First fit | Right Decisions

Update your RDS mobile app to v4.7.2 to download toolkits even when website is down.

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. You will see that each toolkit has a small QR code icon in the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively update to the latest release - RDS app version 4.7.1 - to see this improvement.

Updating to this latest version of the RDS app is also strongly recommended to get the full benefits of the new resilience arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits. To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Immediate action

Ensure patent airway and control residual seizure activity with IV lorazepam 1-2mg (repeated as required to max 8mg) or 10-20mg diazepam
Check BM
Key points - history: Witnessed seizure, drugs, alcohol withdrawal
Get contact details of witnesses (can come to or be contacted by first fit clinic)
Key points – examination: Vital Signs, GCS, Pupils, Localising signs, Evidence of head injury / infection
Investigations: BM, U&E, FBC, glucose, Serum osmolality, consider CT if evidence of head injury

Management in the ED

Airway care
Treatment of further seizures - IV fluids + Pabrinex (2xI+II in NSaline) if alcohol withdrawal. Dextrose can further deplete thiamine stores, precipitating Wernickes’-Korsakoff syndrome. Avoid unless hypoglycaemia.
Admit if post-ictal or if no obvious cause for seizure found
If suitable for discharge, refer to 1st seizure clinic using Trak / New Request and follow instructions on referral form.

Next review date: 31/01/2025

Author(s): GRI ED Handbook.

Reviewer name(s): Pat O'Mailley.