Same-Day Emergency Care: NMUH

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Under Review — this page was due to be reviewed by Friday, 18 October 2024. The information shown here may be outdated.

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

The SDEC service is an advanced nurse practitioner/consultant-led service for patients presenting with conditions within one of the defined ambulatory care pathways, including:

  • 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
View full list of 11 items

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


Eligibility Criteria

Inclusions

  • Non-infectious patients (COVID-19/TB/D&V etc.)
  • At baseline level of cognition (no new confusion)
  • Appropriate level of mobility (no bed bound patients)
  • Pregnant > 36/40 (18/40 - 36/40 requires discussion with obstetrician)
  • 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)
    • Heart rate between 50-100bpm (or stable AF > 130bpm)

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

Exclusions

  • Pain needing opioids (except patients established on opioids who can bring  their own medicines with them, and those only requiring oral morphine)
  • High-risk chest pain suggestive of ACS
  • DKA
  • Suspected 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

All external referrals are discussed with the SDEC consultant and calls are taken between 9am-5pm, Monday to Friday.

Adequate time for travel to NMUH and blood tests results (90 minutes on average) needs to be taken in consideration, therefore referrals made late in the day may mean the medical team on call will assess the patient in ED, or otherwise stable patients will be seen in SDEC the following day.

For frail/elderly patients, call the COE hot phone.


Locations

Same-day Emergency Care (SDEC) Unit

Opening hours are 8am-8pm daily (including bank holidays), last referrals taken by 5pm

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Review date: Friday, 18 October 2024