2 Week Wait – from ED

September 24, 2023

Non-Site-Specific Service The non-site-specific service is an excellent service for the investigation of suspected cancer within 2 weeks. Primarily NSS accept referrals for Cancer of… Read more

Consenting for Blood Transfusion

December 2, 2020

We frequently consent for Blood Transfusion, but what risks do we tell the patients about and how common are those risks? Read more

COVID-19 Vaccine Induced Thrombosis/Thrombocytopenia (VITT)

April 9, 2021

Inclusion Criteria [Both of]: Received AstraZeneca (AZ) COVID 19 vaccination within 42 days (typically 5-42 days from immunisation) New Onset thrombocytopenia (PLTs <150×109/L) – with… Read more

Dabigatran Reversal

September 16, 2019

Bleeding on Dabigatran? <C>ABCD – as usual trying to stop bleedBloods: FBC, Clotting, U&E, G&SDiscuss with Haematologist (esp. if taken within 12-24hr)Idarucizumab (PRAXBIND) 5g IVFound… Read more

DVLA – Driving & Medical Conditions

November 28, 2020

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

High INR

April 26, 2021

Patients sometimes present to ED or are send to ED due to over anticoagulation with warfarin 1. Is there Major/Significant bleeding? Yes Resuscitate (ABCD) Give… Read more

Lower Limb DVT

June 9, 2021

Signs and Symps No single feature is diagnostic: Single limb oedema – Most specific Leg pain – 50% but is nonspecific Calf pain on dorsiflexion… Read more

Massive Transfusion Pathway

April 27, 2021

In the case of patient with Massive Haemorrhage weather that be from Trauma, Surgical, O&G, UGIB, you can activate the MTP Remember: Do the Basics… Read more

Metastatic Spinal Cord Compression (MSCC)

October 3, 2018

This is guide to the investigation of Metastatic Spinal Cord Compression (MSCC) in Oncology/Haematology patients. You need to be a bit more suspicious and have a… Read more


February 19, 2021

Q: Why are Smurf’s Blue?  A: Methaemoglobin (MetHb) of course! – MetHb is produced by oxidisation of the Iron in Haemoglobin (Hb) from Fe2+ to Fe3+… Read more

Octaplex – work fast its an EMERGENCY!

April 3, 2021

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… Read more

Pre-Arrival Blood (O-ve)

March 13, 2019

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… Read more

Primary Intracerebral Haemorrhage

December 1, 2020

In anybody who there is suspicion of a non-traumatic haemorrhage arrange an urgent CT Head. All patients need IV access and  U&E, FBC, Coag If… Read more

Sickle Cell Crisis

June 7, 2019

Painful Crisis Severe pain is the most common reason that patients with sickle cell, will attend the ED. The pain can be agonising (and often… Read more

Transfusion Care Pathway

July 13, 2018

PDF: Transfusion Care Pathway When giving blood products you need to use the transfusion care pathway. Octaplex Blood/Plt’s/FFP It can be found on intranet >… Read more

Upper Limb DVT

April 19, 2023

Upper Extremity DVT (UEDVT) is far less common than Lower Extremity DVT, and posses a diagnostic challenge. We can use the Constant score in combination… Read more

VTE prophylaxis in lower limb Immobilisation (ED – 2023)

June 22, 2022

In the Emergency Department (ED) lower leg immobilisation after injury is a necessary treatment but is also a known risk factor for the development of… Read more