#NoF – Fractured Neck of Femur

December 15, 2019

BOAST Guidance #NoF patients (or other fragility fracture) who requiring CT Head (for head injury) also be performed a CT Neck Fragility fractures indicate the patient is at high… Read more

1. Why we get things wrong – “A tale of two systems”

November 3, 2018

Very few of us come to work intent on doing harm. However, despite that we all keep making mistakes. Most of them pass unnoticed and… Read more

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

Aortic Dissection

April 16, 2021

Aortic Dissection (AD), is uncommon (1 AD:200 ACS) but is…Rapidly FATAL!  Unfortunately recognising aortic dissection is difficult with a clinician pickup rate of 15-43%. Read more

Bell’s Palsy

June 10, 2020

Bell’s Plays is a lower motor neurone (LMN) lesion of the facial nerve (CN VII), which causes one side of the face to “droop” [1%… Read more

Bilary Disease

January 21, 2021

Gallstones are common, with a prevalence of approximately 10–15% of adults in Europe and the U.S. Most of the time patients are asymptomatic. but there are several ways… Read more

Button Battery Ingestion

April 13, 2023

A button battery lodged in the Oesophagus is a medical emergency as it can cause necrosis and significant GI bleed – Refer immediately If anybody… Read more

Chest Trauma – WYMTN

January 6, 2022

Chest injury as part of major trauma, can range from painful to life threatening so prompt treatment and recognition is vital. Esp. in ‘Silver Trauma’… Read more

Chronic Pancreatitis

November 7, 2020

Chronic pancreatitis is a low grade inflammatory disease of the pancreas. It can occur after an attack of acute pancreatitis or can present on its… 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

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

Dental Abscess

April 9, 2021

Dental Abscess requires a Dentist for Definitive Treatment Symptoms: Dental Pain Unpleasant taste Fever and Malaise Trismus Dysphagia Facial Swelling Regional Lymphadenopathy Tooth Decay Gum… Read more

Diverticulosis, diverticular disease and diverticulitis

December 30, 2020

The prevalence of diverticula Is unknown as most are asymptomatic. However, it is rare before the age of 40 and increases with age. Diverticulosis occurs… Read more

Early Pregnancy Bleed <16/40

November 27, 2020

Bleeding in early pregnancy is a relatively common problem and in the many cases (esp. with spotting) the pregnancy remains viable. However, bleeding in early… Read more

Epistaxis – Management

November 13, 2020

Nose bleeds are a bloody common problem (bad pun intended) – most originating at the front to the nose where there is a cluster of… Read more

Eye Clinic Referral Criteria

January 8, 2019

What should you send to Eye Clinic and how soon? Read more

FERNO Traction Splint

November 25, 2023

How to apply the FERNO traction splint for our in-hospital patients Read more

Hyperemesis Gravidarum

July 26, 2019

Nausea and vomiting in pregnancy is common and at best an unpleasant experience for the patient, and at worst can be life threatening. It normal… Read more

Ingested Magnets

May 20, 2021

Ingestion of Strong Magnets is a TIME CRITICAL EMERGENCY (Multiple Magnets OR a single Magnet and Metallic Objects) Strong magnets  (such as Neodymium) Now common… Read more

Lateral Canthotomy

May 7, 2019

Like tension pneumothorax the biggest step is deciding to do it – Remember it it sight saving and they heal well Retrobulbar Haematoma secondary to… 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

Necrotising Fasciitis

November 28, 2020

Necrotising fasciitis (NF) is a rare but serious bacterial infection that affects the soft tissue and fascia (Fournier gangrene, is NF affecting the perineum). In… 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


January 19, 2021

Primary Eyecare Acute Referral Scheme 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

RCEM CPD 2019 Day 1

April 2, 2019

 HEAD AND NECK Tracheostomy Emergency Care – Dr Brendan McGarth www.Tracheostomy.org.uk Needs to distinguish Tracheostomy from laryngectomy as a laryngectomy has no connection to the… Read more

Referral criteria for ENT clinics (CAS)

December 8, 2021

The following conditions can be referred through the ENT CAS clinic. If same day referral required talk directly with ENT on-call If suitable for CAS… Read more

Retrobulbar haemorrhage

February 2, 2020

What is retrobulbar haemorrhage? Rapidly progressing haemorrhage into the retrobulbar space which is rare but potentially sight threatening. Retrobulbar haemorrhage causes a rapid rise in… Read more


January 23, 2019

Our video maybe light hearted but… SEPSIS is a Killer (1:4 Die)  and time matters Recognise, Resuscitate, Review  Read more

Snake Bites

January 29, 2021

In the UK approximately 100 people are envenomated by a snake each year. So what do you need to do if your patient has received… Read more

Sore Throat

November 13, 2020

Background Acute sore throats are often caused by a virus, last about a week and get better without antibiotics. withholding antibiotics rarely causes complications. Antibiotic… Read more

Thomas Spint – how to apply

February 3, 2019

Invented 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

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 GI Bleed (UGIB)

October 20, 2020

Not normally difficult to spot, but look for it in unexplained anaemia, or collapse. Questions Is it VARICEAL? Mortality 35%, so is an emergency whatever… Read more

Urinary Retention

February 2, 2020

A common problem which affects 1 in 10 men between 70-79yrs and 1 in 3 men 80-89yrs (10M:F) Signs/Symptoms Unable to pass urine (may be… Read more

Urology Referral Pathways

July 1, 2021

Referral The first point of contact for urology advice and referral is the general surgical SHO. This is the on-call surgical SHO carrying the on-call… Read more

Vascular Emergencies (Regional Pathways)

December 27, 2020

Intro Vascular surgery has been reconfigured across etc region. The vascular oncall will be based at BRI 24/7. Multiple pathways have been developed below to… Read more