Royal College of Emergency Medicine Guidance 

The Royal College of Emergency Medicine (RCEM) has clinical guidelines available for professionals working in emergency medicine. This section includes guidance on the following: RCEM Guidance, Toolkits and Best Practice. You will find information and college guidance below regarding the following: paracetamol overdose, mental health, drugs and alcohol and guidance implementation. 

RCEM Guidance

College Guidelines 

This page contains guidelines and statements produced by the College's Quality in Emergency Care (QEC) committee. For clinical guidelines relevant to EM published by other organisations please go the External Guidelines page. For clinical guidelines written by Emergency Departments (EDs) and shared for use/adaptation by other EDs please go to the Local Guidelines page.

Position Statements

Position statement - Improving Quality Indicators & System Metrics for EDs in England (March 2019)
Position statement - Advanced Life Support (February 2019)
Paediatric trauma - Stabilisation of the Cervical Spine (Aug 2017)
Position statement on CQUIN to reduce attendances by frequent attenders and mental health attendances (Aug 2017)
Ambulatory Emergency Care Position Statement (Jul 2017)
Position statement on Complications of Early Pregnancy and the role of the ED (Apr 2017)
Position statement on Resuscitative Thoracotomy in Trauma Units (Apr 2017)
RCEM Response to RCR Imaging in Paediatric Trauma Guidelines (Mar 2017)
Clinical responsibility for patients within the emergency department (Nov 2016)
Acute Ischaemic Stroke and Intravenous Thrombolysis (Dec 2015)
Alcohol related harm (May 2015)
Needlesticks - ED care of patients who have been potentially exposed to blood borne viruses (Feb 2013)
Providing pre-transfusion blood samples for Police (Oct 2011)
Triage (April 2011) - published by CEM, ENCA, FEN & RCN
Unscheduled Care Facilities (2009) - Minimum requirements for units which see the less seriously ill or injured. Published by CEC, ENCA, FEN & RCN

Resource Toolkits

Ambulatory Emergency Care (Feb 2019)
Mental Health in the ED (revised October 2019)
Initial assessment of Emergency Department patients (Feb 2017)
ED crowding overview and toolkit (Dec 2015)
Alcohol toolkit (June 2015)
Sepsis (Sept 2016)
The Safety Toolkit (Dec 2013)
Paracetamol Overdose

Best Practice Guidelines

NEW: Traumatic Cardiac Arrest in Adults (September 2019)
NEW: Drug Misuse and the Emergency Department  (May 2019)
NEW: Emergency Department Out of Hours Discharge Medications  (April 2019)
NEW: Management and Transfer of Patients with a Diagnosis of Ruptured Abdominal Aortic Aneurysm to a Specialist Vascular Centre (January 2019)
NEW: The Patient who Absconds (June 2018)

