#NoF – Fractured Neck of Femur
December 15, 2019BOAST Guidance #NoF patients (or other fragility fracture) who requiring CT Head (for head injury) also be performed a CT Neck Fragility fractures indicate the patient is at high… Read more
1. Why we get things wrong – “A tale of two systems”
November 3, 2018Very few of us come to work intent on doing harm. However, despite that we all keep making mistakes. Most of them pass unnoticed and… Read more
2 Week Wait – from ED
September 24, 2023Don’t us MDT forms currently as there is not ability for MDT to arrange test/FU Non-Site-Specific Service (will direct appropriate services for ED only) The… Read more
Aortic Dissection
April 16, 2021Aortic Dissection (AD), is uncommon (1 AD:200 ACS) but is…Rapidly FATAL! Unfortunately recognising aortic dissection is difficult with a clinician pickup rate of 15-43%. Read more
Bell’s Palsy
June 10, 2020Bell’s Plays is a lower motor neurone (LMN) lesion of the facial nerve (CN VII), which causes one side of the face to “droop” [1%… Read more
Bilary Disease
January 21, 2021Gallstones are common, with a prevalence of approximately 10–15% of adults in Europe and the U.S. Most of the time patients are asymptomatic. but there are several ways… Read more
Button Battery Ingestion
April 13, 2023Oesophageal Button Battery = Emergency Refer Immediately If anybody is symptomatic after button battery ingestion they need referral to the Surgical team for urgent endoscopic… Read more
Chest Trauma – WYMTN
January 6, 2022Chest injury as part of major trauma, can range from painful to life threatening so prompt treatment and recognition is vital. Esp. in ‘Silver Trauma’… Read more
Chronic Pancreatitis
November 7, 2020Chronic pancreatitis is a low grade inflammatory disease of the pancreas. It can occur after an attack of acute pancreatitis or can present on its… Read more
Consenting for Blood Transfusion
December 2, 2020We frequently consent for Blood Transfusion, but what risks do we tell the patients about and how common are those risks? Read more
Dabigatran Reversal
September 16, 2019Bleeding on Dabigatran? <C>ABCD – as usual trying to stop bleedBloods: FBC, Clotting, U&E, G&SDiscuss with Haematologist (esp. if taken within 12-24hr)Idarucizumab (PRAXBIND) 5g IVFound… Read more
Dental Abscess
April 9, 2021Dental Abscess requires a Dentist for Definitive Treatment Symptoms: Dental Pain Unpleasant taste Fever and Malaise Trismus Dysphagia Facial Swelling Regional Lymphadenopathy Tooth Decay Gum… Read more
Diverticulosis, diverticular disease and diverticulitis
December 30, 2020The prevalence of diverticula Is unknown as most are asymptomatic. However, it is rare before the age of 40 and increases with age. Diverticulosis occurs… Read more
Early Pregnancy Bleed <16/40
November 27, 2020Bleeding in early pregnancy is a relatively common problem and in the many cases (esp. with spotting) the pregnancy remains viable. However, bleeding in early… Read more
Epistaxis – Management
November 13, 2020Nose bleeds are a bloody common problem (bad pun intended) – most originating at the front to the nose where there is a cluster of… Read more
Eye Clinic Referral Criteria
January 8, 2019What should you send to Eye Clinic and how soon? Read more
FERNO Traction Splint
November 25, 2023How to apply the FERNO traction splint for our in-hospital patients Read more
Hyperemesis Gravidarum
July 26, 2019Nausea and vomiting in pregnancy is common and at best an unpleasant experience for the patient, and at worst can be life threatening. It normal… Read more
Ingested Magnets
May 20, 2021Ingestion of Strong Magnets is a TIME CRITICAL EMERGENCY (Multiple Magnets OR a single Magnet and Metallic Objects) Strong magnets (such as Neodymium) Now common… Read more
Lateral Canthotomy
May 7, 2019Like tension pneumothorax the biggest step is deciding to do it – Remember it it sight saving and they heal well Retrobulbar Haematoma secondary to… Read more
Major Trauma: STOP>SORT>GO
July 4, 2024YAS crews may on occasions (rarely) bring us a Major Trauma patient that meets the criteria for bypass to the MTC because they have a… Read more
Massive Transfusion Pathway
April 27, 2021In the case of patient with Massive Haemorrhage weather that be from Trauma, Surgical, O&G, UGIB, you can activate the MTP Remember: Do the Basics… Read more
Necrotising Fasciitis
November 28, 2020Necrotising fasciitis (NF) is a rare but serious bacterial infection that affects the soft tissue and fascia (Fournier gangrene, is NF affecting the perineum). In… Read more
Octaplex – work fast its an EMERGENCY!
