Hôpital de LaSalle

Consult the algorithm

Specific inclusion criterias: 

• Present signs of biliary colic

Specific exclusion criterias:

• Infection signs: Intense sweats, shivers, fever
• Intense pain for more than 12 h, not alleviated by analgesics
• Active and known liver disease
• Severe hematologic disorder
• Patient taking immunosupressants
• Ascites

To be filled out / given to the patient

• Please print, fill out and fax the referral form. 
• The patient handout and the appointment trajectory should be printed and given to the patient.

Print the document

Consult the algorithm

Specific inclusion criterias: 

• Present signs of nephritic colic

Specific exclusion criterias:

• Signs or urosepsis: shivers, fever, nausea, vomiting, tachycardia
• Intense pain for <12 h, not alleviated by analgesics
• Patient taking immunosuppressants
• Kidney disease or single kidney

To be filled out / given to the patient

• Please print, fill out and fax the referral form. 
• The patient handout and the appointment trajectory should be printed and given to the patient.

Print the document

Consult the algorithm

Specific inclusion criterias:

• < 13 weeks pregnancy

Specific exclusion criterias:

• >1 sanitary napkin/Hour
• Hemodynamically unstable
• Abdominal pain not relieved with PO analgesia
• Fever > 38,5 °C oral

To be filled out / given to the patient

Please print, fill out and fax the referral form. 

The patient handout and the appointment trajectory should be printed and given to the patient.

Print the document

Consult the algorithm

Specific inclusion criterias:

• Patient is experiencing NEW LLQ (left lower quadrant) pain >24h
• The following symptoms are common: Nausea / vomiting, fever > 37.5°C , constipation or change in bowel habits

Specific exclusion criterias:

• Signs of shock: hypotension, tachycardia, desaturation
• Intense pain not relieved by PO analgesia
• Signs of peritonitis: Abdominal rigidity, rebound tenderness upon abdominal palpation, absence of peristalsis

To be filled out / given to the patient

• Please print, fill out and fax the referral form. 
• The patient handout and the appointment trajectory should be printed and given to the patient.

Print the document

Consult the algorithm

Specific inclusion criterias: 

• Presents signs and symptoms of AF (palpitations, tachycardia, fatigue, weakness, lightheadedness, mild dyspnea)

Specific exclusion criterias:

• Signs of hypoperfusion
• HR > 120 beats/min
• AF < 48 h  
• Syncope
• Signs of ischemia: angina, ↑ chest pain 
• Signs of severe heart failure: panting, palpitations, lipothymia
• Patient with mechanical heart valve
• Symptoms of TIA/stroke or previous event: partial paralysis, paralysis, numbness, aphasia, visual/cognitive impairment
• Significant arrhythmia
  • Ventricular tachycardia
  • Ventricular fibrillation
  • Polymorphic ventricular tachycardia
  • Ventricular flutter
  • Idioventricular rhythm
  • Paroxysmal supra-ventricular tachycardia
  • AV block 2^nd degree Mobitz 2 or 3^rd degree
  • Wolf-Parkinson-White syndrome

To be filled out / given to the patient

• Please print, fill out and fax the referral form. 
• The patient handout and the appointment trajectory should be printed and given to the patient.

Print the document

Consult the algorithm

Specific inclusion criterias: 

• Referring MD/ NP must specify Wells Score for the patient on the referral sheet.

Specific exclusion criterias:

• Febrile > 38,5 °C
• Hemorrhage/peptic ulcer within the last 3 months
• Kidney failure (eGFR <30)
• Severe liver failure (AST > 37 IU/L, ALT >41 IU/L)
• Patient anticoagulated
• Active bleeding
• Thrombocytopenia < 50 X 10⁹/L
• Signs of pulmonary emboli: Sudden chest pain (CP) or CP ↑ on deep breath, HR ≥100bpm, RR ≥22/min, O2 Sat<92% (unless chronic)
• Recent CVA
• Concomitant use of drugs that are strong CYP3A4 inhibitors and P-GP inhibitors (ex : antiepileptic, Amiodarone, Diltiazem, Omeprazole)

To be filled out / given to the patient

• Please print, fill out and fax the referral form. 
• The patient handout and the appointment trajectory should be printed and given to the patient.

Print the document