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Vascular Hot Clinic

Checked: 23-04-2019 by katy baetjer Next Review: 23-09-2019

Overview

The following advice is taken from the Directory of Services on eReferral:

Please refer patients with the following conditions as URGENT REFERRALS. They will be seen in the vascular HOT clinic at Southmead Hospital (which is now available via the Vascular Surgery RAS on eRS) or given an urgent clinic review in their local hospital:

• Symptomatic abdominal aortic aneurysm (AAA) - see red flags below.
• Asymptomatic large (>= 5.5 cm) or rapidly expanding (> 5mm in 6 months) AAA
• Symptomatic >= 70% carotid artery stenosis (TIA, Stroke or Amarosis fugax in last 6 months – patients presenting acutely should be referred to local TIA clinic who will refer to vascular service if appropriate.)
• Severe leg ischaemia (rest or night pain, arterial ulceration or tissue loss)
• Upper arm ischaemia – patients with dialysis fistula referred to renal access service
• Infected diabetic foot with vascular compromise (patients presenting acutely with diabetic foot ulcer may also be referred via local multi-disciplinary Diabetic Foot Clinic who will refer on to vascular service.)

Refer

Vascular HOT clinic

GPs can now access this clinic by submitting an urgent vascular referral to the Vascular Surgery RAS via eRS. The Referral Service had been reassured that these referrals are triaged on a daily basis by the vascular team who will then contact the patient and see in the vascular HOT clinic if appropriate. We have also been informed that email referrals are no longer required to access this service.

All vascular referrals should now be sent via eRS to the Vascular Surgery RAS. Clinics are held in Southmead, BRI, WGH & Bath RUH. Referrals will be triaged on a daily basis by the vascular team and booked into appropriate clinics. Please include all relevant clinical and contact details in referrals to help facilitate the triage process.

For more urgent advice or discussion please telephone the office (0117 4140798) or contact the on call general/vascular surgery registrar or vascular consultant on call via NBT switchboard (0117 9505050)

Please see the Vascular services - For clinicians page on the NBT website for further information.

Or see the local Vascular Directory of Services

COVID-19 Update: The vascular service has responded to this pandemic by deferring elective surgery and offering remote (predominantly telephone) consultations. We maintain both a specialist vascular service and a diabetic foot service.

Many patients with vascular disease require emergency or urgent specialist care (see page 4 of the Directory above). Such patients should be referred as per these pathways by telephone, referapatient® or NHS e-RS RAS. The specialist service during periods of ‘surge’ will be consultant led and referrals for advice are welcomed. Patients are at risk of life or limb loss or stroke when urgent vascular intervention is deferred.

Red Flags

All patients with suspected symptomatic AAA should be discussed immediately via the on call vascular team at NBT.

If a ruptured AAA is suspected (classic triade of hypotension, abdominal pain or back pain and a pulsatile abdominal mass) then call 999 and liaise with on call vascular team at NBT.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

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