ACUTE HOSPITAL
CARE PATHWAYS
FOR
RURAL PATIENTS
Click for
introduction
ACUTE HOSPITAL CARE PATHWAYS FOR RURAL PATIENTS
Most patient care takes place in the primary care setting and does not need referral or admission to hospital. However, there are conditions
which require management within a hospital environment. Delivering for Remote and Rural Healthcare (report of the Remote and Rural Steering
Group) recognised that the public and those working within healthcare need to understand more fully what Rural General Hospitals (RGHS) do;
which patients are treated within the RGH and when patients will be transferred to another hospital.
The Remote and Rural Implementation Group established a workstream, led by Professor Andrew Sim, Consultant Surgeon, NHS Western Isles
and Professor of Remote and Rural Medicine, with the University of the Highlands and Islands Millennium Institute, to develop an understanding
across the six RGHs on the pathways of care for patients where hospital management was appropriate. Acute Hospital Care Pathways have been
developed for patients with conditions that will be treated and cared for within an RGH, treated by a visiting specialist or require transfer to
another hospital. These condition specific pathways were agreed by a group of RGH clinicians and launched in September 2010.
It is intended that these pathways will be a living document, updated as required, available to support doctors in training, General Practitioners,
managers, planners and the public. The main publication route will be through the Remote and Rural pages of the North of Scotland Planning
Group website and can be accessed through the following link:
www.nospg.nhsscotland.com/index.php/remote-rural-healthcare/rr-implementation-group-rrig/care-pathways
with links to NHS Board sites and to the Remote and Rural Healthcare portal of the Knowledge Network www.knowledge.scot.nhs.uk
Notes
Index
Pathways
Acute Hospital Care Pathways
There are 16 Acute Hospital Care Pathways - they are divided into three referral pathway groups: Intro
Non Emergency 7 pathways Index
Emergency 3 pathways
Malignant 6 pathways Pathways
Elements used in the design of Acute Hospital Care Pathways
Presenting condition – Non Emergency, Emergency and Malignant
First point of access to healthcare services – primary care practitioner, NHS 24, 999, A&E
Initial specialist referral – Rural General Hospital (RGH) specialist, visiting specialist or another specialist
Subsequent advice/referral – visiting specialist or another specialist
Investigation – Rural General Hospital or Another hospital
Management – Rural General Hospital or Another Hospital
Definitions of words and phrases used in the Acute Hospital Care Pathways
A specialist is usually a medically trained consultant, but can also be a specialist nurse or allied health professional and is sometimes a non-consultant grade doctor.
An RGH Specialist is a specialist who is locally based and has the RGH as his/her main place of work.
A Visiting Specialist is a specialist who is based in another hospital and travels to the RGH on a regular basis.
Another Specialist is one who does not work in the RGH and is based in another hospital.
Another Hospital is any other hospital than the RGH
Development process
The pathways were developed by the Service Models and Care Pathways subgroup of the RRIG - a process involving a variety of health care personnel.
At all stages of development the process and the pathways were approved by the Remote and Rural Implementation Group (RRIG)
In an early draft form the pathways were sent out to 63 doctors who either worked in a rural general hospital or who had a particular interest in rural health care
(13 physicians, 19 surgeons, 16 anaesthetists, 1 obstetrician, 2 paediatricians, 4 medical directors and 7 general practitioners)
A final meeting for validation of the pathways took place in Nairn on the 8th and 9th March 2010. The meeting was attended by:
Dr Alan Henderson, Consultant Physician, Lorn and Islands Hospital, Oban
Mr Gordon MacFarlane, Consultant Surgeon, Gilbert Bain Hospital, Shetland
Mr David Sedgwick, Consultant Surgeon, Belford Hospital, Fort William
Dr Jim Unsworth, Consultant Physician, Gilbert Bain Hospital, Shetland
Mrs Betty Flynn, Regional Nursing Advisor and NMWWPP and Workforce Programme Manager, North of Scotland Planning Group
Dr Annie Ingram, Director of Regional Planning and Workforce Development, North of Scotland Planning Group.
Professor Andrew Sim, Lead Clinician for the Service Models and Care Pathways subgroup of RRIG
and Consultant Surgeon, Western Isles Hospital, Stornoway/UHI Millennium Institute
This is the first edition of the Acute Hospital Care Pathways for Rural Patients and efforts have been made to avoid errors and omissions.
