Royal Cornwall Hospital

Truro

Cornwall TR1 3LJ

For Life-Threatening Emergencies Call 999

© 2023 by Acute GP Service, CPFT. 

Protocols

  • Calls are triaged by the Acute GP Team. If appropriate patients are to be seen in the Emergency Ambulatory Car Area the patients should be entered into the Surgical Clinic on adastra.

  • If patients are to be admitted, tick the Admit to RCH Surgical Department option at the end of the process. Please try to bleep the surgical SHO on Bleep 2961; if they do not answer on the first attempt, phone the St Mawes unit on 3032 and speak to the ward clerk who will add the patient’s name to the take list.

  • Patients who are currently stable but need urgent surgical review can be booked into the St Mawes Unit for review at 10am by a Surgical Registrar. Please phone the St Mawes unit and give the patients details.

  • There are 5-6 USS slots per morning on the St Mawes unit. Patients must be starved (4 hours before) St Mawes unit must be informed and patient booked into slot.

  • Surgical patients who are seen in the Acute GP Clinic who are discharged home can be given open access to St Mawes Unit overnight. The patient’s details must be sent to the St Mawes Unit.

  • Stable patients with renal colic are to be seen in the Acute GP Clinic and placed on the renal colic pathway.

  • Any stable patients with possible gall stones can be seen in the Acute GP Clinic

  • If cholecystitis is diagnosed  or if patients have uncontrolled upper abdominal pain admit to St Mawes. Confirmed cholecystitis needs cholecystectomy during first admission.

  • If patients present with breast abscess discuss with the Clinician in the Mermaid Unit. The patient will either be seen in the Mermaid clinic or in the St Mawes unit.

  • Stoma nurses can review stoma problems in the Ambulatory area.

  • If patients are unstable and are going to resus the ED team will inform the surgical team on arrival.

  • For young women <50 years with pelvic pain please ensure the GP has considered a gynaecological cause before admitting to surgery.

  • Anal fissures if not infected – advise rectogesic/anoheal with oral analgesics and movicol. Consider amitriptyline at night.

  • Thrombosed piles – advise patient to sit on frozen peas and take oral analgesia.

  • For difficult catheter problems the Urology Specialist Nurse – Elaina Howard may be able to help x 2220

  • Patients with D and V go to St Mawes but please inform SHO/ward clerk if likely to need a side room. No default via ED.

  • GP surgeries continue to arrange ambulance transport. This is historical.