Severe pain is the most common reason that patients with sickle cell, will attend the ED. The pain can be agonising (and often underestimated by us), we need to act fast to help ease the symptoms Read more
On 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 process has been agreed with transfusion so this can be done safely and responsibly. Read more
You need to be a bit more suspicious and have a lower threshold for investigation than in patients without Known, Suspected OR Previous Malignancy Read more
When giving blood products you need to use the transfusion care pathway.
It can be found on intranet > Policies & Documents Library >Other Systems [green button] > Clinical records repository > Search [title And transfusion] – its only 9 clicks away (and some writing)
For many conditions the patient should be informed to stop driving and inform the DVLA of their condition. It is the patients responsibility to inform the DVLA, and we should encourage them to do so.
[There is a £1000 fine AND the risk of prosecution] Read more
Patients sometimes present to ED or are send to ED due to over anticoagulation with warfarin
BackgroundSepsis is a life-threatening condition that arises when the body’s response to an infection injures its own tissues and organs. Sepsis can lead to shock, multiple organ failure and death especially if not recognized early and treated promptly.’ (GSA, 2010) Read more
In the case of patient with Massive Haemorrhage weather that be from Trauma, Surgical, O&G, UGIB, you can activate the MTP
Remember:
It is worth remembering that HRI and CRH have different processes for the management of DVT see Management section.
No single feature is diagnostic:
Even if the wells score is high risk we still need a D-Dimer as it will guide what happens in the event of a negative initial scan
| Feature | Score |
|---|---|
| Entire Leg swollen | +1 |
| Tender over deep veins | +1 |
| Pitting oedema (greater in symptomatic leg) | +1 |
| Immobilisation of limb | +1 |
| Previous DVT/PE | +1 |
| Active Cancer | +1 |
| Bed Ridden (>3 days within last 4 weeks) | +1 |
| Collateral superficial veins (non-varicose) | +1 |
| Calf swelling >3cm (in symptomatic leg) | +1 |
| Alternative diagnosis (equally or more likely than DVT) | -2 |
PDF:dvt
