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@cazandal, @chftedsim
EMbeds pulmonary oedema guidelines
There are several terms commonly used “Accelerated Hypertension”, “Hypertensive Emergency”, “Malignant Hypertension”. They all have a very similar definition (ESC/ESH, NICE, ACEP)
Patient has both:
Mortality has improved in recent years with 5yr survival of 80% if treated. However, untreated average life expectancy is 24 months.
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 help guide appropriate use – full guide HERE
Some patients benefit from control of bleeding using embolization techniques, which is a procedure performed by an Interventional Radiologist.
Patients should be treated in their receiving hospital to the maximum of that hospital’s capability, where at all possible. When all local treatment options have been exhausted, the patient should be discussed with one of the Arterial Centres (BRI) with a view to transfer for ongoing management by IR techniques.
Access is very limited to this clinic. It is envisioned by WYVas that access to UVAC for ED patients will be arranged through direct (telephone) referral to either:
We frequently consent for Blood Transfusion, but what risks do we tell the patients about and how common are those risks?
The prevalence of diseases transmitted by tick bite have increased in recent years, within the UK. And it is now recognised that there are 3 main infections
Trust Guidance varies slightly from BNF for those patients over 100kg
| Dalteparin Cr Clearance >29ml/min | Dalteparin Cr Clearance 20-29ml/min | ||
|---|---|---|---|
| Weight (kg) | Dose | Weight (kg) | Dose |
| <45kg | 7,500 units OD | <63kg | 5,000 units am 2,500 units pm |
| 45-56kg | 10,000 units OD | 63-80kg | 5,000 units BD |
| 57-68kg | 12,500 units OD | 81-98kg | 7,500 units am 5,000 units pm |
| 69-82kg | 15,000 units OD | 99-116kg | 7,500 units BD |
| 83-100kg | 18,000 units OD | 117-134kg | 10,000 units am 7,500 units pm |
| 101-115kg | 10,000 units BD | 135-152kg | 10,000 units BD |
| 116-140kg | 12,500 units BD | ||
| >140kg | 15,000 units BD | ||
| Weight (kg) | Dose |
|---|---|
| <50kg | 10,000 units OD |
| 50-69kg | 12,500 units OD |
| 70-79kg | 15,000 units OD |
| 80-89kg | 18,000 units OD |
| 90-109kg | 20,000 units OD |
| 110-124kg | 22,500 units OD |
| 125-139kg | 12,500 units BD |
| 140-154kg | 15,000 units am 12,500 units pm |
| 155-169kg | 15,000 units BD |
This guideline is a brief summary of the RCEM 2012 Safe sedation in the ED and RCEM – Pharmacological Agents for Procedural Sedation and Analgesia in the Emergency Department – March 2019. Please read these documents in full or participate in RCEM learning elearning for further information. Read more