April 3, 2021Activate EARLY in head injury patients on warfarin. Order on EPR & Paper [see below] Infuse over no more than 30 min Recheck INR at 30… Read more
Paediatric Surgical Pathway
June 27, 2024As there are now no longer a paediatric clinical team at HRI, the paediatric surgical pathway is up-dating, this is the current provisional pathway, to… Read more
PEARS
January 19, 2021Primary Eyecare Acute Referral Scheme Read more
Pre-Arrival Blood (O-ve)
March 13, 2019On 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… Read more
RCEM CPD 2019 Day 1
April 2, 2019HEAD AND NECK Tracheostomy Emergency Care – Dr Brendan McGarth www.Tracheostomy.org.uk Needs to distinguish Tracheostomy from laryngectomy as a laryngectomy has no connection to the… Read more
Referral criteria for ENT clinics (CAS)
December 8, 2021The following conditions can be referred through the ENT CAS clinic. If same day referral required talk directly with ENT on-call If suitable for CAS… Read more
Retrobulbar haemorrhage
February 2, 2020What is retrobulbar haemorrhage? Rapidly progressing haemorrhage into the retrobulbar space which is rare but potentially sight threatening. Retrobulbar haemorrhage causes a rapid rise in… Read more
SEPSIS
June 13, 2024Three large scale multi-centre trials into Severe Sepsis and Septic Shock: ProCESS (USA), ARISE(Aus), ProMISe(UK), all showed the same thing. What works is good early… Read more
Snake Bites
January 29, 2021In the UK approximately 100 people are envenomated by a snake each year. So what do you need to do if your patient has received… Read more
Sore Throat
November 13, 2020Background Acute sore throats are often caused by a virus, last about a week and get better without antibiotics. withholding antibiotics rarely causes complications. Antibiotic… Read more
Surgery Referral Pathway
November 9, 2020Introduction The Surgical and ED teams have worked closely to provide an agreed process, to aid patient flow through the ED and help to maintain… Read more
Thomas Spint – how to apply
February 3, 2019Invented by a Welshman ‘Hugh Owen Thomas’, the introduction of this simple device in World War 1 went on to reduce the mortality of #femurs… Read more
Transfusion Care Pathway
July 13, 2018PDF: 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 >… Read more
Upper GI Bleed (UGIB)
October 20, 2020Not normally difficult to spot, but look for it in unexplained anaemia, or collapse. Questions Is it VARICEAL? Mortality 35%, so is an emergency whatever… Read more
Urinary Retention
February 2, 2020A common problem which affects 1 in 10 men between 70-79yrs and 1 in 3 men 80-89yrs (10M:F) Signs/Symptoms Unable to pass urine (may be… Read more
Urology Referral Pathways
July 1, 2021Referral The first point of contact for urology advice and referral is the general surgical SHO. This is the on-call surgical SHO carrying the on-call… Read more
Vascular Emergencies (Regional Pathways)
December 27, 2020Intro Vascular surgery has been reconfigured across etc region. The vascular oncall will be based at BRI 24/7. Multiple pathways have been developed below to… Read more
