A common problem which affects 1 in 10 men between 70-79yrs and 1 in 3 men 80-89yrs (10M:F)
(Multiple Magnets OR a single Magnet and Metallic Objects)
If unsure if magnet classes as a strong magnet ask to see others from parents. If clearly not a strong magnet from the rest of the alphabet letters parents have provided please manage as per Ingestion of Foreign Body and avoid unnecessary radiation. If there is any uncertainty follow the policy below!
Strong magnets (such as Neodymium)
Ingested:
Detection:
Aortic 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
When patients sent in by GP “” – how much do you do?
* Examples of High Risk Patients: Dialysis, Renal Transplant, CKD under renal team. Previous Hyperkalaemia.
** All patients being discharged need to be discussed or seen by a Tier 3+ level Dr who will assign themselves to the patient. Put the Diagnoses as ‘No abnormality Detected’ AND ‘Potassium Level.’
Patients POC results, ECG and PMH reviewed.
Make sure the patients contact number is correct. Inform them if their lab result comes back high then we will contact them. OPer them the choice if the result is normal – would they like a phone call or not. Add their choice to the bubble I.e ‘no call’ ‘wants call’
Move the patient to the ‘Streaming’ Tab and record the time they left in the bubble. Once the lab result is back, if it is raised then recall the patient for treatment. If it is normal then discharge from the system ensuring to put the discharge time as when they left the department.
If the lab sample haemolyses – The decision to recall is at the discretion of the Tier 3+ doctor.
This pathway has been created as a guide to help reduce the investigation burden and length of stay of patients with pseudo-hyperkalaemia. The purpose of having an Tier 3+ level doctor responsible for these patients is they can make a quick global assessment of the patient and decide whether the patient is high risk and if the streaming pathway is appropriate, rather than relying on a regimented list of conditions or parameters.
In hours this should be done by the front door doctor. Out of hours Tier 1/2 doctors can still see these patients but they should then be discussed with a Tier 3+ Doctor.
Thanks to Dr Stuart Mitchell
Hyponatraema is a common finding, especially within our elderly population. However, its significance is is not a simple numbers game, and needs senior input. Prior to treatment the following need to be considered and balanced.
Some patients present to ED with symptoms or investigations suspicious an undiagnosed cancer, but don’t require emergency admission. To reduce the barriers to care the trust has implemented a referral route for ED.
Ensure you include a valid e-mail address on the referral form. The Patient Pathway team will acknowledge receipt of your referral via e-mail within 2 working days. If you do not receive this e-mail, please escalate to the EPIC
Once completed the PPC team will review the request and feed them into either “Fast-Track Clinics” if further workup required or MDT’s if fits those pathways.
This should allow our patients quick access to appropriate clinics, without the inherent delays and wasted clinical time of asking the patient to attend their GP. BMA/NHSe