Consent in Adults, Adolescents and Children in Emergency Departments (Jan 2018)
A brief guide to Section 136 for Emergency Departments (Dec 2017)
Intravenous Regional Anaesthesia for Distal Forearm Fractures (Bier's Block) (revised Nov 2017)
Information sharing to reduce Community Violence (Sept 2017)
Frequent Attenders in the ED (Aug 2017)
Emergency Department Care (Jul 2017)
Management of Investigation Results in the Emergency Department (revised Jul 2017)
Management of Radiology Results in the Emergency Department (revised Jul 2017)
Management of Pain in Children (revised Jul 2017)
A universal FGM flowchart and reporting tool (Jun 2017)
Giving Information to Patients in the Emergency Department (Feb 2017)
The Mental Capacity Act in Emergency Medicine Practice (Feb 2017)
Pharmacological Agents for Procedural Sedation and Analgesia  (revised March 2019)
Ketamine Sedation of Children in Emergency Departments (revised Oct 2016)
ED Patients in Police Custody (revised Jun 2016)
RCEM guidelines for management of Acute Behavioural Disturbance (May 2016)
Reducing redundant activity in the acute setting (Dec 2015)
Management of Adult Patients who attend Emergency Departments after Sexual Assault and / or Rape (revised Oct 2015)
Management of Domestic Abuse (Mar 2015)
End of Life Care for Adults in the ED (Mar 2015)
Chaperones in the Emergency Department (Mar 2015)
Management of Pain in Adults (revised Dec 2014)
Caring for adult patients suspected of having concealed illicit drugs (Jun 2014)
Safeguarding Children (Mar 2014)
HIV Testing in the Emergency Department  (revised Oct 2012)
Safe Sedation in the Emergency Department - Report and Recommendations byRCOA and RCEM (Nov 2012)
'The Silver Book': Quality Care for Older People with Urgent and Emergency Care Needs (Intercollegiate, Jun 2012)
Silver Book - Executive Summary
Silver Book - Short Version
Silver Book - Clinical Governance and Research
Silver Book - Training and Development
Silver Book - References
Providing a witness statement for the Police (Feb 2012)
Clinical guideline use in the Emergency Department (Aug 2011)
Cervical Spine: Management of alert, adult patients with potential cervical spine injury in the Emergency Department (Nov 2010)
Practical guide - a short summary of the above c-spine guideline (Nov 2010)
Information sharing to reduce Community Violence (Aug 2011)

GEMNet Guidelines

The following evidence-based guidelines have been published by GEMNet:
Suspected Scaphoid Fractures - (Flowchart) (Sept 2013)
Thromboprophylaxis in ambulatory trauma patients requiring temporary limb immobilisation - (Flowchart) (Oct 2012)
Info re thromboprophylaxis rev Aug 2013
Example protocol (with thanks to University Hospitals Bristol NHSFT)
Acute allergic reaction - (Flowchart) (Dec 2009)
First seizure in the ED - (Flowchart) (Dec 2009)
Lone acute severe headache - (Flowchart) (Dec 2009)
Tricyclic Antidepressant Overdose - (Flowchart) (Dec 2009)  


RCEM / NPIS Guideline on Antidote Availability for EDs (Jan 2017):
RCEM NPIS Antidote Guideline List
RCEM NPIS Antidote Guideline Appx 1
RCEM NPIS Antidote Guideline Letter


QEC Quick Summaries of External Guidelines

Below is a list of College summaries of clinical guidelines relevant to Emergency Medicine which have been produced by external organisations.
RCEM summary of DVLA fitness to drive medical standards 
RCEM summary of NICE Guideline CG47 - Feverish illness in children 
RCEM summary of NICE Guideline CG54 - Urinary tract infection in children
RCEM summary of NICE Guideline CG88 - Early management of persitent non-specific low back pain
RCEM summary of NICE Guidelines CG100 & CG115 - Alcohol-use disorders
RCEM summary of NICE Guideline CG109 - Transient loss of conciousness  
RCEM summary of NICE Guideline CG112 - Sedation in children and young people
RCEM summary of Royal College of Nursing National Project - Dignity in dementia

For clinical guidelines relevant to Emergency Medicine produced by external organisations please click here.

Ebola Guidance

RCEM Ebola Guidance revised December 2014 
EPRR CRG Opinion on emergency care for Ebola (24 October 2014)

Further links to information and resources on the 2014 Ebola outbreak in West Africa:

Public Health England

RCEM letter to clinicians - travel history (March 2015)
Ebola: infection prevention and control for emergency departments (November 2014)
Ebola: infection prevention and control for primary care (November 2014)

European Centre for Disease Prevention and Control

Ebola outbreak in West Africa
Rapid Risk Assessment (13 October 2014)


World Health Organisation (WHO)

WHO Global Alert and Response (GAR) - Ebola

Selected further guidance and resources

Invasive procedure checklist for EDs (May 2016)
Paracetamol overdose guidance
H1N1 influenza: Principles and resources for EDs (last updated 4th Jan 2011)

Committee templates

Best Practice guideline template (Dec 2014)

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