SCGH ED Clinical Guidelines
Note – The guidelines on this page are a combination of relevant guidelines for the management of a range of Emergency Department presentations, and include:
- Health Department Guidelines
- Available outside of the WA Health network
- SCGH Hospital Wide Guidelines
- Marked as “Intranet links”
- These require access from within the WA Health network
- Here is the link to the SCGOPHCG Policies Hub – including a A-Z title search
- SCGH ED Specific Guidelines
- Denoted by those having the date of development / most recent update after the title (ie. – 10/2019)
- These are predominantly developed by SCGH ED staff in consultation with the relevant inpatient specialty teams for use within the emergency department
- These documents are hosted directly on this website and are accessible for anyone, regardless of the point of internet access
For guidelines not covered on this page. Here is a list of Non-SCGH Clinical Guidelines that provide some useful guidance in patient management for a range of presentations / conditions not included in this list below.
(**) password protected – as per password for EDPACS
Administration / Legal
- SCGH Admission and Bed Allocation Policy – Intranet link
- SCGH Specialty Admission Criteria– Intranet link
- Expedited Transfer of Medical Assessment Unit Patients to Another Specialty – Intranet link
- The purpose of this policy is to outline the procedure to expedite transfer of patients between the MAU and other specialties
- SCGH General Medicine Orientation Manual (download link that includes the “Sub-Speciality Admission Criteria” starting at page 75) – Intranet link
- Perth Tertiary Hospital Metropolitan Catchment Areas
- WA Country Health Service (WACHS) Patient Flow Information
- WACHS Tertiary Hospital Catchments
- List of the receiving metropolitan tertiary hospitals as per referring regional areas / medical and surgical specialties
- SCGH accepts transfer of the following patients:
- patients from the Midwest (includes Gascoyne, Murchison and Midwest Health Districts) and Costal Wheatbelt Regions (see maps below), except those requiring specialist services at another tertiary service (ie. trauma or burns), or
- any patient known to a specialist team at SCGH, or
- patient requiring an SCGH specialty service not available at another tertiary service (ie. NIISWA – afterhours, Neurosurgery – atraumatic), or
- patients that cannot get a bed at their usual receiving tertiary hospital, if one is available at SCGH
- Wheatbelt regional map
- WACHS Tertiary Hospital Catchments
- Forensic Blood Sampling – Legislation (update 3/2017)
- Patient Confidentiality – 08/2018
- Voluntary Assisted Dying – Information Management System
- It is where practitioners can:
- submit forms to the Voluntary Assisted Dying Board in Western Australia
- register for the Department of Health participating practitioner eligibility verification process (including access to the mandatory approved training)
- It is where practitioners can:
- Helicopter Interhospital Transfer Protocol – 2/2023
- APTC Clinicians Dashboard
- Showing all pending APTC directed transfers from the WA regional areas
- My Emergency Visit (MEV) Instructional Videos – 11/2023
- KEMH – SCGH Transfer for Imaging Pathway – 11/2023
Allied Health & Support Services
- Language and Interpreter Services – summary document, including link to NMHS Interpreter Services and Translated Information Policy
- Alcohol and Drug Service (ADS) – Intranet Link
- Link includes the SCGH drug withdrawal management guidelines
Analgesia and Anaesthetics
- SCGH Acute Pain Service (APS) Pocket Guide – link pending
- SCGH ED Prescribing Pathway for Discharge Analgesia – 09/2022
- Hydromorphone – 04/2015
- Oral opiates as discharge medications – 04/2015 **
- Oral Opioid Prescribing in Acute NON-Cancer Pain (from SCGH Medications Guidelines) – Intranet link
- Intranasal Fentanyl: Emergency Department – Intranet link
- CPOP – Community Program for Opioid Pharmacotherapy – Intranet link
- Bier’s block – 06/2019
- Local anaesthetic infiltration – 05/2017
- Procedural sedation documentation and checklist – 08/2010
- Femoral Nerve Block Procedure – 03/2019
Cardiology
- Chest pain pathway (03/2015) & Code STEMI Protocol (03/2022)
- Atrial fibrillation with Tachycardia – 02/2016
- Defibrillation – 05/2009
- Electrical cardioversion – 05/2009
- Transthoracic cardiac pacing – 05/2009
- ECMO for OOHCA – 04/2022
