Referrals to Medical Same Day Emergency Care (mSDEC)

Medical Same Day Emergency Care (mSDEC)

• mSDEC is an Emergency Clinic setting for patients who would otherwise need a short (<24hr) admission to the Acute Medical Units (AMU). The mSDEC takes referrals from Primary Care practitioners such as GPs, Nurse Practioners and ACPs. We mandate that an in person clinical assessment has taken place prior to referral.
• Patients need to be close to their usual level of mobility. The expectation is that patients will need to wait in our waiting room before and during their assessments.
• Trolley space is a major limitation in the clinic so acceptance is ultimately at the discretion of the AMU Consultant running the clinic. Referrals can be made by contacting the consultant on 01603 286286 ext 7767. If this number is not being answered or not working then an alternative is 01603 289623.
• The clinic is open to referrals from 8am to 8pm during weekdays and 10am to 6.30pm at the weekend.

The mSDEC is located on AMUk, level 1 East Block. Paramedics can bring patients directly to the AMU ambulance bay, rather than using the ED entrance.

mSDEC paramedic referral information

Exclusion criteria

• Diarrhoea and Vomiting
• Under the age of 16
• High suspicion of requiring admission
• Severe cognitive impairment or lack of mental capacity, attending without a carer
• Very limited mobility e.g. wheelchair users requiring hoisting or bedbound patients
• Patients without access to their own transport

Conditions less suited to a review in mSDEC

Exacerbation of Asthma / COPD. Both these conditions require a period of observation and potentially nebulisers and oxygen. This makes patients less appropriate for an ambulatory pathway. General Practice are able to refer such patients directly to the AMU but paramedic cases are seen in the Emergency Department.

Headache. The vast majority of patients suffering with headaches are managed in primary care. More serious causes of headache usually require investigation such as imaging and/or a lumbar puncture. General Practitioners are able to refer to the AMU but all other cases of headache are seen in the ED initially.

Trauma, syncope and falls. All patients who have fallen and need further review have an initial assessment of their injuries in the Emergency Department. During the day older or frailer patients can then potentially access the OPED service.

Stroke / TIA. With the development of thrombolysis and thrombectomy Stroke is now considered to be an emergency. Patients are taken to the Emergency Department for review on arrival by the stroke nurse.

Seizures. As patients need to wait in the waiting room, there are clearly concerns if patients go onto have further seizures. Patients who have had a seizure can be referred to the AMU by their GP, or where this is not possible can be seen directly in the ED.