already have been done. It may be too late to save them. And yet in many cases, if you can access somebody with the correct knowledge, the fungus can be identified from the photo in seconds. This can either end the emergency (99% of the time it turns out the mushroom is harmless), or confirm that the mushroom is indeed toxic, and provide accurate information about which toxins are involved and what the response needs to be. Immediately.

So what can be done about this?

Doubtless people will continue to contact me, and I will do my best to help them, but I am not an emergency service and I don’t always answer my phone. There is a helpful Facebook group called Poisons Help; Emergency Identification For Mushrooms & Plants, though not everybody uses Facebook or owns a smartphone. There are many other places online where mushrooms are identified, but not reliably. The internet is full of bad information, and sometimes it takes an expert to tell. There are too many people who over-estimate their ability to identify fungi from photos, or confidently misidentify things having failed to even ask where in the world the photo was taken. Mistakes are frequent, including both toxic species misidentified as edible and edible ones falsely condemned as poisonous.

There really does need to be a change to the procedures followed by the staff who man the 111 lines, and anywhere else in the NHS where people are going to receive this sort of enquiry. The rule needs to be this: if a photo has been supplied then your first response, after establishing that there aren’t any immediate symptoms, must be to attempt to accurately identify the species involved. The NHS should have procedures in place so they know how to do this, instead of telling callers to 111 that they have no idea how to help. If your child has eaten a Deathcap, you shouldn’t have to end up having to navigate your own way through the murky and confusing world of internet mycology, and hope that you end up in contact with somebody who is able to help. As things stand, avoidable deaths or permanent and serious organ damage could very easily occur.

Here are four of the most dangerous toxic mushrooms found in the British Isles:

Deathcap (Amanita phalloides)

Fool’s Funnel (Clitocybe rivulosa)

Livid Pinkgill (Entoloma sinuatum)

Deadly Fibrecap (Inocybe erubescens) (photo by Andrea Kunze)

 

 

2 thoughts on “Your child has just eaten a wild mushroom? Don’t bother calling the NHS.

  1. Sofia

    Hello Geoff,
    I caught a glimpse of this issue regarding NHS assistance in suspected poisoning that you worryingly explain in your webpage.
    I am a pharmacist with a young child living in York. I must thank you for expressing your concern on the actual procedures. Without reviewing these we would stuck in inefficient and possible dangerous bureaucracy. However, what do you honestly think is the best option for worried parents? Ringing the emergency line needs to be the first port of call. The triage system then should direct them to the next steps. Dealing with suspected poisoning is basic to their training. This may happen with a big range of things !. I do not think that trying to identify the mushroom is the priority. The priority must be watching for symptoms to establish the urgency required. Toxicology tests are also out of the question altogether at this stage. Does this make sense to you?
    Looking forward to hearing from you.
    Thank you truly for caring and voicing your concerns !

    Reply
  2. Geoff Dann Post author

    But if you wait for the symptoms of poisoning from the most seriously toxic species, you’ve missed the best chance of saving the patient. By the time your body has started reacting to the toxins in a Deathcap, it is probably too late (you need to empty the digestive system, and fast…once the amatoxins are in the bloodstream, you are looking at liver failure). If you have no idea what has been ingested then that’s all you can do, but in this age of everybody having a camera and being able to send an email from their smartphone, this is not the case. The people who contact me always have a photo. That’s why they contact me.

    The priority, if they have a photo, has got to be to ask a trusted expert to try to identify the mushroom. Nine times out of ten, this will produce exactly the information that is needed. Mostly it will turn out to be harmless, or relatively so. And if it isn’t, then at least you’ll have some idea which toxins you are potentially dealing with.

    Reply

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