Referral

All patients with suspected or confirmed pancreatitis should be referred promptly to the on-call surgical team once initial assessment has been carried out and appropriate initial management instigated.

Those patients that display features of possible acute severe pancreatitis should be reviewed by senior emergency department staff. They should also be considered early for HDU or ICU care and this should be discussed and arranged with the on-call surgical team.

Patients with organ failure or poor prognostic signs (persistent SIRS, Glasgow score >3, APACHE score >8 and Ranson score >3) should be assessed for admission to a high dependency unit.

Learning Bite

Any patient with haemodynamic instability or features of severe pancreatitis should be managed in a critical care environment.