#NoF – Fractured Neck of Femur
December 20, 2017Update: BOAST Guidance If a patient with a #NoF (or other fragility fracture requiring admission) has received a head injury requiring CT a CT Neck… Read more
Achilles Tendon Rupture
May 5, 2019A common sporting injury, especially in disciplines that require stop start sprints or rapid changes of direction Read more
Acromioclavicular Joint Injuries
May 10, 2019One of the most common shoulder injuries, acromioclavicular joint (ACJ) dislocations account for around 9% of shoulder girdle injuries Read more
Adult Sedation
June 4, 2020This guideline is a brief summary of the RCEM 2012 Safe sedation in the ED and RCEM – Pharmacological Agents for Procedural Sedation and Analgesia… Read more
Animal Bites – Mammalian
July 17, 2018Dog, and other mammalian bites, are a common presentation with the ED. They can be easy to treat, but need some particular attention if we… Read more
Burns Referral Pathway
May 8, 2019A new burns referral pathway has been developed with Mid Yorks to securely send images of the patients burn. Allowing the burns team to arrange… Read more
C-Spine Injury
September 4, 2018C-spine injury ranges from the obvious fracture-dislocation to the less obvious ligamentous injury, affecting about 2.5% of blunt trauma patients. However, ALL of them are… Read more
COVID-19 (VTE prophylaxis in Lower Limb Injury)
April 20, 2020During the Covid-19 pandemic alternatives to LMWH have been agreed – [For those who can’t inject themselves] Read more
CT Abdo/Pelvis & Pregnancy Testing
December 11, 2019Radiology are now requesting blood pregnancy testing reproductive females from 10-35days from last period. But what is wrong with urine pregnancy testing? Read more
Dabigatran Reversal
September 16, 2019Bleeding 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
Dislocated Shoulder (Teaching Video)
December 1, 2018Great review of shoulder reduction, techniques and sedation. Learning points: Most techniques will work 80% of the time (Best results tailor the technique to the… Read more
Domestic Abuse
August 27, 2018Domestic abuse can affect anyone and often its not readily disclosed on an ED admission. We must be alert to the fact some of our… Read more
Elbow Crutches
May 22, 2018Measuring for and advising patients on the use of elbow crutches is an important skill for ED staff. Read more
Eye Clinic Referral Criteria
January 8, 2019What should you send to Eye Clinic and how soon? Read more
Fracture Clinic is Changing
March 26, 2019Fracture Clinic is changing to Virtual Fracture Clinic (VFC) It’s been found that 30% of patients referred to fracture clinic where discharged with only advice… Read more
Haematoma Block – Colles’
September 27, 2019Haematoma blocks can be a safe and effect method of pain relief to facilitate reducing Colles’ fractures. What to give? 1% Lidocaine Onset 10-15min Offset… Read more
Head Injury
February 27, 2018Background Defined as any traumatic injury to the head other than superficial facial injuries. The commonest cause of death and disability in people age 1-40… Read more
Humeral Brace – Application
October 6, 2019Inclusion Criteria – All closed neurovascular intact adult humeral shaft fractures Exclusion Criteria – Intra-articular fractures of either the proximal or distal humerus, and surgical… Read more
LA – Toxicity
December 22, 2017We are regularly doing femoral blocks next to major vessels. So warn the patient of the symptoms, & keep them monitored(at least 15 min). Symptoms… Read more
Limping Child
April 21, 2018This is a relatively common presentation within the ED that has a myriad of possible diagnoses ranging from sprain to malignancy. One thing to remember… Read more
Lisfranc Injuries
February 9, 2019A Lisfranc injury describes an injury of the foot between the metatarsal and tarsal spaces. Around 20-40% of lisfranc injuries are initially missed, so a… Read more
Lower Back Pain: Red & Yellow Flags
December 14, 2019Each year 1:15 of the adult population will seek medical help for Lower Back Pain, that is 2.6 million patients in the UK. Most Lower… Read more
Lower Limb ED Physio Referrals
May 31, 2018Lower limb (LL) and especially knee injuries are a very common presentation within the ED, but in the acute phase can be difficult to give a… Read more
Mallet Finger
May 19, 2018Mallet Deformity is an inability to maintain extension of the distal phalanx of the finger at the distal intraphalangeal joint. Read more
Morton’s Neuroma
October 24, 2018Morton’s Neuroma is a painful condition resulting from the fibrous thickening of the plantar interdigital nerve of the foot. Often described as feeling like… Read more
Nail Trephination
May 9, 2018Bleeding under the nail from blunt trauma can be very painful. Lucky we have the tools on hand to ease some of that pain. Read more
Neck of 5th Metacarpal Fractures
June 21, 2019Neck of fifth Metacarpal (Boxer’s) fractures are a common injury, and how we treat them locally is changing. Read more
Octaplex – work fast its an EMERGENCY!
