RHC ED 'Who Takes What?' referrals - Orthopaedics/Plastics/Neurosurgery
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Objectives
This page acts as a guide to which speciality, in general, admits which diagnoses in RHC. If there are any concerns or discussions which differ to the allocations below then discuss with ED senior.
|
Diagnosis |
Specialty |
|
Cellulitis over a joint |
Ortho |
|
Finger/metacarpal fractures |
Plastics |
|
Scaphoid/carpal fractures |
Ortho |
|
Necrotising fasciitis |
Plastics |
|
Spinal injuries |
Neurosurgery |
|
Suspected spine fractures |
Ortho if neurosurgery don’t want them/until cross sectional imaging |
|
Hand/Wrist lacerations needing exploration |
Plastics |
|
Antecubital fossa and axillary soft tissue injuries |
Plastics/ortho depending on injured structures (early discussion at consultant level) |
|
Flexor/Extensor tendon injuries |
Plastics |
|
Head injuries |
See head injury pathway, not ortho |
|
Nail bed injury/paronychia of finger |
Plastics |
|
Nail bed injury/paronychia of toe |
Ortho |
|
Hair tourniquet syndrome |
Plastics |
|
Suspected vascular injury |
Plastics or paediatric surgery (see guideline) |
|
Lacerations over femoral triangle requiring exploration |
Paediatric surgery, (low threshold for calling plastics if any suggestion of vascular injury, early discussion at consultant level) |
|
Suspected osteomyelitis/discitis |
Ortho |
|
Suspected septic arthritis |
Ortho |
Last reviewed: 19 April 2024
Next review: 30 April 2027
Author(s): Ms Alexandra Smith, Consultant Paediatric Orthopaedic Surgeon, RHCG
Co-Author(s): Stakeholders: Mr David McGill, Consultant Plastic Surgeon, RHCG; Ms Emer Campbell, Consultant Neurosurgeon, RHCG
Approved By: Paediatric Emergency Department