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A-a gradient = Alveolar Oxygen – arterial Oxygen This is “relatively” simple way of working out if the paO2 on a ABG is normal, and demonstrates… Read more

We are frequently asked to check the lactate on Venous Blood Gases (VBG’s), by the nursing staff. However, remember to look at the first result… Read more

Asthma is common and potentially fatal. Severity – Severe or Life threatening – think RESUS Treatment within 30 min – bronchodilators and steroids should bee… Read more

COPD patients vary widely, due to their comorbidities, social circumstances, and wishes. So choosing the best treatment pathway for the patient can be complex. Involve… Read more

NHS England has introduced the use of a “40 step desaturation test” into discharge planning from the ED. You will have heard Covid -19 patients… Read more

The 4C mortality score has been developed by ISARIC[BMJ], based on 35.463 UK Covid-19 patients. If cases climb prognostication may become more important and this… Read more

NIV/CPAP  is an Aerosol Generating Proceedure (AGP) Staff must wear full APG PPE In Side room with a door Door Marked with APG sign –HERE… Read more

Deteriorating Patients Early senior decision making around DNACPR, is vital for both staff, patients, and families. Document decsion making and communications clearly There will be… Read more

You may have seen in the news early results from the RECOVERY trial. In Covid-19 patients requiring either Oxygen or Intubation, dexamethasone has been shown… Read more

Experience is showing that those with diabetic patients with COVID-19 are more likely to develop DKA/HSS. However, treating them with the traditional large amount of… Read more

Local instructional videos for donning/doffing Non-Aerosol Generating Procedures Aerosol Generating Procedures Disponible FFP3 (Leeds) Read more

Due to the limited capacity when referring patients to the “New Arrhythmia Clinic” we MUST Send a BNP We don’t need to wait for the result… Read more

Eligibility Symptoms suggestive of Acute Myocardial Infarction Chest Pain within 12 hours ECG showing acute myocardial infarction ST elevation >1mm in limb leads ST elevation… Read more

Both COVID-19 infection and treatment with dexamethasone impair glycemic control. So its important to monitor blood sugars and consider DKA & HHS in COVID-19 patients.… Read more

AKA: Paediatric Inflammatory Multi-system Syndrome – Temporally associated with SARS-CoV 2  Although COVID-19 seems a benign disease in almost all children there are increasing evidence (however… Read more

Some patients who present with COVID-19 infection will be not suitable for escalation and actively dying when they attend the ED, for these patients the… Read more

During the current Covid-19 pandemic relatives are not attending the hospital with patients, which means we are increasingly having to have difficult conversations over the… Read more

During the Covid-19 pandemic alternatives to LMWH have been agreed – [For those who can’t inject themselves] Read more

British Society of Thoracic Imaging (BSTI) have released a free learning resource containing CXR and CT of confirmed Covid-19 cases, will short history including time… Read more

NIPPV 3 machines are used throughout the trust to deliver NIV and CPAP – and should be commenced in ED if transfer to ward/ICU is… Read more

The 2019-20 Flu season has arrived, and we need to be thinking about who to test and who to treat. Full guide HERE But don’t forget… Read more

Please see the updated SOP for Middle East respiratory syndrome coronavirus. Make sure you are familiar with this protocol and for anymore information please contact… Read more

CAP is far less common than URTI’s, however, it needs to be considered within your differentials. Depending on severity there is a guide to investigation… Read more

Severe Pneumonia: Please Request/Send – Samples Sputum/Blood/Urine BTS Definition of CAP Signs of acute Lower Respiratory Tract illness (LRTI) [Cough] &:  ≥1 other LRTI Symptom… Read more

PE is somehow both the most over and under diagnosed condition. with severity ranging from the questionable sub-segmental PE to the Massive PE (an indication… Read more

Unfortunately the the normal pathway for investigation of PE performs poorly in pregnancy RCOG have the following pathway 1. Investigation – of suspected PE Clinical… Read more

Trust Guidance varies slightly from BNF for those patients over 100kg Non-Pregnant PE/DVT treatment CrCl Calculator – HERE CrCl <20ml/min contact haematologist Pregnant PE/DVT treatment… Read more