- Activate EARLY in head injury patients on warfarin.
- Order on EPR & Paper [see below]
- Infuse over no more than 30 min
- Recheck INR at 30 min after finished infusion
Indications
- EMERGENCY reversal of Warfain
- Factor II or X deficiency
In the UK approximately 100 people are envenomated by a snake each year.
So what do you need to do if your patient has received a venomous bite from a snake? (not the classic UK cocktail).
Gallstones are common, with a prevalence of approximately 10–15% of adults in Europe and the U.S. Most of the time patients are asymptomatic. but there are several ways gallstone disease can present.
The prevalence of diverticula Is unknown as most are asymptomatic. However, it is rare before the age of 40 and increases with age.
For people with diverticulosis, the lifetime risk of developing acute diverticulitis is about 4–25%
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?
Necrotising fasciitis (NF) is a rare but serious bacterial infection that affects the soft tissue and fascia (Fournier gangrene, is NF affecting the perineum). In many cases NF progresses rapidly and early recognition and treatment is vital to halt progress. The mainstay of treatment is IV antibiotics and aggressive surgical debridement. Any delay increased the amount of tissue loss as well as the mortality. Read more
Bleeding in early pregnancy is a relatively common problem and in the many cases (esp. with spotting) the pregnancy remains viable. However, bleeding in early pregnancy should never be thought of as normal, and it is vital that we investigate this appropriately.
Anti-D immunoglobulin guide
Acute sore throats are often caused by a virus, last about a week and get better without antibiotics. withholding antibiotics rarely causes complications. Antibiotic stewardship is everyone’s responsibility to prevent resistance developing.
Are there any concerns regarding airway compromise? – If yes – transfer to resus, give high flow Oxygen, IV steroids, IV antibiotics, Nebulised adrenaline 1:1000, IV fluids, take bloods and refer to both anaesthetics and ENT registrar.
Otherwise:
Assess all under 5s with a temperature as per the NICE fever guidelines
Assess the patient for signs of severe sepsis – if present use the severe sepsis guidelines
If no signs of sepsis assess patient, exclude Quinsey (unilateral swelling, paina nd trismus) and calculate the FeverPAIN score and Centor score
FeverPAIN = 1 point for each of –
Centor = 1 point for each of –
Can the aptient swallow fluids and medication – if not give a stat dose of IV Dexametasone, IV antibiotics, IV fluids and analgesia – review in 2 hours. If they can swallow at this time then you can consider discharge with a patient information leaflet.
Patients to seek medical advice if become more unwell or not improving after 1 week
Self care advice – Paracetamol, Ibuporfen, Adequate fluids, Medicated lozenges
Phenoxymethylpenicillin 5-10 days
If Penicillin allergy – Clarithromycin or Erythromycin 5 days
Tonsillitis Patient Information Leaflet