Chronic pancreatitis is a low grade inflammatory disease of the pancreas. It can occur after an attack of acute pancreatitis or can present on its own. Some patients are best under the Surgical team and some under Gastro/Medical teams Read more
Category: GIT
Upper GI Bleed (UGIB)
Not normally difficult to spot, but look for it in unexplained anaemia, or collapse.
Questions
- Is it VARICEAL? Mortality 35%, so is an emergency whatever the GBS is.
- Non-Variceal what’s the GBS? will help guide treatment
Anyone being admitted should be brought to HRI
Emergency Endoscopy is arranged by Med Reg
CT Abdo/Pelvis & Pregnancy Testing
Radiology are now requesting blood pregnancy testing reproductive females from 10-35days from last period. But what is wrong with urine pregnancy testing?
Read moreD&V in kids
Paediatric gastroenteritis can be a pain for everyone but as with most of EM – Keep It Simple
- Not dehydrated – make sure they can tolerate fluids, and encourage hydration, think about ORT
- Dehydrated – look for the red flags that indicate they are developing shock. Use ORT unless IV indicated
- Shocked – you will need access and it will probably be difficult (IO on awake children really isn’t that bad)
Dabigatran Reversal
Bleeding on Dabigatran?
- <C>ABCD – as usual trying to stop bleed
- Bloods: FBC, Clotting, U&E, G&S
- Discuss with Haematologist (esp. if taken within 12-24hr)
- Idarucizumab (PRAXBIND) 5g IV
- Found in Emergency Drug cupboard
- We experienced delay finding as spelt wrong in the catalogue!
Pre-Arrival Blood (O-ve)
On rare occasions you may receive a pre-alert, where you want blood available for the patient when they arrive (for example in major haemorrhage). This process has been agreed with transfusion so this can be done safely and responsibly. Read more
Transfusion Care Pathway
When giving blood products you need to use the transfusion care pathway.
- Octaplex
- Blood/Plt’s/FFP
It can be found on intranet > Policies & Documents Library >Other Systems [green button] > Clinical records repository > Search [title And transfusion] – its only 9 clicks away (and some writing)