December 16, 2017In recent incidents we have had significant delays in giving OCTAPLEX, So ….. Activate EARLY in head injury patients on warfarin. Order on EPR &… Read more
Paediatric Clavicle Fracture
March 26, 2018Clavicle fracture is a common presentation and some patients can be managed at home without fracture clinic follow up. Inclusion Criteria Isolated mid-shaft clavicle fracture… Read more
Paediatric Ketamine Sedation
June 4, 2020RCEM 2012 Safe sedation in the ED and RCEM Ketamine for paediatric procedural sedation guideline. Please read these documents in full or participate in RCEM… Read more
Paronychia
October 5, 2018Infection in the skin fold (or paronychium) to lateral edge of the nail (of the finger or toe, but most commonly finger). Leads to a… Read more
PEARS
December 8, 2018Primary Eyecare Acute Referral Scheme Read more
Posterior Shoulder Dislocation
December 3, 2020Posterior shoulder dislocation is far less common than anterior dislocation. But it is commonly missed with some sources stating 50% of posterior dislocations are missed… Read more
Rabies [notifiable disease]
July 17, 2018Recent Incident: Bat contact was not recognized (effectively touching a bat without gloves means treatment is recommended) Rabies is an acute viral encephalomyelitis caused by members of… Read more
Radial Buckle Fractures
March 26, 2018Some Radial Buckle #’s in children can be managed with: Well fitting splint Advice sheet This decision tree must be followed to identify suitable patients… Read more
Rape & Sexual Assault
March 6, 2018Don’t Preform intimate examinations on Sexual assault/Rape patients Unless life-threatening injuries are suspected e.g Haemorrhage. As our examination will inevitably destroy evidence that may aid… Read more
Rare Antidotes – how to get
August 30, 2018Getting some of the rarer antidotes has recently been clarified across Yorkshire (Accessing rarely used antidotes-SOP) Read more
Rhabdomyolysis
January 15, 2019We 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
Rock Paper Scissors OK (RPSOK)
October 4, 2019URM! anyone for Rock Paper Scissors OK (RPSOK) Assessment of nerve function after upper limb injury in children has been shown to be poorly documented.… Read more
Safeguarding Adult & Child
January 7, 2018Safeguarding is massively important but often not done! This can be due to lack of recognition OR not knowing what help there is. Often our… Read more
Sex, Bites, and Needle Sticks
February 28, 2018First Aid (ALL) Encourage bleeding Wash with copious amounts of water or saline Don’t Suck Don’t use Caustic agents Read more
Silver Trauma
October 21, 2019The population is ageing and thus our ‘typical’ trauma patient is also changing. In 2017 the TARN report “Major injury in older people” highlighted the… Read more
Tetanus – Wounds
July 26, 2018Changes in: Tetanus prone and High Risk definitions Immunisation schedule Primary: 2, 3 & 4 months old Boosters: 3½ – 5yrs and 13-15yrs Warning: Immunisation… Read more
Tetanus Immunoglobulin – SHORTAGE
July 4, 2018Changes in: Tetanus prone and High Risk definitions Recently there have been supply problems with Human Tetanus Immunoglobulin, currently we are using the alternatives below. Post-Exposure… Read more
Thomas Spint – how to apply
February 3, 2019Invented by a Welshman ‘Hugh Owen Thomas’, the introduction of this simple device in World War 1 went on to reduce the mortality of #femurs… Read more
Tick Bites
July 17, 2018Though less common locally than in some areas, tick bites pre and post removal do offer some concern to patients. Read more
TXA – Tranexamic Acid
October 16, 2019TXA a bleeding wonder drug! Crash 2 Study (2010) Multi-Centre RCT of the use of TXA in trauma Inclusion – Adult trauma patients with ≥1… Read more
Upper Limb ED Physio Referrals
April 28, 2018Upper limb (UL) and especially shoulder injuries are a fairly common presentation within the ED, but in the acute phase can be difficult to give a… Read more
Vaccination Schedules UK & International
March 27, 2019Working out what your patient might have been vaccinated for can be tricky, and more so if they were raised outside of the UK. Luckily… Read more
VTE prophylaxis in Lower Limb Injury
December 16, 2017Consider in ALL over 16’s with lower limb immobilisation. Bloods not required for everyone. Prescribe for 2 weeks (to cover any delay to # clinic)… Read more