Cardiothoracics
- Policy for the insertion of a chest drain by trainees – 05/2015
- SCGH Massive Transfusion Protocol – Intranet link
- Rib Fractures / Chest Wall Injury in the Elderly – 12/2023
- ECMO for OOHCA – 04/2022
- Pulmonary embolism advanced care pathway – 03/2023
Critical Care
- Airway management – 01/2013
- SCGH Massive Transfusion Protocol – Intranet link
- Tissue (Organ) donation – 09/2015
- Central line insertion – 05/2009
- Metaraminol: High Dependency Unit – Intranet link
- Central Venous Line (CVL) – SCGH Recommended Fixation Standard – 11/2015
- Post resuscitation care – 01/2013
- ECMO for OOHCA – 04/2022
- Pulmonary embolism advanced care pathway – 03/2023
Dental
Dermatology
- Delusional Parasitosis
- Stevens-Johnson Syndrome / Toxic Epidermal Necrolysis – FSH Guideline 06/2023
Disaster
- SCGH ED Disaster Management Resources – where can I find them in the ED?
ED Ultrasound
Endocrine
- Adult Variable Rate Intravenous Insulin Guideline (updated 02/2021) – Intranet link
- Adult Diabetic Ketoacidosis (DKA) Guideline (updated 02/2021) – Intranet link
- Adult Hyperosmolar Hyperglycaemic State (HHS) Guideline (updated 02/2021) – Intranet link
- Updated 2020 Diabetic Guidelines Educational Package – Intranet link
ENT
Environmental
Gastroenterology & Hepatology
- Upper GI bleeding – 05/2022
- Paracentesis in Chronic Liver Disease – Intranet link
- Decompensated Chronic Liver Disease Guideline – 02/2017
- PEG re-insertion – 01/2009
General Medicine
- Eating Disorder Management – 09/2016
- Hyponatraemia Management Guidelines – 07/2020
- Hyperkalaemia Management Guidelines – SCGH – 08/2023 – Intranet link
- Suspected Cauda Equina Pathway – 07/2020
- Chest wall injury (rib fractures) – 01/2015
General Surgical
- Some surgical guidelines coming soon…?!
Geriatric Medicine
- Geriatrics Assessment Team (GAT) Referral Criteria – 02/2024
- Older Adult Discharge Supports:
- Rib Fractures / Chest Wall Injury in the Elderly – 12/2023
Haematology & Oncology
- SCGOPHCG Transfusion Policy Manual– Intranet link
- Transfusion Forms – Intranet link
- SCGH Massive Transfusion Protocol – Intranet link
- Jehovah’s witnesses and blood products – 11/2015 **
- Neutropenic Sepsis Guideline – Intranet link
- Iron Deficiency Management Guideline for SCGH ED – 10/2023
- Iron infusions for chronic anaemia – 12/2020 – Intranet link
- 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 – Intranet link
- Vaccine Induced Immune Thrombotic Thrombocytopaenia (VITT):
- THANZ Advisory Statement for Haematologists: VITT Multidisciplinary Guideline for Doctors
- ACEM – Thrombosis with Thrombocytopaenia Syndrome (TTS) following COVID-19 vaccination: Assessment of patients presenting to the Emergency Department with TTS symptoms
- DOHWA: VITT Clinican Alert (16th of April 2021)
- Where to report adverse events:
- Deep Vein Thrombosis (DVT) – 08/2023
Immunology
- Anaphylaxis Management Pathway – 05/2023
- Management of Immune Related Adverse Events Associated with use of Immune Checkpoint Inhibitors – Intranet link
- PEP (Post Exposure Prophylaxis) HIV: Starter Packs for Occupational and Non-Occupational exposure – Intranet link
- Where to report vaccine associated adverse events:
Infectious Disease
- SCGH ED COVID-19 Guidelines (Updated) – 12/2021
- Vaccine Induced Immune Thrombotic Thrombocytopaenia (VITT):
- THANZ Advisory Statement for Haematologists: VITT Multidisciplinary Guideline for Doctors
- ACEM – Thrombosis with Thrombocytopaenia Syndrome (TTS) following COVID-19 vaccination: Assessment of patients presenting to the Emergency Department with TTS symptoms
- DOHWA: VITT Clinican Alert (16th of April 2021)
- Where to report adverse events:
- Vaccine Induced Immune Thrombotic Thrombocytopaenia (VITT):
- SCGH ED Adult Sepsis Pathway – 12/2019
- SCGH Infection Control Unit – Intranet link
- SCGH Infection Protection and Control Manual – Intranet link
- Patient Placement/Admission Criteria: Standard & Additional Transmission Based Precautions (PS026) – Intranet link
- SCGH Viral Haemorrhagic Fever Policy – Intranet link
- 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:
- COVID-19
- 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 link
- SCGH Antimicrobial prescribing policy – Intranet link
- SCGH Antimicrobial Formulary List – Intranet link
- This list has been created to identify the antimicrobials available and outline the restrictions that exist for certain antimicrobials prescribed at SCGH.
