External Guidelines

NHS Evidence

NHS Evidence provides health and social care professionals with access to 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.

See latest evidence updates: https://www.evidence.nhs.uk/nhs-evidence-content/evidence-updates

 

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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. If you would like to recommend guidelines for publication here or you wish to report any dead links please e-mail philip.mcmillan@collemergencymed.ac.uk

Click on a category to see related guidelines:

 

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

 

• Cancer patients in crisis: responding to urgent needs (Royal College of Physicians, The Royal College of Radiologists, Nov 2013)

• 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)

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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)
  • Evidence update (Jan 2013)
  • 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/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

• Major trauma and the use of tranexamic acid in children: Evidence statement (RCPCH, Nov 2012)

• CRASH-2: tranexamic acid and trauma patients (LSHTM, Mar 2011)

• 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

• Resource: Carbon Monoxide Poisoning Awareness Poster for EDs (August 2012) - see accompanying statement from Dr Ed Walker, CEM Toxicology Group. With thanks to HPA for use of COMA acronym.
  • Poster: Free gas checks
  • Poster: CO detectors

• 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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Complex regional pain syndrome (CRPS)

• Complex regional pain syndrome in adults (RCP, May 2012)
  • CRPS concise guidance

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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

• When a patient seeksadvice or information about assistance to die (GMC, Jan 2013)
  • Guidance for the Investigation Committee and case examiners when considering allegations about a doctor’s involvement in encouraging or assisting suicide (GMC, Jan 2013)

• 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)
  • Subsribe to the National End of Life Care Programme newsletter via http://www.endoflifecareforadults.nhs.uk/)

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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)
  • CEM Summary

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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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GI

• Acute upper GI bleeding (NICE CG141, Jun 2012)

• Management of Bariatric Patients in the ED - poster (Monkhouse SJW, Morgan JDT, Norton SA, 2012)

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

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Handover

• The ABC of Handover - Tool for EM (Imperial College Healthcare, 2012)
  • Implementation Guide

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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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Headache

• Headaches: diagnosis and management of headaches in young people and adults (NICE CG150, Sept 2012)

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Hip Fracture

• The management of hip fracture in adults (NICE CG124, June 2011)
  • Evidence update March 2013

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Hypertension

• Hypertension: management of hypertension in adults in primary care (NICE CG127, August 2011)
  • Evidence update March 2013

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Influenza

• Communications strategy agreed for potential flu pandemic (DH, Dec 2012)

• 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)
  • CEM summary of guideline CG88
     

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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

• Resources for young people - U can cope (Royal College of Psychiatrists, Aug 2012)

• Patient advice leaflet: Feeling on the edge? Helping you get through it (Royal College of Psychiatrists, Apr 2012)

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

• Delirium: Diagnosis, prevention and management (NICE CG103, July 2010)
  • CG103 evidence update April 2012

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

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Older People

• 'The Silver Book': Quality Care for Older People with Urgent and Emergency Care Needs (Multiple, June 2012)
  • Silver Book - Executive Summary
  • Silver Book - Short Version
  • Silver Book - Clinical Governance and Research
  • Silver Book - Training and Development
  • Silver Book - References

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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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Paediatric EM

• Standards for Children and Young People in Emergency Care Settings, [third edition] (RCPCH, June 2012)

• International Standards of Care for Children in Emergency Departments (IFEM, 2012)

• Right care, right place, first time? Joint statement on the urgent and emergency care of children and young people (CEM, RCGP, RCN, RCPCH, Dec 2011)

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Pneumonia

• Guidelines for the Management of Community Acquired Pneumonia in Adult (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

• Ectopic pregnancy and miscarriage (NICE CG154, December 2012)

• Saving Mothers’ Lives:Reviewing maternal deaths to make motherhood safer 2006–2008. The Eighth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom (Centre for Maternal and Child Enquiries, March 2011)

• Maternal Collapse in Pregnancy and the Puerperium (Royal College of Obstetricians and Gynaecologists, Feb 2011)

• 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

• Protecting children and young people: the responsibilities of all doctors (GMC, July 2012)

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

• Safeguarding Children and Young People: roles and competencies for healthcare staff (Intercollegiate, September 2010)

• 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)
  • CEM Summary

• 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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Sickle Cell

• Sickle cell acute painful episode (NICE CG143, June 2012)
  • CG143 Education 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)

• Management of the Child with a Decreased Conscious Level (RCPCH, 2005)
  • Decreased Conscious Level Multi-site Audit Report (RCPCH, 2012)

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Urinary tract infection

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

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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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