Comments/corrections can be posted on the Care Pathway section of the Remote & Rural Healthcare page of the North of Scotland Planning Group website
(http://www.nospg.nhsscotland.com)
Index for Acute Care Hospital Pathways
Notes Pathways
Please click on the relevant 'x' to link to the appropriate pathway
Non Emergency Emergency Malignant
Condition or Disease Non E 1 Non E 2 Non E 3 Non E 4 Non E 5 Non E 6 Non E 7 E1 E2 E3 M1 M2 M3 M4 M5 M6
Abortion complications X X X X X X
Abortion habitual X X
Abortion medical X X X
Abortion missed X X X X X X
Abortion spontaneous X X X X X X
Abscess amoebic X X X X X X
Abscess ano-rectal X
Abscess cutaneous X
Abscess hepatic X X X X X X
Abscess intracranial X X
Abscess pancreatic X X
Abscess paracolic diverticular dis X X
Abscess peritonsillar X X X
Abscess pilonidal X
Abscess urethral X X X
Achalasia X X
Acute coronary syndrome X X X
Adhesions intra abdominal X X
Alcohol withdrawal X
Alcoholic liver disease X X X
Amenorrhoea X X
Amputation traumatic X X X
Anal fissure X X
Anal fistula X X X
Anaphylaxis X
Aneurysm abd aorta rupture X X X
Aneurysm abdominal aorta X X X
Aneurysm other X X X X X
Aneurysm thoracic dissection X X
Aneurysm thoracic ruptured X X
Angina X X
Animal bites X X
Appendicitis acute X
Arrthymias acute X X X
Arthritis inflammatory X X X
Arthritis osteo X X
Arthritis rheumatoid X X
Arthritis septic X X X
Asthma X X x
Atrial fibrillation X X
Atrial flutter X X
Balanitis X X
Barrett’s oesophagus X X
Bartholin cyst/abscess X X
Basal cell carcinoma of skin X X X X X
Benign Prostatic Hypertrophy X X X X X x
Bile duct stones X X X X X X
Birth trauma X X
Birth trauma (acute) X X
Bladder calculi X X X
Bolus obstruction oesophagus X
Brain injury diffuse X X X
Brain injury focal X X X
Bronchiectasis X X
Burns 30% X X
Burns 10 – 30% X X
Bursitis X X X X
Cancer Anal canal X X
Cancer Bladder X X X X
Cancer Bone and cartilage X X X
Cancer Brain and spinal cord X X
Cancer Breast X X X
Cancer Bronchus X X X X X
Cancer Cervix X X
Cancer Colon X X
Cancer Eye X X
Cancer Gall bladder X X X
Cancer Kidney X X X
Cancer Larynx X X
Cancer Lip and oral cavity X X X X
Cancer Liver X
Cancer Nasal cavity & middle ear X X X
Cancer Oesophagus X X X
Cancer Other endocrine organ X X X
Cancer Ovary X X X
Cancer Pancreas X X X X
Cancer Penis X X
Cancer Prostate X X X X
Cancer Rectum X X
Cancer Sinuses X X X
Cancer Small intestine X X X
Cancer Stomach X X
Cancer Testis X X X X
Cancer Thyroid X X X
Cancer Trachea X X
Cancer Urinary tract other X X X
Cancer Uterus X X X
Cancer Vulva/vagina X X X X
Carbon monoxide poisoning X X
Cardiac contusion X X X
Cardiac laceration/punct X X X
Cardiomyopathy X X X X
Cataract X
Cellulitis X
Cerebral infarction X X
Cervical disc disorders X X X X X X X X X
Cervix erosion & ulcer X X
Cholangitis X
Cholecystitis X
Cholelithiasis X X
Chronic pain syndrome X X X
Condition or Disease Non E 1 Non E 2 Non E 3 Non E 4 Non E 5 Non E 6 Non E 7 E1 E2 E3 M1 M2 M3 M4 M5 M6
Cirrhosis X X
Clostridium dificile infection X X
Colonic polyps X X
Conduction disorders other X X
Congenital adrenal hyperplasia X
Connective tissue disorder X X X X
COPD exacerbations X X
Crohn’s disease X X X X X X
Crush injury genitalia X X
Crush injury hand X X X
Crush injury lower limb X X X
Cyst breast X
Cyst epididymal X
Cyst follicular etc X
Cyst ovarian X X X
Cyst ovarian torsion or rupture X X X
Cystitis X X X
Deep vein thrombosis X X X
Dehydration X
Diabetes mellitus X
Diarrhoea acute X
Dislocated elbow X X
Dislocated finger X X
Dislocated hip X X X
Dislocated knee X X
Dislocated shoulder X X X
Diverticular disease X
Diverticular disease perforation X
Diverticular disease stricture X
Drug overdose X X X
Duct ectasia X
Dupuytren’s contract X X X X X
Dyspareunia X X
Dyspepsia X
Dysproportion X
Eclampsia X X X X X
Embolism mesenteric X X X
Embolism obstetric X X
Embolus or thrombosis arterial X X X
Empyaema X X
Encephalopathy X
Endocarditis X X X X
Endometriosis X X X
Epididymo-orchitis X X
