External Guidelines

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NHS Evidence

On 10 May 2011 a new version of NHS Evidence – the service which provides health and social care professionals with access to quality-assured, best-practice information – went live.
 
NHS Evidence now provides you with access to a broadened range of relevant and high quality information including the latest guidelines, high quality patient information, research uncertainties and other selected information across a wide range of conditions and specialties.

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Below is a list of clinical guidelines relevant to Emergency Medicine produced by external organisations. This page is regularly reviewed and updated by the CEC Best Practice subcommittee. Please report any dead links to philip.mcmillan@collemergencymed.ac.uk

Click on a category to see related guidelines:

Abdominal	Chronic obstructive pulmonary disease (COPD)	Post-traumatic stress disorder
Acute coronary syndromes	Diabetic foot disease	Pregnancy
Acutely ill patients	End of life	Pre-hospital
Advance care planning	Falls	Pulmonary embolism
Airway management	Feverish children	Radiology
Alcohol	Fitness to drive	Rheumatology
Allergies	Gastrointestinal bleeding	Safeguarding children
Ambulatory care	Head injury	Sedation
Anthrax	Hip	Seizure
Aortic diseases	Hypertension	Self-harm
Arrhythmia	Influenza	Sepsis
Asthma	Low back pain	Stroke / TIA
Atrial fibrillation	Lower limb	Syncope
Bleeding	Meningitis	Toxicity
Breathlessness	Mental health	Transient loss of consciousness
Carbon monoxide	Organ Donation	Urinary tract infection
Cellulitis	Pneumonia	Venous thrombosis
Chest pain	Pneumothorax	Violent behaviour

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Abdominal

• Blunt abdominal trauma: Clinical Policy: Critical Issues in the Evaluation of Adult Patients Presenting to the Emergency Department With Acute Blunt Abdominal Trauma (American College of Emergency Physicians, 2003)

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Acute coronary syndromes

• Unstable angina and NSTEMI: the early management of unstable angina and non-ST-segment-elevation myocardial infarction (NICE CG94, March 2010)

• Acute Myocardial Infarction in patients presenting with ST-segment elevation (Management of) (European Society of Cardiology, 2008) View Details

• Acute Coronary Syndromes in patients presenting without ST-segment elevation (Management of) (European Society of Cardiology, 2007) View Details

• Acute Heart Failure: ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure (European Society of Cardiology, 2008) View Details

• The clinical effectiveness and cost effectiveness of drugs for early thrombolysis in the treatment of acute myocardial infarction (NICE TA52, 2002)

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Acutely ill patients

• Acutely ill patients in hospital (NICE CG50, July 2007)

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Advance care planning

• Advance care planning - National Guidelines (Royal College of Physicans, 2009). View Details

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Airway management

• Emergency Airway Management in the Trauma Patient (NSW Institute of Trauma and Injury Management, 2008) View Details

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Alcohol

• Alcohol-use disorders: physical complications (NICE CG100, June 2010). See also NICE Public health guidance Alcohol-use disorders: preventing harmful drinking (NICE PH24, June 2010)

• CEM Summary of NICE CG100 & CG115 (Jan 2012)

• Paddington Alcohol Test - this is not a clinical guideline but a clinical and therapeutic tool to ‘make the connection’ between Emergency Department (ED) attendance and drinking alcohol (Imperial Healthcare NHS Trust, 2009)

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Allergies

• Care pathways for children with allergies (RCPCH, 2010)
  • http://www.rcpch.ac.uk/allergy
  • http://www.rcpch.ac.uk/allergy/healthprofessionals
  • http://www.rcpch.ac.uk/allergy/families
  • http://www.rcpch.ac.uk/allergy/anaphylaxis
  • http://www.rcpch.ac.uk/allergy/asthmarhinitis
  • http://www.rcpch.ac.uk/allergy/drugallergy
  • http://www.rcpch.ac.uk/allergy/eczema
  • http://www.rcpch.ac.uk/allergy/foodallergy
  • http://www.rcpch.ac.uk/allergy/latexallergy
  • http://www.rcpch.ac.uk/allergy/venomallergy

