Gastroenterology & Hepatology referrals

SJH Emergency Medicine
NHS Lothian

During the weekday daytime SJH has its own gastroenterology team. Referrals should be made whilst / after resuscitation has occurred. For certain conditions, or at weekends, referral to the RIE team may be more appropriate. Please note for patients under 16 years, there is a separate paediatric GI team.

Whilst a TRAK referral system exists, most of the referrals made via the ED (as emergencies) will likely still be made by telephone.

Upper GI bleeds should be managed as per the separate protocol, and during the day (if needs to be referred) should be a consultant to consultant referral.

RIE referrals

From July 1st 2024 the RIE GI reg bleep 2117 will be deactivated and replaced with an on call phone. For the following emergency cases the GI team should be contacted immediately via switchboard:

  • GI bleeding with ongoing bleeding/instability despite resuscitation
  • Sharp foreign body in the oesophagus, button battery pre-pylorus, or ingestion >1 magnet
  • Acute liver failure (jaundice and coagulopathy in the setting of a high ALT in patients with no pre-existing liver disease or recent heavy alcohol use)
  • A patient being referred to critical care with a primary GI/Hepatology issue

TRAK referrals

For non-emergent TRAK referrals please do the following:

  • Select patient
  • Clinical menu
  • Order
  • Order item
  • Type ‘gastroe’ in box and click magnifier
  • Select gastroenterology/liver referral
  • Complete details including a clinical question and idea of urgency

Please see the attached guide for a visual description of this.

Editorial Information

Last reviewed: 31/07/2024

Next review date: 31/07/2026

Author(s): Deepankar Datta.

Reviewer name(s): Deepankar Datta.

References
  1. NHS Lothian GI team, TRAK GI referral notice, June 2024
Evidence method

From documents sent out from GI team re: moving to TRAK for referrals