Epistaxis X X X X X
Failed induction X X X
Falls in the elderly X
Fat necrosis X
Fibroadenoma breast X X
Fibrosclerosis breast X X
Fistula Colovesical X
Fistula gastrocolic X X X
Fistula urethral X X X
Fistula vesicointestinal X
Fistula vesico-vaginal X X X X
Flail chest X X X
Foetal abnormality X
Foetal damage X
Foetal distress X
Foetal growth disorder X
Foreign body alim tract X X
Foreign body ear X
Foreign body eye X
Foreign body GU tract X X
Foreign body resp tract X X X
Fourniers gangrene X X X
Fracture Cervical spine X X X
Fracture lower limb complex X
Fracture lower limb simple X X X
Fracture lumbar spine X X X
Fracture mal- and non-union X X X X
Fracture neck of femur X X
Fracture osteoporotic X X X X X X
Fracture ribs & sternum X X X
Fracture serious foot X X
Fracture thoracic spine X X X
Fracture upper limb complex X X X
Fracture upper limb simple X
Frost bite + tissue loss X X X
G-6P-D deficiency X
Gallstone ileus X
Gas gangrene X X X
Gastritis & duodenitis X
Gastro Oesophageal Reflux Dis X X X X
Gestation length disorder X
Goitre non toxic X X
Guillain Barre Syndr X X
Gynaecomastia X X X
Haemarthrosis X X X
Haematemesis & melaena X
Haematuria X X X X
Haemolytic jaundice X
Haemopericardium X X X
Haemopneumothorax X X X
Haemorrhage antepartum X X
Haemorrhage extra dural X X
Haemorrhage in early pregnancy X X X X X X
Haemorrhage intracranial X X X
Haemorrhage intrapartum X X
Haemorrhage large bowel X X
Haemorrhage oesophageal varices X X X
Haemorrhage other GI X X X X X
Haemorrhage peptic ulcer X
Haemorrhage placenta praevia X X
Haemorrhage post partum X X
Haemorrhage sub dural X X X
Haemorrhage subarachnoid X X
Condition or Disease Non E 1 Non E 2 Non E 3 Non E 4 Non E 5 Non E 6 Non E 7 E1 E2 E3 M1 M2 M3 M4 M5 M6
Haemorrhoids X X
Haemothorax X X X
Hallux valgus X X
Head inj GCS 12 X
Head inj GCS 15 X
Head injury + focal neur abnorm X X X
Headache (acute) X X
Heart block X X X X
Heart failure X X X
Hepatitis chronic X X
Hernia femoral X X
Hernia hiatus X X
Hernia incisional X
Hernia inguinal (adult) X
Hernia inguinal (child) X X
Hernia inguinal comp adult X
Hernia inguinal comp child X
Hernia paraoesophageal X X
Hernia umbilical X
Hernia ventral X
Hydatid disease liver X X X
Hydatidiform mole X X X
Hydrocoele X X
Hydronephrosis X X X
Hypercalcaemia X X X X
Hyperemesis X X
Hypertension X X
Hypertension of preg X X X
Hypertensive emergency X X
Hypoglycaemia X X X
Hypopituitrism X X
Hypothermia X
Hypothyroidism X
Incontinence faecal X X X
Incontinence stress X X X
Infertility female X X
Infertility male X
Injury intra abdominal viscus X X X
Injury liver X X X
Injury multiple serious X X X
Injury pulmonary X X X
Injury renal X X
Injury soft tissue X
Insect bites X
Internal derangement knee X X X X X X X X
Intussusception X X X
Ischaemic colitis X X X
Jaundice haemolytic X X
Jaundice hepatocellular X X X
Jaundice obstructive X X X X X X
Keloid scar X X X X
Kyphosis, scoliosis etc X X
Labour pre-term X X X
Labour prolonged X X X
Lactation disorders X X X
Leukaemia X X
Lymphadenitis acute X
Lymphoedema X X X X
Lymphoma Hodgkins X X
Lymphoma non-Hodgkins X X
Malabsorption X X
Malig immunoprolif disorder X X
Malignant melanoma X X X X X
Malnutrition X
Malpresentation X
Mastitis X
Mastoiditis acute X X
Meningitis (adults) X X X
Meniscus problems X X X X X X X X
Menopause problems X
Menorrhagia X X
Mesothelioma X X X X X
Migraine X X
Mineral deficiencies X
Mittleschmertz X X X X
Multiple gestation X
Multiple myeloma X X
Multiple sclerosis X X
Myocardial infarction X X X
Necrotising fasciitis X X X
Nephritic syndrome X
Nephritic syndrome acute X X X
Nephrotic syndrome X
Neurological injury upper limb X X X
Neurological injury lower limb X X
New born problems serious X X
Nipple discharge X X
Obesity X
Obstructed labour X X X
Obstruction gastric outlet X
Obstruction large bowel X X X X
Obstruction small bowel X
Obstruction trachea X X X
Obstructive & reflux uropathy X X X X X
Oesophageal varices X X
Oesophagitis X
