When to consider emergency admission or urgent referral – ICST
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    When to consider emergency admission or urgent referral

    Patients  who should be admitted to hospital as an emergency include those who are systemically unwell with red-flag symptoms such as:

    • Jaundice
    • ALT more than 500
    • Significant coagulopathy

     

    Patients should be referred for an urgent outpatient appointment if they are systemically well, but have red flag symptoms. When making an urgent referral, it is important that a liver aetiological screen is also organised to check for blood borne and hepatic viruses.

    Some patient will have abnormal liver blood tests as a result of an intercurrent illness such as a viral or bacterial infection, or after the commencement of a new medication. If these patients are not systemically unwell and have no red flag symptoms, they should have a repeat liver blood test to check the abnormal liver blood test resolves without the need for intervention.

    Some patients will have abnormal liver blood tests from a non-liver cause, including:

    • Elevated bilirubin due to Gilbert syndrome
    • Isolated elevated ALP can be due to vitamin D deficiency
    • Underlying malignancy
    • Raised ALT can be due to muscle injury from myositis or rhabdomyolysis

    When to consider emergency admission or urgent referral

    Patients  who should be admitted to hospital as an emergency include those who are systemically unwell with red-flag symptoms such as:

    • Jaundice
    • ALT more than 500
    • Significant coagulopathy

     

    Patients should be referred for an urgent outpatient appointment if they are systemically well, but have red flag symptoms. When making an urgent referral, it is important that a liver aetiological screen is also organised to check for blood borne and hepatic viruses.

    Some patient will have abnormal liver blood tests as a result of an intercurrent illness such as a viral or bacterial infection, or after the commencement of a new medication. If these patients are not systemically unwell and have no red flag symptoms, they should have a repeat liver blood test to check the abnormal liver blood test resolves without the need for intervention.

    Some patients will have abnormal liver blood tests from a non-liver cause, including:

    • Elevated bilirubin due to Gilbert syndrome
    • Isolated elevated ALP can be due to vitamin D deficiency
    • Underlying malignancy
    • Raised ALT can be due to muscle injury from myositis or rhabdomyolysis
    Mark as Understood
    © Institute of Clinical Science and Technology (ICST) 2020 Support: support@icst.org.uk