2WW – Suspected Cancer
01-Jan-2025Some 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-2024Adrenal 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-2023Diabetic 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-2024Things 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-2021Diabetic 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-2024For 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-202390% 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-2024Remember: 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-2024Hypernatraemia 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-2025HHS (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-2023Hypocalcaemia 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-2023Hypoglycaemia (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-2023Hypokalaemia (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-2025Classification 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-2023Hyponatraema 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-2023Remove 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-2020Paediatric 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-2024The 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-2025When 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-2024We 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-2025Time 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