Those suspected of concealing illicit drugs often present near ports and borders however they can present to any ED or be brought in by the police.
Body Packers – Swallow large quantities of well packaged drugs to smuggle them into countries or institutions. These are often well manufactured with a low risk of rupture but the potential for serious toxicity if rupture occurs.
Body Stuffers – Swallow small quantities of poorly packaged illicit substances often at the point of arrest to conceal them. These have a much high risk of package rupture but involve smaller quantities of substances.
Authorisation for an intimate search or radiological investigation must come from an inspector or higher with written consent from the patient.
Intimate searches must be carried out by a police surgeon but require immediately available resuscitation facilities therefore may be conducted in the ED. ED physicians should not handle the drugs at any time.
AXR or low dose CT scanning can be used to detect concealed packages in Body Packers.
Try to obtain a history of what and how much has been concealed
The provision of out of hours mental health services for Children and young people (under the age of 18) is changing: –
Between 8pm and 9am the onsite Mental Health Liason team (RAID) will see these patients initally and help with the mental health aspects of their care. Between 9am and 8pm contact CAMHS via switchboard as normal.
Some patients who present with COVID-19 infection will be not suitable for escalation and actively dying when they attend the ED, for these patients the best management may be palliative care. The primary symptom that causes distress is breathlessness.
Palliative Care of COVID-19 patients will ideally be provided with a syringe driver and their symptoms well controlled using the standard guidance available via the Kirkwood Hospice Palliative Care Toolkit available HERE – Latest
However if there is no syringe driver available an alternative pathway has been produced
Parents who have experienced a sudden and unexpected death of a baby or child often feel anxious when they have another baby. CONI is a programme working with local public healthcare providers to facilitate a service for bereaved parents to help with the anxieties around another baby.