The North Middlesex University Hospital same-day emergency care (SDEC) service provides consultant-led service for patients referred with acute medical pathologies. It offers same-day diagnostics and treatment without the need for overnight stay.

The most common SDEC pathways, include:

• Acute headache
• Acute kidney injury (AKI)
• Atrial fibrillation (AF)
• Cellulitis
• DVT
• Deranged LFTs
• Iron deficient anaemia (IDA)
• Idiopathic intracranial hypertension (IIH)
• Nitrous oxide toxicity
• Suspected PE
• Pyelonephritis

Other patients can be accepted after discussion with the SDEC consultant.

Eligibility Criteria

Inclusions

• No confirmed or potential communicable diseases
• At baseline level of cognition (no delirium)
• Appropriate level of mobility (no bed-bound patients)
• Pregnant <36/40 (>36/40 please refer to maternity)
• Over 16 years
• Haemodynamically stable NEWS2 ≥ 4
• Heart rate between 50-100bpm (or stable AF > 130bpm)*
• Systolic BP between 100-180mmHg
• O2 Saturation ≥ 94% on room air (except patients with COPD with baseline O2 Sats between 88-92%, or on ambulatory O2 which they can bring with them)

*Haemodynamically stable patients with vital parameters outside the range above can be accepted upon discretion of the SDEC consultant

Exclusions

• Potential or confirmed communicable diseases (COVID, TB, gastroenteritis, etc.)
• Uncontrolled acute pain needing opioids (except patients established on opioids who can bring  their own medicines with them)
• High-risk chest pain (suggestive of ACS)
• Diabetic ketoacidosis (DKA)
• Suspected pulmonary embolism (PE) with haemodynamic compromise
• Headaches with differential including intracranial bleed and meningitis.
• Seizures
• Cardiogenic Syncope requiring ECG monitoring
• Active GI bleed
• TIA/Stroke
• Aggressive / psychotic patients
• Patients with physical trauma-related issues

How to Refer

Locations

Same-day Emergency Care (SDEC) Unit