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Ambulatory care

• The Directory of Ambulatory Emergency Care for Adults (2007)

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Anthrax

• Interim Clinical Guidance for the Management of Suspected Anthrax in Drug Users (Health Protection Scotland, 2010)

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Aortic diseases

• Aortic Dissection (Diagnosis and Management of) (European Society of Cardiology, 2001) View Details

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Arrhythmia

• Supraventricular Arrhythmias (Guidelines for the Management of Patients with) (American Heart Association, 2003)

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Asthma

• British Guideline on the Management of Asthma (The British Thoracic Society / Scottish Intercollegiate Guidelines Network, 2009)

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Atrial fibrillation

• Atrial Fibrillation (Management of) (European Society of Cardiology, 2010)

• The management of atrial fibrillation (NICE CG36, June 2006)

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Bleeding

• Guideline on the selection and use of theraputic products to treat haemophilia and other hereditary bleeding disorders (United Kingdom Haemophilia Centre Doctors' Organisation (UKHCDO), 2008)

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Breathlessness

• Emergency Oxygen Use in Adult Patients (The British Thoracic Society, 2008)

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Carbon monoxide

• Carbon Monoxide Poisoning Algorithm (Health Protection Agency, 2009) View Details

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Cellulitis

• Guidelines on the management of cellulitis in adults (CREST, 2005)

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Cervical spine

• Cervical Spine (Dr Siong-Seng Liau, 2003)

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Chest pain

• Chest pain of recent onset: assessment and diagnosis of recent onset chest pain or discomfort of suspected cardiac origin (NICE CG95, March 2010)

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Chronic obstructive pulmonary disease (COPD)

• Management of chronic obstructive pulmonary disease in adults in primary and secondary care (NICE CG101, June 2010)
  • NICE CG101 Evidence Update (Jan 2012)

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Diabetic foot disease

• Putting feet first: Commissioning specialist services for the management and prevention of diabetic foot disease in hospitals (Diabetes UK, July 2009)

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End of life

• Diagnosis of death: A code of practice for the diagnosis and confirmation of death (Academy of Medical Royal Colleges, 2008)
  • (CEM summary)

• Treatment and care towards the end of life: good practice in decision making (GMC, 2010)

• The route to success in end of life care - achieving quality in ambulance services (National End of Life Care Programme, Feb 2012)

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Falls

• Falls: the assessment and prevention of falls in older people (NICE CG21, November 2004)

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Feverish children

• Feverish illness in Children (NICE CG47, May 2007)

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Fitness to drive

• At a glance guide to the current medical standards of fitness to drive (DVLA, Feb 2011)

• CEM summary of DVLA fitness to drive medical standards (Jan 2012)

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Gastrointestinal bleeding

• Management of acute upper and lower gastrointestinal bleeding (Scottish Intercollegiate Guidelines Network, 2008)

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Head injury

• Triage, assessment, investigation and early management of head injury in infants, children and adults (NICE CG56, September 2007)

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Hip Fracture

• The management of hip fracture in adults (NICE CG124, June 2011)

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Hypertension

• Hypertension: management of hypertension in adults in primary care (NICE CG127, August 2011)

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Influenza

• Human H1N1 and Seasonal Influenza (Various, Jan 2011)

• Flu Pandemic (Department of Health, 2009) - See here for more advice about Flu.

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Low back pain

• Low Back Pain: Early management of persistent non-specific low back pain (NICE CG88, May 2009)

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Lower limb

• Standards for the management of open fractures of the lower limb (British Association of Plastic Reconstructive and Aesthetic Surgeons, Sep 2009)

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Meningitis

• Bacterial meningitis and meningococcal septicaemia (NICE CG102, Sept 2010)
  • NICE CG102 Evidence update (Jan 2012)

• Meningitis - early management of meningococcal disease in children (Meningitis Research Foundation, 2006) (this is an expert opinion based algorithm which reflects best current practice – it is very useful and helpful) View Details