Oligohydramnios X
Osteomyelitis X X X X X X X X
Otitis externa X
Otitis media X X
Palliative care X X X X
Pancreatitis acute X X X
Pancreatitis chronic X X
Paralytic ileus X
Parametritis X X X X X X X
Parkinson’s disease X X
Condition or Disease Non E 1 Non E 2 Non E 3 Non E 4 Non E 5 Non E 6 Non E 7 E1 E2 E3 M1 M2 M3 M4 M5 M6
Paroxysmal tachycardia X X X X
Patella disorders X X X X X X
Pelvic cellulitis X X X X X X X
Perforated tympanic membrane X
Perforation abdominal viscus X
Perforation peptic ulcer X
Pericarditis acute X
Perimenopausal probs X
Perinatal problems X X X X
Perineal laceration X
Peripheral vascular disease X X X
Peritonitis acute X
Phimosis X
Phlebitis X
Pilonidal disease X
Pleural effusion X X X
Pleurisy X
Pneumonia X X
Pneumonia aspiration X
Pneumothorax X X X X
Poisoning acute X X X
Polymyalgia X
Post coital bleeding X X
Post operative surgical problems X X X X X X
Post partum breast problems X X
Post phlebitic syndrome X X X
Pregnancy + abn pelvic organs X
Pregnancy ectopic X X X
Pregnancy normal delivery X X
Premature rupture of membranes X X
Prolapse female genital X
Prolapse rectal X X
Prostatitis X X
Pseudo obstruction X X
Pseudocyst pancreatic X X
Psychiatric disorder chronic X X X
Psychiatric disorder acute X X
Psychosis acute X X
Puerperal sepsis X X X
Pulmonary embolism X
Pulmonary oedema X X
Pyelonephritis acute X
Pyogenic arthritis X X X
Pyogenic granuloma X X
Pyometra X X X X X X
Pyothorax X X X
Raynaud’s syndrome X X X
Renal & ureter calculi X X X X X X
Renal failure acute X X
Respiratory failure chronic X X
Retained placenta X X
Rheumatic heart dis X X
Rotator cuff syndr X X X X X
Ruptured aorta X X X
Ruptured bladder X
Ruptured uterus X X
Ruptured vena cava X X X
Salpingitis X X X X X X
Sarcoidosis X X X
Sarcoma soft tissue X X X
Seborrhoeic keratosis X
Sepsis X X X
Sexually transmitted diseases X X X
Shock X X X
Sialadenitis X X
Sialolithiasis X X X X X X
Sick sinus syndrome X X
Skin lacerations X X
Snake bites X X
Squamous cell carcima of skin X X X X X
Status epilepticus X X X
Stoma care X
Strains and sprains X
Stroke X X
Substance abuse X X
Syncope X
Thrombophlebitis X
Thyroiditis X
Thyrotoxicosis X X
Tonsillitis acute X
Tonsillitis chronic X X
Torsion of testis X
Torticollis X X X X
Toxic liver disease X
Transient Ischaemic Attacks X X X
Ulcer chronic venous X X X X
Ulcer decubitus X X X X
Ulcer duodenal X
Ulcer gastric X
Ulcerative colitis X X X X X X
Umbilical cord complications X
Ureteric colic X X X X X X
Ureteric stones X X X X X X
Urinary tract infection X X
Urinary retention x
Vaginitis X X X
Varicocoele X X
Varicose veins X X X
Vascular injury lower limb X X X
Vascular injury neck X X X
Vascular injury upper limb X X X
Ventricular fibrillation X
Vitamin deficiencies X
Vocal cord diseases X X X X
Volvulus X X
Non Emergency
Conditions
1 Non Emergency Conditions
Abortion complications Conduction disorders other
Abortion medical Connective tissue disorders
Abortion missed Crohn’s disease
Abortion spontaneous Cyst breast
Abscess amoebic Cyst epididymal
Abscess hepatic Cyst follicular etc
Achalasia Cystitis
Adhesions intra abdominal Deep vein thrombosis
Alcohol withdrawal Diabetes mellitus
Alcoholic liver disease Diverticular disease
Anal fissure Drug overdose
Anal fistula Duct ectasia
Angina Dupuytren’s contract
Asthma Dyspepsia
Atrial fibrillation Empyaema
Atrial flutter Endocarditis
Balanitis Endometriosis
Barrett’s oesophagus Epididymo-orchitis
Bartholin cyst/abscess Failed induction
Benign Prostatic Hypertrophy Falls in the elderly
Bile duct stones Fat necrosis
Birth trauma Fibroadenoma breast
Bladder calculi Fibrosclerosis breast
Bronchiectasis Fistula Colovesical
Bursitis Fistula gastrocolic
Cardiomyopathy Fistula urethral
Cerebral infarction Fistula vesicointestinal
Cervical disc disorder Fistula vesico-vaginal
Cholelithiasis Fracture mal- and non-union
Chronic pain syndrome Fracture osteoporotic
Cirrhosis Gastritis & duodenitis
Colonic polyps Gastro Oesophageal Reflux Dis
