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City hospitals Sunderland A&E Department Information Card Pack Produced by Dr Sarah Frewin Correspondence to s.e.fr

City hospitals Sunderland A&E Department Information Card Pack Produced by Dr Sarah Frewin Correspondence to s.e.frewin@doctors.org.uk Review date: January 2012. Nexus C-spine rules NICE COPD guidance Glasgow pancreatitis score NICE head CT guidance (amendment)

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City hospitals Sunderland A&E Department Information Card Pack Produced by Dr Sarah Frewin Correspondence to s.e.fr

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  1. City hospitals Sunderland A&E Department Information Card Pack Produced by Dr Sarah Frewin Correspondence to s.e.frewin@doctors.org.uk Review date: January 2012

  2. Nexus C-spine rules NICE COPD guidance Glasgow pancreatitis score NICE head CT guidance (amendment) Alvarado score NICE head CT guidance Rectal bleeding differentials Chest pain differentials Upper GI bleed differentials Breathlessness / hypoxia differentials Abdominal pain differentials Bradyarrhythmia differentials Jaundice differentials Tachyarrhythmia differentials Rockall score (GI bleed) Reversible causes of cardiac arrest ABCD2 (TIA) ECG interpretation Severe sepsis criteria New York heart failure classification Sepsis screening tool Grading of murmurs Severe sepsis 1st hour pathway Headache differentials Soft tissue antibiotic policy Dizziness differentials Curb 65 (pneumonia) AMTS LRTI antibiotic policy Timed get up and go test Meningitis antibiotic policy Stroke mimics UTI antibiotic policy falls /collapse differentials Wells criteria (PE) Pain assessment Wells criteria (DVT) Confusion differentials MRC dyspnoea scale Hypotension differentials ASA grading (anaesthetics) Stages of hypovolemic shock BTS asthma exacerbation grades CO poisoning

  3. COPD Guidance (NICE)

  4. Asthma Exacerbation Grades (BTS)

  5. TIMED GET UP AND GO TEST Patient wearing regular footwear, using usual walking aid, and sitting back in a chair with armrest. Ask patient to do the following: 1. Stand up from the armchair 2. Walk 3 meters (in a line) 3. Turn 4. Walk back to chair 5. Sit down Observe patient for postural stability, steppage, stride length and sway Scoring:- Normal:- Completes task in < 10 seconds Abnormal:- Completes task in >20 seconds Low scores correlate with good functional independence High scores correlate with poor functional independence and higher risk of falls

  6. PC:- Headache, N&V, drowsiness, dizziness, dyspnoea, chest pain Questions Do you feel better away from home or work? Does anyone else in the house have the same symptoms? Have you recently had a heating / cooking appliance installed? Have all cookers / heaters been service in the last year? Do you ever use your oven / stove for heating purposes? Has there been any change to the ventilation in your home (eg double glazing)? Have you noticed any soot / increase condensation around appliances lately? Does your work involve exposure to smoke / petrol fumes? What type of home do you live in (detached / semi / hostel etc.)? Suspected CO poisoning Management Blood for COHb estimation Oxygen Do not allow patient to go home to where there are suspect appliances Contact local HPA

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