• Meningitis - early management of suspected bacterial meningitis and meningococcal and septicaemia in immunocompetent adults (Meningitis Research Foundation, 2006) View Details

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Mental health

• Dignity in dementia: improving care in general hospital settings (Royal College of Nursing, Sept 2011)

• Managing Urgent Mental Health Needs in the Acute Trust (AoMRC, 2008)

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Organ Donation

• Organ donation for transplantation: improving donor identification and consent rates for deceased organ donation (NICE CG135, Dec 2011)

• The Role of Emergency Medicine in Organ Donation: Report of a Workshop, 4 October 2011 (BTS, NHS Blood & Transport, CEM)

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Pneumonia

• Guidelines for the Management of Community Acquired Pneumonia in Adults (The British Thoracic Society, updated 2009)

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Pneumothorax

• Guidelines for the Management of Spontaneous Pneumothorax (The British Thoracic Society, 2010)

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Post-traumatic stress disorder

• Post-traumatic stress disorder: The management of PTSD in adults and children in primary and secondary care (NICE CG26, March 2005)

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Pregnancy

• Pregnancy and complex social factors (NICE CG110, September 2010)

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Pre-hospital

• Pre-hospital Anaesthesia (Assoc. of Anaesthetists of Great Britain and Ireland, 2008)

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Pulmonary embolism

• Acute Pulmonary Embolism (Diagnosis and Management of) (European Society of Cardiology, 2008) View Details

• Guidelines for the Management of Suspected Acute Pulmonary Embolism (The British Thoracic Society, 2003)

• Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting With Suspected Pulmonary Embolism (American College of Emergency Physicians, 2002)

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Radiology

• Standards of practice and guidance for trauma radiology in severely injured patients (Royal College of Radiologists, 2011)

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Rheumatology

• Guidelines for management of the hot swollen joint in adults (British Society of Rheumatology, 2006)

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Safeguarding children

• The Physical Signs of Child Sexual Abuse - Interim Statement (RCPCH, Aug 2011) - Details: http://www.rcpch.ac.uk/csa

• When to suspect child mistreatment (NICE, CG89, July 2009) View Details

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Sedation

• Sedation in children and young people (NICE CG112, December 2010)

• Clinical Policy: Procedural Sedation and Analgesia in the Emergency Department (American College of Emergency Physicians, 2005)

• Safe Sedation Practice for healthcare procedures in adults (AoMRC, 2001)

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Seizure

• The epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care (NICE CG20, October 2004)

• Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Seizures (American College of Emergency Physicians, 2004)

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Self-harm

• Self-harm: The short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care (NICE CG16, July 2004)

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Sepsis

• Surviving Sepsis Campaign (Survive Sepsis, 2009). See CEM clinical standards for sepsis and additional resources

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Stroke / TIA

• Diagnosis and initial management of acute stroke and transient ischaemic attack (TIA) (NICE CG68, July 2008)

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Syncope

• Syncope (Guidelines on Diagnosis and Treatment of) (European Society of Cardiology, 2009) View Details

• Syncope: Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department with Syncope (American College of Emergency Physicians, 2007)

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Toxicity

• Management of Severe Local Anaesthetic Toxicity (Assoc. of Anaesthetists of Great Britain and Ireland, 2010)

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Transient loss of consciousness

• Transient loss of consciousness in adults and young people (NICE CG109, August 2010)
  • CEM summary of NICE CG109 (Jan 2012)
  • NICE CG109 Evidence Update (Mar 2012)

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Urinary tract infection

• Urinary tract infection in children: diagnosis, treatment and long-term management (NICE CG54, August 2007)

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Venous thrombosis

• Reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients admitted to hospital (NICE CG92, January 2010)
  • CEM response
  • NICE CG92 EVIDENCE UPDATE - Feb 2012

• Procedures for the outpatient management of patients with deep venous thrombosis (BCSH, 2005)
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Violent behaviour

• Violence: The short-term management of disturbed/violent behaviour in in-patient psychiatric settings and emergency departments (NICE CG25, February 2005)

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