Adult Medical Emergency Handbook - Scottish Intensive Care Society

i
AGE > 55 years
arterial PO 2 100 U/l
glucose >10 mmol/l (in absence of diabetes)
urea >16 mmol/l
(A C-reactive protein level over 100 mg/l may also reflect the presence
of a severe attack and can be used to monitor progress and the need
for CT scan).
INTER HOSPITAL TRANSFER BETWEEN UPPER GI (RIE)
AND LOWER GI (WGH) UNITS IN EDINBURGH
• Both units receive “General Surgery” where the diagnosis is either
uncertain or outwith the GI tract. Allocation will depend on bed
availability and patient location. Bed Bureau will usually decide
destination.
• Patients assessed in either hospital should have appropriate first
line investigations carried out in that hospital, if feasible, to confirm
diagnosis before transfer, e.g. abdominal ultrasound for suspected
biliary colic and CT abdo/pelvis for acute diverticular disease etc.
Discussion must take place at Registrar or Consultant level
only.
• Patients must be stable before transfer and the “transfer form”
(attached) must be completed in all cases. Between arranging
transfer and the patient leaving, the referring team must continue
to ensure resuscitation and ongoing monitoring is taking place,
with regular review and reassessment.
• Patients who are unstable and therefore unsuitable for transfer
should be discussed between consultants.
• In-patient emergencies arising in St John’s Hospital outside those
hours where there are surgeons on site (8am – 6 pm Monday –
Thursday and 8 am – 2 pm Friday) should be discussed initially
with the consultant on-call at the Western General Hospital.
Clearly if the problem is upper gastrointestinal/biliary pancreatic
adult medical emergencies handbook | NHS LOTHIAN: UNIVERSITY HOSPITALS DIVISION | 2009/11
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