Treat and refer guidelines Flashcards

1
Q

What are the indications NOT to T&R for Hypoglycaemia

A
  • Incomplete recovery
  • Unwitnessed onset
  • Prolonged episode
  • Pt on oral hypoglycaemic medication
  • OD on medication
  • unable to consume further carbohydrates
  • Unable to be monitored for 4 hours
  • No PHx of diabetes
  • Cause requires further investigation
  • Injury/seizure
  • Pregnancy
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2
Q

What are the indications NOT to T&R for Epistaxis

A
  • Unable to control bleeding after 15min
  • Recent Hx of facial/head trauma
  • Hx of bleeding disorder of anticoagulant therapy
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3
Q

What are the indications NOT to T&R for Suspected Gastroenteritis

A
  • Significant dehydration requiring fluid IV
  • Potential GIT bleeding
  • Severe/constant abdominal pain
  • BGL >17
  • Absence of diarrhoea
  • PHx of inflammatory bowel disease
  • Pregnancy
  • Co-morbidities
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4
Q

What are the indications NOT to T&R for Heroin OD

A
  • Incomplete recovery (GCS<15, RR<10)
  • > 1 dose of naloxone
  • Opioids other than heroin involved
  • Polypharmacy OD
  • Other causes of altered CS
  • Seizure
  • Suspected aspiration / APO
  • Pregnancy
  • Pt is a risk to others
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5
Q

What are the indications NOT to T&R for Minor burns

A
  • Burn involves face/hands/feet/major joints/genitalia
  • Circumferential burns of limbs/chest
  • Partial/full-thickness burns
  • Smoke inhalation or inhalation injury
  • Chemical, electrical or radiation burns
  • Suspected non-accidental burns
  • Associated traumatic injuries
  • Pain unable to be controlled with oral analgesia
  • Co-morbidities that may impair wound healing
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6
Q

What are the indications NOT to T&R for Minor wounds

A
  • Uncontrolled serious bleeding
  • Neurovascular impairment or loss of function
  • Penetrating injury/degloving/crush injuries
  • Other injuries requiring hospital Mx
  • Pain unable to be controlled with oral analgesia
  • Suspected muscle / tendon damage
  • Foreign material unable to be cleaned out of wound
  • Bite wounds
  • Wound > 6 hours old
  • Signs of infection
  • Co-morbidities
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7
Q

What are the indications NOT to T&R for seizure

A
  • Incomplete recovery (to normal GCS)
  • Suspected non-epileptic cause
  • No PHx of epilepsy/first presentation seizure
  • Different to usual presentation
  • Concurrent illness
  • Injury/aspiration/submersion
  • Patient administered IM/IV midaz
  • Unwitnessed seizure
  • Hx of multiple seizures per episode
  • Pt has feeling of impending seizure
  • Unable to be monitored by a responsible adult
  • Pregnancy
  • Pt requests transport
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8
Q

What are the indications NOT to T&R for Soft tissue injury

A
  • Evidence of significant # or dislocation
  • Neurovascular impairment
  • Pain unable to be controlled by oral analgesics
  • Suspected non-accidental injury
  • Ankle/foot injuries - positive ottawa ankle rules
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9
Q

What are the indications NOT to T&R for Lower back pain

A
  • Pain not isolated to Lower back
  • Loss of bladder/bowel control
  • Saddle anaesthesia
  • Lower limb weakness/numbness
  • Hx of fall or significant trauma
  • PHx osteoporosis or chronic steroid use
  • Suspected dissecting AAA
  • Pain unable to be controlled by oral analgesics
  • PHx of cancer or recent unexplained weight loss
  • Fever pr recent PHx of infection
  • PHx of IV drug use
  • Immunocompromised
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