Index
1 Non Emergency Conditions
Goitre non toxic Keloid scar
Gynaecomastia Labour pre-term
Haematuria Labour prolonged
Haemolytic jaundice Lactation disorders
Haemorrhage other GI Lymphoedema
Haemorrhage in early preg Malabsorption
Haemorrhoids Malnutrition
Headache (acute) Mastitis
Heart block Meniscus problems
Heart failure Migraine
Hepatitis chronic Mineral deficiencies
Hernia femoral Mittleschmertz
Hernia hiatus Multiple sclerosis
Hernia incisional Nephritic syndrome
Hernia inguinal (adult) Nephritic syndrome acute
Hernia inguinal (child) Nipple discharge
Hernia paraoesophageal Obstruction gastric outlet
Hernia umbilical Obstructive & reflux uropathy
Hernia ventral Oesophageal varices
Hydatid disease liver Oesophagitis
Hydrocoele Osteomyelitis
Hydronephrosis Palliative care
Hypercalcaemia Pancreatitis chronic
Hypertension Parametritis
Hypoglycaemia Parkinson’s disease
Hypopituitrism Paroxysmal tachycardia
Hypothyroidism Patella disorders
Incontinence faecal Pelvic cellulitis
Incontinence stress Perinatal problems
Internal derangement knee Peripheral vascular disease
Jaundice hepatocellular Phimosis
Jaundice obstructive Pilonidal disease
Index
1 Non Emergency Conditions
Pleural effusion Toxic liver disease
Pneumothorax Transient Ischaemic Attacks
Polymyalgia Ulcer chronic venous
Post operative surgical problems Ulcer decubitus
Post partum breast problems Ulcer duodenal
Post phlebitic syndrome Ulcer gastric
Pregnancy normal delivery Ulcerative colitis
Prolapse rectal Ureteric colic
Prostatitis Ureteric stones
Pseudo obstruction Urinary tract infection
Pseudocyst pancreatic Vaginitis
Psychiatric disorder chronic Varicocoele
Pulmonary oedema Varicose veins
Pyogenic granuloma Vitamin deficiencies
Raynaud’s syndrome Volvulus
Renal and ureteric calculi
Respiratory failure chronic
Rheumatic heart dis
Rotator cuff syndr
Salpingitis
Sarcoidosis
Seborrhoeic keratosis
Sialolithiasis
Sexually transmitted diseases
Sick sinus syndrome
Stoma care
Stroke
Substance abuse
Syncope
Thyroiditis
Thyrotoxicosis
Torticollis
Index
2 Non Emergency Conditions
Abortion complications Hypopituitrism
Abortion medical Incontinence faecal
Abortion missed Internal derangement knee
Abortion spontaneous Jaundice obstructive
Abscess amoebic Keloid scar
Abscess hepatic Lactation disorder
Anal fistula Lymphoedema
Aneurysm abdominal aorta Meniscus problems
Aneurysm other Migraine
Benign prostatic hypertrophy Mittleschmertz
Bile duct stones Osteomyelitis
Bursitis Palliative care
Cardiomyopathy Pancreatitis chronic
Cervical disc disorders Parametritis
Chronic pain sundrome Parkinson's disease
Crohn’s disease Paroxysmal tachycardia
Cyst ovarian Patella disorders
Cystitis Pelvic cellulitis
Deep vein thrombosis Post operative surgical problems
Dupuytren’s contract Prolapse rectal
Eclampsia Prostatitis
Endometriosis Pyometra
Fistula gastrocolic Renal and ureteric calculi
Fistula vesico-vaginal Respiratory failure chronic
Fracture osteoporotic Rotator cuff syndr
G-6P-D deficiency Salpingitis
Haematuria Sarcoidosis
Haemolytic jaundice Ulcer chronic venous
Haemorrhage other GI Ulcer decubitus
Haemorrhage in early preg Ulcerative colitis
Hydatid disease liver Ureteric colic
Hydatidiform mole Ureteric stones
Hydronephrosis Vocal cord diseases
Index
3 Non Emergency Conditions
Abscess amoebic Gynaecomastia
Abscess intracranial Haematuria
Abscess hepatic Haemorrhage other GI
Achalasia Haemolytic jaundice
Atrial fibrillation Heart Block
Atrial flutter Heart failure
Anal fistula Hepatitis chronic
Aneurysm abdominal aorta Hernia hiatus
Angina Hernia paraoesophageal
Barrett's oesophagus Hydatid disease liver
Bile duct stones Hydatidiform mole
Bronchiectasis Hydrocoele
Bursitis Hydronephrosis
Cardiomyopathy Hypertension
Cervical disc disorders Hypoglycaemia
Chronic pain syndrome Incontinence faecal
Cirrhosis Internal derangement knee
Colonic polyps Jaundice hepatocellular
Conduction disorders (other) Jaundice obstructive
Congenital adrenal hyperplasia Keloid scar
