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Same day emergency care (SDEC)

Please choose a specialty to see information on referring patients for same day emergency care at University Hospitals Birmingham.

Medicine

Inclusion criteria

  • Aged 16 or older
  • General medicine
  • "Fit to sit"/mobilising
  • Common presentations:
    • Low-risk chest pains (suspected to be ACS, PE or respiratory)
    • Breathlessness (No COVID-19 history)
    • TIA (strokes should go to A&E)
    • DVT
    • Headaches with no neurological deficit
    • Cellulitis
    • Stable anaemia
    • Stable deranged bloods 

Exclusion criteria

  • Any patient suspected of either being COVID-positive or having been in contact with COVID-positive cases
  • Not "fit to sit"
  • High-risk chest pain:
    • STEMI
    • New acute ECG changes such as LBBB
    • Ongoing cardiac chest pain
    • haemodynamically unstable (e.g. hypotensive, tachyarrhythmia)
  • NEWS >7/SEWS >2
  • Time-critical diagnoses (stroke/sepsis/STEMI) or red flag sepsis
  • Trauma – acute/suspected
  • Specialty (surgical/renal/oncology etc)
  • acute mental health
  • Seizures – status or recurrent
  • Airway compromise/altered airway
  • GCS <15 (at any point leading up to admission)
  • Overdose or intoxication with alcohol/drugs
  • Hypothermia
  • Severe pain (pain score >6/10 despite analgesia)
  • Haematemesis/melaena
  • T1/T2 respiratory failure
  • Requiring O2 therapy
  • Asthma with peak flow <75% of best/predicted
  • Infection risk – Diarrhoea and vomiting/COVID-19/flu
UnitSiteOpening hoursContact
Medical SDEC Good Hope Hospital 07:00 – 19:00, seven days a week (last referral 19:00) 0121 424 7921
Medical SDEC Heartlands Hospital 07:00 – 22:00, seven days a week (last referral 19:00) 0121 424 0191
Medical SDEC Queen Elizabeth Hospital Birmingham 07:00 – 19:00, seven days a week (last referral 19:00) 0121 371 2725

Surgery

Inclusion criteria

Acute onset:

  • severe abdominal pain (requiring admission or definitive surgical review, e.g. suspected diverticulitis, pancreatitis, cholecystitis, appendicitis)
  • peri-anal conditions (e.g. abscess)
  • right iliac fossa pain (suspected appendicitis, except that caused by gynaecology conditions)
  • suspected acutely symptomatic gallstones – cholecystitis, pancreatitis, exacerbation biliary pain (but not chronic biliary colic)
  • painful hernia (non-reducible, obstructed, incarcerated, strangulated
  • abscesses (on the trunk/axilla/perianal, buttocks), not limb/face/neck
  • suspected bowel obstruction
  • suspected visceral perforation (stable)
  • suspected pancreatitis
  • surgical post-operative complications and wound issues
  • bariatric surgery complications (Heartlands Hospital only)
  • Endoscopic complications
  • To QEHB Surgical Assessment Unit (SAU), virtual SAU patients attending ED with condition related to original admission, or any other emergency general surgical complaint

Exclusion criteria

  • Trauma patients
  • All medical referrals, including melaena and jaundice
  • Patients who are critically unwell, requiring level 2 or 3 care, or unstable patients
  • Patients requiring immediate (category 1) operations or interventions
  • Patients with a potentially compromised airway
  • Suspected severe sepsis, generalised peritonitis or massive haemorrhage
  • Patients with active diarrhoea and vomiting who are assessed as requiring isolation
  • Acutely unwell patients arriving via ambulance
  • All gynaecological patients
    • should be directed to GAU, including abdominal pain following prior gynaecology/obstetric intervention and all pregnant patients with lower abdominal pain
  • Patients under the age of 16
  • Multi-morbid patients with uncertain diagnosis need senior A&E review before decision to transfer
  • All chronic conditions should be referred through standard primary care route
  • VirtualSAU patients attending ED with a condition unrelated to their original admission, or complaint that is not general surgical in nature
  • No vascular patients to Good Hope Hospital or Queen Elizabeth Hospital Birmingham SAUs
  • No urology patients to Good Hope Hospital SAU
UnitSiteOpening hoursContact
Surgical Assessment Unit Good Hope Hospital 09:00 – 18:30
  • 0121 424 9949
  • 0121 424 7233
Surgical Assessment Unit Heartlands Hospital 24 hours a day, seven days a week
  • 0121 424 2763
  • 0121 424 0681
Surgical Assessment Unit Queen Elizabeth Hospital Birmingham 24 hours a day, seven days a week
  • 0121 371 4065
  • 0121 371 6025

Paediatrics

Inclusion criteria

All acute medical referrals of children and young people up to the age of 16 years will be considered for referral apart from the exceptions below. If uncertain whether a patient is suitable for referral, discuss the case via the contact numbers provided for advice.

Exclusion criteria

  • Any patient presenting with a time-critical condition, requiring immediate treatment upon arrival at hospital, must continue to be pre-alerted to the Emergency Department
  • Babies under 10 days of age with feeding difficulties or jaundice who are usually seen on post-natal ward
UnitSiteOpening hoursContactOut of hours
Children's Assessment Unit Good Hope Hospital 09:00 – 17:00, Monday – Friday Via UPAGs system on 0121 582 3120 Please call 0121 424 2000 and ask switchboard to bleep the paediatric registrar for Good Hope Hospital
Paediatric Assessment Unit Heartlands Hospital 09:00 – 17:00, Monday – Friday Via UPAGs system on 0121 582 3120 Please call 0121 424 2000 and ask switchboard to bleep the paediatric registrar for Heartlands Hospital

Gynaecology

Inclusion criteria

  • Pregnant patient:
    • Hyperemesis
    • Abdominal pain
    • Vaginal bleeding
  • Non-pregnant:
    • Menstrual problems
    • Low abdominal pain (could be colorectal problems/appendicitis)
    • Previous gynae problems, now presenting with similar symptoms
  • Post-gynae operation re-attendance
  • Post-miscarriage/delivery problems like fever, vaginal bleeding or discharge
  • Vulval vaginal symptoms
  • IUCD, vaginal pessaries related problems (comes under previous gynae problems)
UnitSiteOpening hoursContactNotes
Gynaecology Assessment Unit Good Hope Hospital 24 hours a day, seven days a week
  • 0121 424 3505
  • 0121 424 3506
  • Contact clinical nurse specialist (CNS) "in hours" (between 07:00 and 19:30)
  • Registrar cover available 24/7
  • West Midlands Ambulance Service crew should call ahead and discuss with CNS (or registrar if "out of hours")
Gynaecology Assessment Unit Heartlands Hospital 24 hours a day, seven days a week 0121 424 7747
  • Contact clinical nurse specialist (CNS) "in hours" (between 07:00 and 19:30)
  • Registrar cover available 24/7
  • West Midlands Ambulance Service crew should call ahead and discuss with CNS (or registrar if "out of hours")

Last reviewed: 05 May 2022