Routine:
Full blood count, urea and electrolytes, liver function, glucose, calcium
Haemoglobin <80 g/L→▸ If Hb <80 g/L: consider blood transfusion (checking ferritin, transferrin saturation, RBC folate and vitamin B12 before transfusion).
▸ If iron deficient: consider iron supplements.
▸ If unexplained: consider OGD and colonoscopy/CT pneumocolon.
Anaemic but Hb >80 g/L→▸ Check ferritin, transferrin saturation, RBC folate and vitamin B12. Replace if necessary, monitor response. If unexplained consider OGD and colonoscopy.
Abnormal urea, electrolytes→▸ Discuss with supervising clinician within 24 h.
▸ Consider appropriate IV fluid therapy/oral replacement.
Abnormal liver function tests  →

  • ▸ Discuss with supervising clinician within 24 h.

  • ▸ Patient will need a liver ultrasound and liver screen including hepatitis B and C serology, ferritin, α feta protein, α1 antitrypsin, liver autoantibodies, total Igs, cholesterol, triglycerides.

Abnormal glucose level→If no history of diabetes:

  • ▸ Between 7–11 mmol/L: refer to GP.

  • ▸ >11 mmol/L and ketones in urine: this is an emergency.

  • ▸ >11–20 mmol and no ketones in urine: discuss with supervising clinician within 24 h.

  • ▸ >20 mmol/L and no ketones in urine: this is an emergency.

If known diabetic:

  • ▸ Do not check glucose levels.

  • ▸ Consider checking HbA1c.

Abnormal corrected calcium level→

  • ▸ If 2.6–2.9 mmol/L: discuss with supervising clinician within 24 h.

  • ▸ If >3.0 mmol/L: this is an emergency.

  • GP, general practitioner; RBC, red blood cell; OGD, oesophago-gastroduodenoscopy.