Night OWLS is a confidential support line for children, young people, their parents and carers who live in Bradford, Leeds, Calderdale, Kirklees and Wakefield. This is a pilot scheme funded till March 2022.
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In Aug 2021 the treatment of paracetamol toxicity within the trust is due to change, for both adults and children. We will start using the SNAP N-acetyl cysteine (NAC) regime 12hrs, and 2 bags, (instead of the traditional 21hr & 3 bag regime)
There has been a resent increase in cases of Legionnaires Disease in the North West. So remember to request Urine Legionella Antigen test, if you have suspicions.
True Hypothermic Arrest is thankfully rare in the UK. However, when it does happen it is resource intense and prolonged. The ERC 2021 guidance has introduced a new decision step HOPE score to the algorithm, once the Initial phase of resuscitation has been completed without ROSC.
If the is HOPE score is <0.1 the team may which to consider terminating CPR [Warning: Adults ONLY Children have better survival] Read more
Within ED we often have little information about the patient we are resuscitating. Post-ROSC (return of spontaneous circulation )we commonly perform CT head, but evidence and Resus Council Guidance suggests extending this scan can pick up important pathology that can otherwise be missed (13%).
Direct dial from HRI 152539, From CRH 2539.
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 bleep. Some of the on call general surgical SHO have a urology background.
If a time critical emergency such as torsion is presenting, then the first point of contact should be the urology registrar.
Urologist are happy to operate on patients over the age of 3 years old. Under the age of 3 if this on a urological emergency such as a torsion then this patient should be referred to Leeds paediatric urology services.
Any patent with a post op complication for up to 7 days form urological procedure – should be streamed directly to the urology team via the surgical SHO. If the patient is unwell and needs resuscitation and immediate management for example sepsis, then ED team needs to be involved in resuscitation measures and the urological registrar needs to be involved as well
Currently ALL Pyelonephritis should be admitted under the urology team. There is a conversation between urology and medical teams happening currently to see if that requires further rationalisation. However currently the position is all pyelonephritis patients who need admitting are done so under the urology team.
Appropriate Antibiotics should be prescribed using the current antibiotic guidelines.
CTKUB are now available 24/7.
Patient presenting >50 years old with a renal colic story, should have a ultrasound scan done at the bedside to ensure that there is no aortic aneurysm before being sent for a CT KUB.
Uncomplicated renal colic needs a non contrast CT scan. This should be organised by the ED
Uncomplicated renal colic patients can wait CT KUB for results on SDEC. (The case must be to be discussed with the surgical SHO on-call and accepted by them before transfer of the patient. SDEC closes at 6 pm)
All frank hematuria needs investigation
New catheters and catheter complications – follow current guidelines. Community nurses follow up for TWOC or other catheter care (HOUDINI team in Kirklees)
Hyperammonaemia is a TIME CRITICAL medical emergency with the risk of death and serious neurological damage.
No single feature is diagnostic:
