SCGH ED Clinical Guidelines

SCGH specific clinical guidelines.

• Non-SCGH Clinical Guidelines
• (## ) local intranet links and require access via the health network.
• (**) password protected – as per EDPACS

Administration / Legal

• Emergency Department – Inpatient Admissions (Sir Charles Gairdner Hospital Policy 193) ##
• Direct Admissions (Sir Charles Gairdner Hospital Policy 222) ##
• Specialty Admission Criteria ##
• Forensic Blood Sampling – Legislation – update 3/2017
• Patient Confidentiality – 08/2018

Allied Health & Support Services

• Language and Interpreter Services
• Alcohol and Drug Service (ADS) – (Intranet link)

Analgesia and Anaesthetics

• Analgesia in the ED – 04/2015 **
• Hydromorphone – 04/2015
• Oral opiates as discharge medications – 04/2015 **
• Oral Opioid Prescribing in Acute NON-Cancer Pain (from SCGH Medications Guidelines)
• Intranasal Fentanyl: Emergency Department
• CPOP – Community Program for Opioid Pharmacotherapy
• Bier’s block – 06/2019
• Local anaesthetic infiltration – 05/2009
• Procedural sedation documentation and checklist – 08/2010
• Femoral Nerve Block Procedure – 03/2019

Cardiology

• Chest pain pathway including code STEMI – 03/2015
• Atrial fibrillation with Tachycardia – 02/2016
• Defibrillation – 05/2009
• Electrical cardioversion – 05/2009
• Transthoracic cardiac pacing – 05/2009
• ECMO for OOHCA – 10/2017
• ECMO / ECPR Resources

Cardiothoracics

• Policy for the insertion of a chest drain by trainees – 05/2015
  • Chest Drain Insertion Guideline – 05/2009
  • Blunt Dissection Chest Drain (28Fg) Insertion Pack
• Chest wall injury (rib fractures) – 01/2015
• ECMO for OOHCA – 10/2017
  • ECMO / ECPR Resources

Critical Care

• Airway management – 01/2013
• Major haemorrhage / Massive Transfusion Protocol – 01/2009
• Tissue (Organ) donation – 09/2015
• Central line insertion – 05/2009
• Metaraminol: High Dependency Unit
• Central Venous Line (CVL) – SCGH Recommended Fixation Standard – 11/2015
• Post resuscitation care – 01/2013
• ECMO for OOHCA – 10/2017
• ECMO / ECPR Resources

Dental

• Dental injuries – 11/2015

Disaster

• SCGH ED Disaster Management Resources

ED Ultrasound

• SCGH ED Clinician Performed Emergency Ultrasound Guidelines – 01/2008

Endocrine

• Adult Insulin Subcutaneous Order and Blood Glucose Record – updated 2015

DRAFT GUIDELINES

Below are some draft guidelines in the final stages of approval. However, very similar guidelines are currently in use at FSH, and are pending approval at the other tertiary sites in WA. These draft guidelines are endorsed for use in their current format, over the previous 2006 guidelines, by the Endocrinology Department SCGH.

• Adult Variable Rate Insulin Guidelines – draft 2019
• SCGH Adult Diabetic Ketoacidosis (DKA) Guidelines and Management Record  – multi-page (easier to read) draft 2019
• SCGH Adult Diabetic Ketoacidosis (DKA) Guidelines and Management Record – single page (for printing) draft 2019
  • DKA – 02/2006
• SCGH Adult Hyperosmolar Hyperglycaemic State (HHS – formery known as HONK) Guidelines and Management Record – draft 2019
  • HONK – 02/2006

ENT

• Epistaxis – 02/2010

Environmental

• Anaphylaxis – 11/2013
• Diving emergencies – 09/2015

Gastroenterology & Hepatology

• Upper GI bleeding – 11/2015
• Paracentesis in Chronic Liver Disease – 11/2013##
• Decompensated Chronic Liver Disease Guideline – 02/2017
• PEG re-insertion – 01/2009

General Medicine

• Eating Disorder Management – 09/2016
• Hyponatraemia Management Guidelines – 08/2019

General Surgical

• Hot surgical clinic – 02/2015

Haematology & Oncology

• Blood Transfusions (link to hospital site) ##
  • Consent to Blood Products (Form C)
  • Refusal to Consent to Blood Products (From D)

• Major haemorrhage / Massive Transfusion Protocol – 05/2017
• Jehovah’s witnesses and blood products – 11/2015**
• Febrile Neutropenia Management Guideline
• Iron infusions for chronic anaemia – 08/2017
• Blood transfusion reaction algorithm – 11/2015
• NOAC’s and bleeding – 11/2013
• Management of Immune Related Adverse Events Associated with use of Immune Checkpoint Inhibitors – 05/2017

Immunology

• Anaphylaxis – 11/2013
• Management of Immune Related Adverse Events Associated with use of Immune Checkpoint Inhibitors – 05/2017
• PEP (Post Exposure Prophylaxis) HIV: Starter Packs for Occupational and Non-Occupational exposure

