What we do

Patients can be seen in the Ambulatory Emergency Care Unit following referral from the following services:

•    Emergency Department
•    Urgent Care Centres
•    AMU departments
•    or by referral from GP or other health care professional

We triage referrals from GPs across East Lancashire and Blackburn with Darwen communities.

The unit will accommodate patients that are able to walk and have not been assessed as being at any risk of harm. The patients in the department will have on-going clinical supervision and will receive relevant treatment to help them return home more quickly. If a patients condition deteriorates, patients will be admitted to the relevant specialist ward.

The aim of the Unit is that patients have access to services based on their identified medical needs. They will be assessed by senior nurses and medics and relevant tests will  performed as required. A medical plan will be made and if further assessment treatment or additional care is needed, this will be instigated. All assessment findings and details of treatment given will be documented in the patient medical records. These sent to the patient’s general practitioner within 48 hours.


Examples of inclusion criteria:

•    Self-limiting palpitations
•    Low risk chest pains
•    Cellulitis that can be treated with oral antibiotics or are suitable for OPAT therapy
•    New Jaundice or abnormal liver function tests but are otherwise stable
•    Non-specific headaches
•    Poorly controlled hypertension
•    Pulmonary Embolism or DVT and follow up if unprovoked
•    Chronic conditions such as CCF/Asthma/COPD with flare up but are clinically stable
•    Non-specific collapse where patient has made a full recovery
•    Intravenous fluids to be given <6 hours for AKI 1 or Postural Hypertension
•    Atrial Fibrillation if haemodynamically stable with a heartrate <120 bpm
•    Hypoglycaemia/ Hyperglycaemia
•    Review of patients who have had a first fit and fully recovered
•    Review of patients and diagnostics/ pathology tests required to facilitate an earlier discharge

The exclusion criteria for admission is :-

•    Age less than 16
•    Clinically unwell
•    Acute bleeding- High risk Gastrointestinal bleeds
•    Immobility
•    Recent major surgery
•    Cerebral bleed
•    High risk chest pain
•    Known infection - MRSA/CDiff
•    Patients who do not have adequate support socially
•    Patients who will need admission when initially triaged from ED
•    Mental health patients/ risk of suicide
•    High risk of falls
•    Blood transfusions
•    Acute or chronic confusion
•    Patients requiring a RAT/Mobility assessment

Outpatient’s prescriptions will be given if medication on discharge is required.

The Hospital's main pharmacy shuts at 6pm. All medications to be dispensed thereafter will be via the pharmacy located on the Acute Medical Unit (AMU) side A.

Patients are referred to Ambulatory Care from the Emergency Department, Urgent Care and GPs to be assessed, diagnosed and have treatment commenced the same day.

Referrals can be made from 09:00-18:00. All referrals for admission to Acute Medicine are received by telephone during these hours. Referrals received by telephone are triaged by a Senior Nurse/Senior Medical Clinician.

 

The Ambulatory Care unit can be found on level 1 (ground floor) at the Royal Blackburn Teaching Hospital.

- Enter the building via the main entrance
- Turn right
- Follow the corridor to the left
- Turn left again past the lifts and the Macmillan Cancer stand
- Ambulatory Care can be found on the left hand side of the corridor

 

Helen Hughes

(Currently being updated)

For any general enquiries or advice about our service please telephone 01254 734756

The unit is open, Monday to Sunday from 8am to 8.30pm

Emergency Department vs Ambulatory Care

Where should I go?
Likely same-day discharge?
Patient able to walk?

Think AEC!


Painless Typically treated in ED:

•    Clinically unwell septic patients
•    Acute bleeding
•    Recent major surgery
•    Cerebral Bleed
•    High-risk chest pain (heart score greater than 4), abnormal EGC and troponin
•    Mental health patients (overdone, high risk of suicide)
Infections (such as diarrhoea or C Difficile)
 

Typically treated in AEC:

•    Palpitations/Stable new Atrial Fibrillation
•    Low-risk chest pain
•    Cellulitis that can be treated with antibiotics or are suitable for OPAT therapy
•    Anaemia
•    Painless jaundice or abnormal liver function
•    Non-specific headaches
•    Non-specific collapse
•    Postural hypotension
•    Poorly controlled hypertension
•    Follow up for unprovoked DVTs and outpatient PE's