- Neutropenic Sepsis Guideline – Intranet link
- Admission criteria – HITH (IV Antibiotics) – Intranet link
- STIs – 07/2016
- Sepsis Triage Screening Tool – 01/2018
- Guidelines for Rabies and Australia Bat Lyssavirus exposure – Intranet link
- MERS CoV – 06/2015
- PEP (Post Exposure Prophylaxis) HIV: Starter Packs for Occupational and Non-Occupational exposure – Intranet link
- Blood Cultures – How and when to take (SCGOPHCG Guideline) – Intranet link
- Febrile Returned Traveller – Ax & Mx Guidelines – 08/2023
- Rabies and Australian Bat Lyssavirus exposures:
- How to access post-exposure prophylaxis (PEP): Information for HEALTHCARE PROVIDERS IN METROPOLITAN PERTH Flow Chart
- Post-exposure prophylaxis (PEP): Information for CACHE STOCK HOLDERS Flow Chart
Legal
Neurology
- Stroke Call Pathway – 12/2021
- SJA Bat Phone Stroke Call Information Sheet – copies of this are found next to Bat Phone, and should be filled out for every pre-hospital stroke call
- Acute Large Vessel Occlusion (LVO) Stroke: Emergency Clot Removal Information Sheet – 5/2017
- Transient Ischaemic Attack
- Spontaneous intracerebral haemorrhage – 11/2014
- Vertigo Assessment Guideline – 11/2020
- Lumbar puncture – 05/2009
- Seizures – 09/2009
- Acute Headache Investigation Pathway – 07/2023
Neurosurgery
- Head injury – 05/2015
- Spinal cord injury assessment and documentation – 04/2015
- Suspected Cauda Equina Pathway – 07/2020
Oncology
- Febrile Neutropenia Management Guideline – Intranet link
- Management of Immune Related Adverse Events Associated with use of Immune Checkpoint Inhibitors – Intranet link
Ophthalmology
Orthopaedics
- Arthrocentesis (joint aspiration) – 05/2009
- Spinal cord injury assessment and documentation – 04/2015
- Femoral Nerve Block Procedure – 03/2019
- Bier’s block – 06/2019
- Orthopaedic Investigation Ordering Guideline – 08/2019
- Basic Fracture Treatment – 05/2018
- Base of 5th Metatarsal Fracture – Patient Information Handout – 01/2018
- Femoral Fracture Traction Splint (CT-7) – Training Video – 05/2022
- Ring Removal Guidelines – 08/2023
Obstetrics & Gynaecology
- First Trimester Pregnancy Complications:
- Mx of of 1st Trimester Pain &/or Bleeding – SCGH ED – 10/2015
- First trimester pregnancy complications – KEMH – (version date 08/2023 when linked)
- includes: bleeding / hyperemesis / ectopic pregnancy / miscarriage …
- Guideline for the Mx of Nausea & Vomiting in Pregnancy and Hyperemesis Gravidarum – Society of Obstetric Medicine of Australia and New Zealand – 2019
- Sexual assault – 02/2009
- Obstetric patients at SCGH ED – 11/2015
- Radiology Procedure for Imaging Pregnant Patients – 01/2016
- KEMH – SCGH Transfer for Imaging Pathway – 11/2023
Paediatrics
- Perth Children’s Hospital (PCH) Guidelines & Calculators
- Children’s Antimicrobial Mx (ChAMP) Guidelines
- Kids Health WA Paediatric Calculators
Palliative Care
- SCGH Palliative Care Service webpage – Intranet link
- Evidence Based Clinical Guidelines for adult patients in terminal phase – palliative care book
- Voluntary Assisted Dying – Information Management System
- It is where practitioners can:
- submit forms to the Voluntary Assisted Dying Board in Western Australia
- register for the Department of Health participating practitioner eligibility verification process (including access to the mandatory approved training)
- It is where practitioners can:
Pharmacy
- SCGH Medication Guidelines – Intranet link
- Antiemetic Guideline – SCGH ED – 02/2024
Psychiatry & Behavioural
- SCGH Mental Health Escalation Plan (Draft Document) – 12/2022
- for escalation of mental health patients in SCG ED >24/24
- SCGH ED Policy – Mental Health Crisis Transfers Policy (ie. via SJA / Police / RFDS / Private Hospital)
- NMHS Patient Flow Process to access a Mental Health Bed – 3/2014
- Eating Disorder Management – 09/2016
- Delusional Parasitosis
- Child & Adolescent Mental Health Service (CAMHS)
- CAMHS Emergency Telehealth Service
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
- Medical Imaging Archive Transition from IMPAX to IntelePACS – How to access IntelePACS – 07/2023
- IV Contrast Agents use in CT Imaging
- Joint Advisory Statement between The Royal College of Radiologists & Royal College Emergency Medicine regarding Emergency Computed Tomography scans and the use of Intravenous Iodinated Contrast Agents
- Iodinated Contrast Media Guideline – The Royal Australian and New Zealand College of Radiologists (RANZCR) – download and see “Recommendations” page 15
- Radiology Eorder Information – 09/2023
- KEMH – SCGH Transfer for Imaging Pathway – 11/2023
Renal
Respiratory
- SCGH Respiratory Admission Guidance – 04/2021
- Policy for the insertion of a chest drain by trainees – 05/2015
- COPD – 08/2015
- Pulmonary embolism initial diagnostic pathway – 09/2017
- Pulmonary embolism advanced care pathway – 03/2023
- Pneumothorax – 04/2014 (for review)
Rheumatology
- Giant Cell Arteritis – 09/2022 – Intranet link
Toxicology and Toxinology
- Toxicology Handbook (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
- Drink Spiking Mx – 10/2022:
- Nitrous Oxide (N2O) – Management of Recreational Use (RPH ED Guideline) – 01/2021
- Drug Withdrawal Management Guidelines – as per SCGH Drug & Alcohol Service intranet link
Trauma
- Resuscitation / Trauma Team Roles – 4/2015
- SCGH Trauma Call Criteria – 02/2021
- Traumatic Cardiac Arrest Guideline (Royal Melbourne Hospital) – 5/2018
- Cervical spine injury investigation – 01/2015
- Philadelphia collar application – 04/2015
- Head injury – 05/2015
- Femoral Nerve Block Guideline – 03/2019
- Burns Assessment & Management – 08/2021
- Wound Closure Advice from Closing the Gap Website
- Chest wall injury (rib fractures) – 01/2015
- SCGH Massive Transfusion Protocol – Intranet link
- Ring Removal Guidelines – 08/2023
- Rib Fractures / Chest Wall Injury in the Elderly – 12/2023
Urology
Vascular
- Deep Vein Thrombosis (DVT) – 08/2023
- Central catheter related venous thrombosis – 04/2014
- Foot and leg ulcers – 05/2015
- Type B Aortic Syndrome Guideline – 01/2022– Intranet link
- Type B dissection = distal to the subclavian artery, and is managed by Vascular Surgery
- Type A dissection = proximal to the subclavian artery, and is managed by Cardiothoracic Surgery
- SCGH Massive Transfusion Protocol – Intranet link