SCGH ED Clinical Guidelines

Page currently in development………..

## denotes direct intranet links – these are not searchable by the search engine below, and will require access via the health network.

**denotes password protection – password as per EDPACS

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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)
• Social Work – coming soon…
• Care Coordination Team – coming soon…

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
• Upper limb nerve blocks – 05/2009
• Femoral nerve blocks – coming soon…

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
• Aortic dissection – coming soon…

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

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
• Tonsillitis – coming soon…

Environmental

• Anaphylaxis – 11/2013
• Diving emergencies – 09/2015
• Hyperthermia – coming soon…

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
• Syncope – coming soon…
• Hypokalaemia – coming soon…
• Hyperkalaemia – coming soon…
• Pyelonephritis – coming soon…
• Cellulitis – coming soon…
• Palliative care – coming soon…
• Angioedema – coming soon…

General Surgical

• Hot surgical clinic – 02/2015
• Obstructive jaundice – coming soon…

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
    • 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!)
    • Patient Placement/Admission Criteria: Standard & Additional Transmission Based Precautions (PS026)
    • SCGH Viral Haemorrhagic Fever Policy
      • SCGH VHF ED Specific Action Cards – pending…

• 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)
• Accidental body tissue exposure (needle stick injuries) – coming soon…
• Fever in the returned traveller – coming soon…

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
• Low back pain – 05/2009
• Investigation of subarachnoid haemorrhage – coming soon…

Oncology

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

Ophthalmology

• Emergency Eye Assessment Sheet – 12/2016

Orthopaedics

• Arthrocentesis (joint aspiration) – 05/2009
• Femoral Nerve Block Procedure – 03/2019
• Bier’s block – 06/2019
• Fractured NOF – coming soon…

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
• Pharmacological management of the agitated patient – 01/2009
• Physical restraints – 12/2006
• Code blacks – 01/2006
• MHOA – coming soon…

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)
• Pleural effusion – coming soon…

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
• Opiate overdose – coming soon…
• Amphetamine intoxication – coming soon…
• Body packers – coming soon…
• Alcohol withdrawal – coming soon…
• Drug and Alcohol Service – coming soon…

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 Management – CME talk by Liz Wharton (FSH Burns Unit) 2/2016
• Wound Closure Advice from Closing the Gap Website
• Emergency department thoracotomy – coming soon…

Urology

• Urinary catheterisation – 05/2009
• Urinary retention and trial of void – coming soon…
• Renal colic – coming soon…

Vascular

• Deep Vein Thrombosis (DVT) – 5/2016
• Central catheter related venous thrombosis – 04/2014
• Foot and leg ulcers – 05/2015
• Acute limb ischaemia – coming soon…
• Ruptured AAA – coming soon…