Connective tissue disorder Lactation disorders
Crohn’s disease Lymphoedema
Cyst ovarian Malabsorption
Dupuytren’s contract Meniscus problems
Eclampsia Mittleschmertz
Empyaema Multiple sclerosis
Endocarditis Nephritic syndrome acute
Fistula gastrocolic Nephrotic syndrome
Fistula urethral Osteomyelitis
Fistula vesico-vaginal Pancreatitis chronic
Fracture mal- and non-union Parametritis
Gastro Oesophageal Reflux Dis
Paroxysmal tachycardia
Index
3 Non Emergency Conditions
Patella disorders
Pelvic cellulitis
Peripheral vascular disease
Pleural effusion
Post operative surgical problems
Post phlebitic syndrome
Pseudocyst pancreatic
Pyometra
Raynaud’s syndrome
Renal and ureteric calculi
Rheumatic heart disease
Rotator cuff syndr
Salpingitis
Sarcoidosis
Sialolithiasis
Sick sinus syndrome
Syncope
Thyrotoxicosis
Torticollis
Transient ischaemic attacks
Ulcer chronic venous
Ulcer decubitus
Ulcerative colitis
Ureteric colic
Ureteric stones
Vaginitis
Varicocoele
Varicose veins
Vocal cord diseases
Index
4 Non Emergency Conditions
Abortion habitual Tonsillitis chronic
Amenorrhoea Torticollis
Arthritis osteo Ulcer decubitus
Arthritis rhematoid Vaginitis
Benign prostatic hypertrophy Vocal cord diseases
Bladder calculi
Cataract
Cervical disc disorders
Cervix erosion & ulcer
Connective tissue disorders
Dupuytren’s contract
Dyspareunia
Epistaxis
Fracture mal- and non-union
Fracture osteoporotic
Hallux valgus
Incontinence stress
Infertility female
Internal derangement knee
Keloid scar
Kyphosis, scoliosis etc
Meniscus problems
Menopause problems
Menorrhagia
Osteomyelitis
Palliative care
Patella disorders
Perimenopausal probs
Post coital bleeding
Psychiatric disorder chronic
Rotator cuff syndr
Sexually transmitted diseases
Index
5 Non Emergency Conditions
Abortion habitual Patella disorders
Alcoholic liver disease Pelvic cellulitis
Amenorrhoea Post coital bleeding
Arthritis osteo Psychiatric disorder chronic
Arthritis rheumatoid Pyometra
Asthma Rotator cuff syndr
Benign prostatic hypertrophy Salpingitis
Bladder calculi Sialolithiasis
Cervical disc disorders Tonsillitis chronic
Cervix erosion & ulcer Vocal cord diseases
Connective tissue disorders
Cyst ovarian
Dupuytren’s contract
Dyspareunia
Endometriosis
Epistaxis
Fistula vesico-vaginal
Fistula urethral
Fracture mal- and non-union
Gynaecomastia
Gastro Oesophageal Reflux Dis
Hallux valgus
Hydatidiform mole
Incontinence stress
Infertility female
Internal derangement knee
Kyphosis, scoliosis etc
Meniscus problems
Menorrhagia
Nipple discharge
Osteomyelitis
Parametritis
Index
6 Non Emergency Conditions
Cervical disc disorders
Haemorrhage in early preg
Hyperemesis
Hypertension of preg
Palliative care
Index
7 Non Emergency Conditions
Abortion complications Peripheral vascular disease
Abortion medical Post partum breast problems
Abortion missed Post phlebitic syndrome
Abortion spontaneous Pregnancy + abn pelvic organs
Aneurysm abdominal aorta Pregnancy normal delivery
Aneurysm other Raynaud’s syndrome
Birth trauma Ulcer chronic venous
Cervical disc disorders Varicose veins
Dysproportion
Eclampsia
Failed induction
Fibroadenoma breast
Fibrosclerosis breast
Foetal abnormality
Foetal damage
Foetal growth disorder
Gastro Oesophageal Reflux Dis
Gestation length disorder
Goitre non toxic
Hyperemesis
Hypertension of preg
Infertility male
Labour pre-term
Labour prolonged
Lymphoedema
Malpresentation
Multiple gestation
Obesity
Obstructive & reflux uropathy
Oesophageal varices
Oligohydramnios
Perinatal problems
Index
Emergency
Conditions
1 Emergency Conditions
Abortion complications Brain injury focal
Abortion missed Burns 12
Fracture osteoporotic Head inj GCS 15
Fracture ribs and sternum Head injury + focal neur abnorm
Fracture thoracic spine Heart block
Fracture upper limb complex Heart failure
Fracture upper limb simple Hepatic failure acute
Frost bite + tissue loss Hernia femoral
Gallstone ileus Hernia inguinal child
Gas gangrene Hernia inguinal comp adult
Guillain Barre Syndr Hernia inguinal comp child
Haemarthrosis Hypercalcaemia
Haematemesis & melaena Hypertensive emergency
Haematuria Hypoglycaemia
Index
1 Emergency Conditions
Hypothermia Paralytic ileus
Injury intra abdominal viscus Parametritis
Injury liver Paroxysmal tachycardia
Injury multiple serious Patella disorders
Injury pulmonary Pelvic cellulitis
Injury renal Perforation abdominal viscus
Injury soft tissue Perforation peptic ulcer
Insect bites Pericarditis acute
Internal derangement knee Perinatal problems
Intussusception Perineal laceration
Ischaemic colitis Peritonitis acute
Jaundice hepatocellular Phlebitis
Jaundice obstructive Pleural effusion
Labour prolonged Pleurisy
Lymphadenitis acute Pneumonia
Mastoiditis acute Pneumonia aspiration
Meningitis (adults) Pneumothorax
Meniscus problems Poisoning acute
Mittleschmertz Post operative surgical problems
Myocardial infarction Pregnancy ectopic
Necrotising fasciitis Premature rupt of membranes
Nephritic syndrome acute Pseudo obstruction
Neurological injury upper limb Psychiatric conditions acute
New born problems serious Psychosis acute
Obstructed labour Puerperal sepsis
Obstruction large bowel Pulmonary embolism
Obstruction small bowel Pulmonary oedema
Obstruction trachea Pyelonephritis acute
Obstructive & reflux uropathy Pyogenic arthritis
Osteomyelitis Pyogenic granuloma
Otitis externa Pyometra
Otitis media Pyothorax
Pancreatitis acute
Index
1 Emergency Conditions
Renal & ureter calculi Volvulus
Renal failure acute
Retained placenta
Ruptured aorta
Ruptured bladder
Ruptured uterus
Ruptured vena cava
Salpingitis
Sepsis
Sexually transmitted diseases
Shock
Sialadenitis
Sialolithiasis
Skin lacerations
Snake bites
Status epilepticus
Strains and sprains
Stroke
Substance abuse
Thrombophlebitis
Tonsillitis acute
Torsion of testis
Torticollis
Transient Ischaemic Attacks
Ulcerative colitis
Umbilical cord complications
Ureteric colic
Ureteric stones
Urinary retention
Urinary tract infection
Vascular injury neck
Vascular injury lower limb
Vascular injury upper limb
Ventricular fibrillation
Index
2 Emergency Conditions
Abortion complications Dislocated hip
Abortion missed Dislocated knee
Abortion spontaneous Dislocated shoulder
Abscess amoebic Embolism mesenteric
Abscess hepatic Embolus or thrombosis arterial
Abscess pancreatic Endocarditis
Abscess peritonsillar Epistaxis
Abscess urethral Flail chest
Acute coronary syndrome Foreign body alim tract
Amputation traumatic Foreign body GU tract
Aneurysm abd aorta rupture Foreign body resp tract
Aneurysm other Fourniers gangrene
Aneurysm thoracic dissection Fracture Cervical spine
Aneurysm thoracic ruptured Fracture lower limb simple
Arrythmias acute Fracture lumbar spine
Arthritis inflammatory Fracture osteoporotic
Arthritis osteo Fracture ribs & sternum
Arthritis septic Fracture serious foot
Benign prostatic hypertrophy Fracture thoracic spine
Bile duct stones Fracture upper limb complex
Brain injury diffuse Frost bite + tissue loss
Brain injury focal Gas gangrene
Burns 30% Haemopericardium
Burns 10 – 30% Haemopneumothorax
Cardiac contusion Haemorrhage extra dural
Cardiac laceration/punct Haemorrhage other GI
Clostridium dificile infection Haemorrhage in early preg
Crohn’s disease Haemorrhage intracranial
Crush injury genitalia Haemorrhage oesophageal
varices
Crush injury hand Haemorrhage other gastrointest
Crush injury lower limb Haemorrhage sub arachnoid
Cyst ovarian torsion or rupture
Index
2 Emergency Conditions
Haemorrhage sub dural Poisoning acute
Haemothorax Post operative surgical problems
Head inj GCS 30% Gas gangrene
Carbon monoxide poisoning Guillain Barre syndrome
Cardiac contusion Haemarthrosis
Cardiac laceration/punct Haemopericardium
Cervical disc disorder Haemopneumothorax
COPD exacerbation Haemorrhage antepartum
Crohn’s disease Haemorrhage extra dural
Crush injury hand Haemorrhage other GI
Crush injury lower limb Haemorrhage in early preg
Cyst ovarian torsion or rupture
Index
3 Emergency Conditions
Haemorrhage intracranial Pancreatitis acute