Infectious Disease

• SCGH ED Adult Sepsis Pathway Trial Document – 04/2019
• SCGH Infection Control Unit (Intranet only)
• SCGH Infection Protection and Control Manual
• Patient Placement/Admission Criteria: Standard & Additional Transmission Based Precautions (PS026)
• SCGH Viral Haemorrhagic Fever Policy
• Standard and Transmission Based Precautions Policy Includes a table at the bottom that lists precautions indicated for each infectious agent. Note: Airborne Infection Isolation Rooms (AIIRs) must be used for patients with the following conditions:
  • Pulmonary tuberculosis
  • Chickenpox or disseminated shingles infections
  • Measles
  • SARS
  • Avian Influenza
  • Viral Haemorrhagic Fever
  • +/- Mumps (droplet precautions, but prefer door!)
• SCGH Infectious Disease Guidelines (intranet)
  • SCGH Antimicrobial prescribing policy
• SCGH Antimicrobial Formulary List (intranet) This list has been created to identify the antimicrobials available and outline the restrictions that exist for certain antimicrobials prescribed at SCGH.
• Febrile Neutropenia Management Guideline (intranet)
• Admission criteria – HITH (IV Antibiotics) (intranet)
• STIs – 07/2016
• Sepsis Triage Screening Tool – 01/2018
• Guidelines for Rabies and Australia Bat Lyssavirus exposure (intranet)
• MERS CoV – 06/2015
• PEP (Post Exposure Prophylaxis) HIV: Starter Packs for Occupational and Non-Occupational exposure (intranet)

Legal

• Forensic Blood Sampling – Legislation – update 3/2017

Neurology

• Stroke Call Pathway – 11/2017
  • Acute Large Vessel Occlusion (LVO) Stroke: Emergency Clot Removal Information Sheet – 5/2017
• Spontaneous intracerebral haemorrhage – 11/2014
• Vertigo assessment – 01/2014 (for review)
• Lumbar puncture – 05/2009
• Seizures – 09/2009
  • FSH ED Seizure Guideline – 12/2014 
  • SCGH First Seizure and Epilepsy: SAFETY & DRIVING INSTRUCTIONS-11/2016

Neurosurgery

• Head injury – 05/2015
• Spinal cord injury assessment and documentation – 04/2015

Oncology

• Management of Immune Related Adverse Events Associated with use of Immune Checkpoint Inhibitors – 05/2017

Ophthalmology

• Emergency Eye Assessment Sheet – 12/2016
• Acute Angle Closure Glaucoma Management – 01/2020

Orthopaedics

• Arthrocentesis (joint aspiration) – 05/2009
• Femoral Nerve Block Procedure – 03/2019
• Bier’s block – 06/2019
• Orthopaedic Investigation Ordering Guideline – 08/2019

O&G

• Mx of of 1st Trimester Pain &/or Bleeding – 10/2015
• Sexual assault – 02/2009
• Obstetric patients at SCGH ED – 11/2015
• Radiology Procedure for Imaging Pregnant Patients – 01/2016

Pharmacy

• SCGH Medication Guidelines

Psychiatry & Behavioural

• Mental Health Catchment Areas – 02/2016
• NMHS Patient Flow Process to access a Mental Health Bed – 3/2014
• Eating Disorder Management – 09/2016

Radiology

• Radiology Procedure for Imaging Pregnant Patients – 01/2016
• Cervical spine injury investigation – 01/2015
• Pulmonary embolism initial diagnostic pathway – 05/2011
• X-Ray Risk Calculator – as the name suggests
• Diagnostic Imaging Pathways WA DOH

Renal

• CAPD peritonitis – 02/2014

Respiratory

• Policy for the insertion of a chest drain by trainees – 05/2015
  • Chest Drain Insertion Guideline – 05/2009
  • Blunt Dissection Chest Drain (28Fg) Insertion Pack
• COPD – 08/2015
• Pulmonary embolism initial diagnostic pathway – 09/2017
• Pulmonary embolism advanced care pathway – 02/2018
• Pneumothorax – 04/2014 (for review)

Toxicology and Toxinology

• Toxicology Hanbook (3rd Edition) – via SCGH Library
• Paracetamol poisoning – 06/2019
• Lithium toxicity – 04/2016
• Snake bite envenomation – 09/2015
• Emergency Department Prescription and Recreational Drug Screening Trial – 12/2015

Trauma

• Resuscitation / Trauma Team Roles – 4/2015
• SCGH Trauma Call Criteria – 11/2017
• Cervical spine injury investigation – 01/2015
• Philadelphia collar application – 04/2015
• Head injury – 05/2015
• Femoral Nerve Block Guideline – 03/2019
• Burns Assessment & Management – 08/2019
• Wound Closure Advice from Closing the Gap Website

Urology

• Urinary catheterisation – 05/2009

Vascular

• Deep Vein Thrombosis (DVT) – 9/2019
• Central catheter related venous thrombosis – 04/2014
• Foot and leg ulcers – 05/2015