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Important: please update your RDS app to version 4.7.3 Details with newsletter below.

Please update your RDS app to v4.7.3

We asked you in January to update to v4.7.2.  After the deployment planned for 27th February, this new update will be needed to ensure that you are able to download RDS toolkits even when the RDS website is not available. We will wait until as many users as possible have downloaded the new version before switching off the old system for app downloads and moving entirely to the new approach.

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 update to the latest release:

 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.

Right Decision Service newsletter: February 2025

Welcome to the February 2025 update from the RDS team

1.     Next release of RDS

 

A new release of RDS is planned (subject to outcomes of current testing) for week beginning 24th February. This will deliver:

 

  • Fixes to mitigate the recurring glitches with the RDS admin area and the occasional brief user interface outages which have arisen following implementation of the new distributed technology infrastructure in December 2024.

 

  • Capability to embed content from Google calendar, Google Maps, Daily Motion, Twitter feeds, Microsoft Stream into RDS pages.

 

  • Capability to include simple multiplication in RDS calculators.

 

The release will also incorporate a number of small fixes, including:

  • Exporting of form within Medicines Sick Day Guidance in polypharmacy toolkit
  • Links to redundant content appearing in search in some RDS toolkits
  • Inclusion of accordion headers alongside accordion text in search result snippets.
  • Feedback form on mobile app.
  • Internal links on mobile app version of benzo tapering tool

 

We will let you know when the date and time for the new release are confirmed.

 

2.     New RDS developments

There is now the capability to publish toolkits on the web with left hand side navigation rather than tiles on the homepage. To use this feature, turn on the “Toggle navigation panel” option at the top of the Page settings menu at toolkit homepage level – see below. Please note that publication to downloadable mobile app for this type of navigation is still under development.

The Benzodiazepine tapering tool (https://rightdecisions.scot.nhs.uk/benzotapering) is now available as part of the RDS toolkit for the national benzodiazepine prescribing guidance developed by the Scottish Government Effective Prescribing team. The tool uses this national guidance developed with a wide-ranging multidisciplinary group. This should be used in combination with professional judgement and an understanding of the needs of the individual patient.

3.     Archiving and version control and new RDS Search and Browse interface

Due to the intensive work Tactuum has had to undertake on the new technology infrastructure has pushed back the delivery dates again and some new requirements have come out of the recent user acceptance testing. It now looks likely to be an April release for the search and browse interface. The archiving and version control functionality may be released earlier. We’ll keep you posted.

4.     Statistics

At the end of January, Olivia completed the generation of the latest set of usage statistics for all RDS toolkits. If you would like a copy of the stats for your toolkit, please contact Olivia.graham@nhs.scot .

 

5.     Review of content past its review date

We have now generated reports of all RDS toolkit content that has exceeded its review date by 6 months or more. We will be in touch later this month with toolkit owners and editors to agree the plan for updating or withdrawing out of date content.

 

6.     Toolkits in development

Some important toolkits in development by the RDS team include:

  • National CVD prevention pathways – due for release end of March 2025.
  • National respiratory pathways, optimal cancer diagnostic pathways and cancer prehabilitation pathways from the Centre for Sustainable Delivery. We will shortly start work on the national cancer referral pathways, first version due for release via RDS around end of June 2025.
  • HIS Quality of Care Review toolkit – currently in final stages of quality assurance.

 

The RDS team and other information scientists in HIS have also been producing evidence summaries for the Scottish Government Realistic Medicine team, to inform development of national guidance around Procedures of Limited Clinical Value. This guidance will in due course be translated into an RDS toolkit.

 

7. Training sessions for new editors (also serve as refresher sessions for existing editors) will take place on the following dates:

  • Friday 28th February 12-1 pm
  • Tuesday 11th March 4-5 pm

 

To book a place, please contact Olivia.graham@nhs.scot, providing your name, organisation, job role, and level of experience with RDS editing (none, a little, moderate, extensive.)