Haemorrhage intrapartum Parametritis
Haemorrhage large bowel Pelvic cellulitis
Haemorrhage oesophageal Perinatal problems
varices
Haemorrhage other gastrointest Pneumonia
Haemorrhage placenta praevia Pneumonia broncho
Haemorrhage post partum Pneumothorax
Haemorrhage sub arachnoid Poisoning acute
Haemorrhage sub dural Post operative surgical problems
Haemothorax Pregnancy ectopic
Head inj GCS <12 Premature rupture of
membranes
Head injury + focal neur abnorm
Psychiatric conditions acute
Heart block Psychosis acute
Hypercalcaemia Puerperal sepsis
Hypertension of preg Pyogenic arthritis
Injury intra abdominal viscus Pyometra
Injury liver Pyothorax
Injury multiple serious Renal failure acute
Injury pulmonary Renal & ureter calculi
Internal derangement knee Retained placenta
Intussusception Ruptured aorta
Ischaemic colitis Ruptured uterus
Jaundice obstructive Ruptured vena cava
Labour pre-term Sepsis
Meningitis (Adults) Shock
Meniscus problems Sialolithiasis
Myocardial infarction Skin laceration
Necrotising fasciitis Snake bite
Neurological injury upper limb Status epilepticus
Neurological injury lower limb Ulcerative colitis
New born problems serious Ureteric colic
Obstructed labour Ureteric stones
Obstruction large bowel Vascular injury neck
Obstruction trachea Vascular injury lower limb
Obstructive & reflux uropathy Vascular injury neck
Osteomyelitis Vascular injury upper limb
Index
Malignant
Conditions
1 Malignant Conditions
Basal cell carcinoma of skin
Squamous cell carcima of skin
Index
2 Malignant Conditions
Basal cell carcinoma of skin
Cancer Anal canal
Cancer Bladder
Cancer Breast
Cancer Bronchus
Cancer Colon
Cancer Gall bladder
Cancer Kidney
Cancer Lip and Oral Cavity
Cancer Oesophagus
Cancer Pancreas
Cancer Penis
Cancer Prostate
Cancer Rectum
Cancer Small intestine
Cancer Stomach
Cancer Testis
Cancer Thyroid
Cancer Urinary Tract other
Malignant melanoma
Mesothelioma
Obstruction large bowel
Squamous cell carcima of skin
Index
3 Malignant Conditions
Basal cell carcinoma of skin
Cancer Anal canal
Cancer Bladder
Cancer Bone and cartilage
Cancer Brain and Spinal Cord
Cancer Breast
Cancer Bronchus
Cancer Colon
Cancer Gall bladder
Cancer Kidney
Cancer Liver
Cancer Oesophagus
Cancer Other endocrine organ
Cancer Ovary
Cancer Pancreas
Cancer Penis
Cancer Prostate
Cancer Rectum
Cancer Small intestine
Cancer Stomach
Cancer Testis
Cancer Thyroid
Cancer Urinary tract other
Cancer Uterus
Cancer Vulva/vagina
Leukaemia
Lymphoma Hodgkins
Lymphoma non-Hodgkins
Malig immunoprolif disorder
Malignant melanoma
Mesothelioma
Multiple myeloma
Obstruction large bowel
Sarcoma soft tissue
Squamous cell carcima of skin
Index
4 Malignant Conditions
Basal cell carcinoma of skin
Cancer Bladder
Cancer Bronchus
Cancer Eye
Cancer Larynx
Cancer Lip and oral cavity
Cancer Nasal cavity & middle ear
Cancer Other endocrine organ
Cancer Prostate
Cancer Sinuses
Cancer Trachea
Cancer Vulva/vagina
Malignant melanoma
Mesothelioma
Sarcoma soft tissue
Squamous cell carcima of skin
Index
5 Malignant Conditions
Basal cell carcinoma of skin
Cancer Bladder
Cancer Bone and Cartilage
Cancer Bronchus
Cancer Cervix
Cancer Eye
Cancer Lip and oral cavity
Cancer Nasal cavity & middle ear
Cancer Ovary
Cancer Pancreas
Cancer Prostate
Cancer Sinuses
Cancer Testis
Cancer Urinary tract other
Cancer Uterus
Cancer Vulva/vagina
Malignant melanoma
Mesothelioma
Squamous cell carcima of skin
Index
6 Malignant Conditions
Cancer Prostate
Cancer Bone and cartilage
Cancer Brain and spinal cord
Cancer Breast
Cancer Bronchus
Cancer Cervix
Cancer Gall bladder
Cancer Kidney
Cancer Larynx
Cancer Lip and oral cavity
Cancer Nasal cavity & middle ear
Cancer Oesophagus
Cancer Other endocrine organ
Cancer Ovary
Cancer Pancreas
Cancer Sinuses
Cancer Small intestine
Cancer Testis
Cancer Thyroid
Cancer Trachea
Cancer Uterus
Cancer Vulva/vagina
Leukaemia
Lymphoma Hodgkins
Lymphoma non-Hodgkins
Malig immunoprolif disorder
Malignant melanoma
Mesothelioma
Multiple myeloma
Sarcoma soft tissue
Index