2WW – Suspected Cancer

01-Jan-2025

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… Read more

Adrenal Crisis

11-Apr-2024

Adrenal crisis or insufficiency is a life threatening emergency due to the lack of glucocorticoid. Adrenal crisis can be primary due to destruction of the… Read more

Diabetic Hyperglycaemia (Kids)

20-Sep-2023

Diabetic children sometimes attend ED with hyperglycaemia, but not in DKA (what should we do?) Paeds have produced some advice to follow: Ketones over 0.6?… Read more

DKA – Adult

05-Sep-2024

Things to remember Give 0.9%NaCl Actrapid “Fixed Rate” 0.1unit/kg/hr Basal Insulin e.g. Levemir, Lantus, Semglee, Abasaglar, Toujeo, Tresiba, please continue this at usual dose and times… Read more

DKA in Kids

27-Apr-2021

Diabetic Ketoacidosis – remember in paediatrics this may be the 1st presentation of diabetes. Fluid – are more considered that adults due to the risk… Read more

DVLA – Driving & Medical Conditions

28-Nov-2024

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… Read more

Hypercalcaemia

10-Jun-2023

90% of hypercalcaemia is due to either malignancy or hyperparathyroid. Severity: Adjusted Calcium (Ca) Severe: >3.5mmol/l – URGENT treatment (risk of dysrhythmia) Moderate: 3.0-3.5mmol/l  – PROMPT treatment (maybe well tolerated if… Read more

Hyperkalaemia

03-Dec-2024

Remember: is it a haemolysed blood sample? (you can do an iSTAT) Severity Mild: 5.5-5.9mmol/l – No urgent action required (Dietary & Medication modification &… Read more

Hypernatraemia

14-Feb-2024

Hypernatraemia is a not a common presentation in ED, as intense thirst often prevents significant hypernatraemia in neurologically intact individuals. So… Mortality rates are high… Read more

Hyperosmolar Hyperglycaemic State (HHS)

13-Apr-2025

HHS (A.K.A. HONK) is a diabetic emergency, but unlike DKA we don’t always think about it. Patients with HHS are often elderly with multiple co-morbidities,… Read more

Hypocalcaemia

13-Jan-2023

Hypocalcaemia can life threatening, due to arrhythmias and seizures. Severity – Adjusted Calcium (Ca) Mild: >1.9mmol/l Severe: ≤1.9mmol/l OR Symptomatic Read more

Hypoglycaemia – Adult

10-Jun-2023

Hypoglycaemia (Blood glucose under 4.0 mmol/l) is potentially fatal and should be treated. it may be defined as “mild” self-treated, or “severe” treated by a… Read more

Hypokalaemia

10-Jun-2023

Hypokalaemia (low potassium), is a common problem. It is found in 14% of outpatients and 20% of inpatients, however only 4-5% of those are of… Read more

Hypomagnesaemia

25-Apr-2025

Classification Normal: 1.1-0.7 Mild: 0.69-0.5 – No symptoms or non-specific symptoms, such as lethargy, muscle cramps, or muscle weakness Severe: <0.5 – Severe neurologic symptoms… Read more

Hyponatraemia

13-Jan-2023

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… Read more

Hypothermia

24-Nov-2023

Remove COLD, Add WARM, Don’t SHAKE 32-35ºC [Mild] – Shivering, Tachycardia, Tachypnoeic, Vasoconstriction 30-32ºC [Moderate] – Shivering stops, Pale/Cyanosed, Hypotensive, Confused, Lethargic <30ºC [Severe] –… Read more

Paediatric Hypoglycaemia

27-Nov-2020

Paediatric Hypoglycaemia (BM <2.6) is a relatively common presentation in the Emergency Department. However, if we don’t do the BM it’s easy to miss. Hypoglycaemia… Read more

Proximal Myopathy/Muscle Weakness

01-May-2024

The Case An elderly patient attends the ED with difficulty mobilising, Nursing staff tell you that the patient needs a CT head for STROKE? –… Read more

Pseudo-Hyperkalaemia Pathway

07-Apr-2025

When patients sent in by GP “” – how much do you do? Pseudo-Hyperkalaemia Pathway * Examples of High Risk Patients: Dialysis, Renal Transplant, CKD… Read more

Rhabdomyolysis

15-Jan-2024

We often worry about patients developing rhabdomyolysis and consequently developing AKI. However, there is much debate and little consistency in the published data, over how… Read more

Time Critical Medications

27-Aug-2025

Time Critical Medication (TCM) is scheduled medication that the patient is already on when they present to the Emergency Department (ED). The medications are “time… Read more