 

To invite colleagues to sign up to receive this newsletter, please signpost them to the registration form  - also available in End-user and Provider sections of the RDS Learning and Support area.   If you have any questions about the content of this newsletter, please contact his.decisionsupport@nhs.scot  If you would prefer not to receive future newsletters, please email Olivia.graham@nhs.scot and ask to be removed from the circulation list.

With kind regards

 

Right Decision Service team

Healthcare Improvement Scotland

 

 

Acute Pelvic Pain, Initial Management (312)

Please report any inaccuracies or issues with this guideline using our online form

Background
Pelvic pain is a common reason for women to present as an emergency to Gynaecology. Symptoms of pelvic or abdominal pain have significant overlap with symptoms of non-gynaecological conditions such as appendicitis. Liaison with other specialities may therefore be appropriate. Other specialities may not recognise atypical presentations of ectopic pregnancy and all women of reproductive age who present with abdominal or pelvic pain should have pregnancy testing performed.

Some women will require hospitalisation for assessment due to the severity of their symptoms. However where a patient is clinically stable it may be more appropriate to offer urgent out-patient assessment within Early Pregnancy Assessment Units or an Emergency Gynaecology Service.

Gynaecological causes of Acute Pelvic Pain

  • Ectopic Pregnancy
  • Miscarriage
  • Ovarian Cyst Accident (torsion, rupture,haemorrhage)
  • Mittelschmertz (Ovulation pain)
  • Pelvic Inflammatory Disease. See guideline – GG&C PID Guideline
  • Dysmenorrhoea
  • Exacerbation of Endometriosis

Assessment of the patient with acute pelvic pain

Clinical history

It is important to take an accurate history including –

  • Age and parity (particularly previous ectopic pregnancies)
  • LMP
  • Pain- onset, duration, site, radiation, nature, severity, exacerbating and relieving factors.
  • Associated symptoms- vaginal bleeding, vaginal discharge, bowel and urinary symptoms.
  • Menstrual and contraceptive history.
  • Previous gynaecological and obstetric history.

‘Red Flag’ Symptoms

  • Episodes of collapse.
  • Shoulder tip pain.
  • Significant exacerbation of pain with movement.
  • Fever and Rigors

Examination

  • Temperature, pulse, blood pressure, respiration rate and oxygen saturation
  • Abdominal examination.
  • Speculum and bimanual examination.

Investigations

Initial Investigations

  • Urinary pregnancy test
  • Urine dipstick.
  • Midstream specimen. Send for culture if dipstick positive for protein, nitrites or leucocytes.
  • Swabs for Chlamydia and Gonorrhoea if clinical suspicion of pelvic infection. See guideline – GG&C PID guideline
  • Full blood count and C-reactive protein.
  • Serum HCG if suspicion of ectopic pregnancy

Subsequent Investigations

  • Ultrasound- transvaginal where possible. Women who are not suitable for transvaginal scanning should be asked to attend with a full bladder.

Indications for Immediate Hospital Admission

  • Persistent tachycardia (pulse >100)
  • Hypotension
  • History of collapse
  • Severe pain
  • Signs of peritonism
  • Temperature over 38oC

If Severe Symptoms, consider

  • IV access and fluids
  • FBC and Group and retain
  • Sepsis 6 Protocol
  • Analgesia
  • Nil by mouth
  • Senior review

If stable / mild symptoms

Women who are stable/have mild symptoms can be discharged with an urgent outpatient review. They should be offered simple analgesia and given instructions to return if their symptoms deteriorate.

Editorial Information

Last reviewed: 05/06/2018

Next review date: 30/04/2023

Author(s): Catrina Bain.

Approved By: Gynaecology Clinical Governance Group

Document Id: 312

References

Management of Ovarian Cysts in Premenopausal Women RCOG Green Top Guideline Number 62. November 2011.

Diagnosis and Management of Ectopic pregnancy. RCOG Green Top Guideline 21 November 2016