Treatment Resources

Diagnosis of low back pain can be intriguing and complex. Careful history-taking and physical examination are essential to ensure red flags (serious issues) are not missed, that treatment is appropriate, evidence-based and timely, and that follow-up and review are well documented and understood by the patient. This article covers some of the more common causes of back pain in primary and urgent care.

Laryngeal cancer falls under the umbrella term of head and neck cancers and is the second commonest cancer type within this group. The condition often presents with symptoms shared with those of other less serious diseases, making diagnosis challenging.
This article hopes to give nurses and non-medical prescribers an overview of symptoms, diagnosis, treatment, and prognosis with the aim of raising awareness and helping to get an earlier diagnosis of this devastating disease.

Each year, 245,000 people in the UK develop sepsis, with most cases arising in primary care (Rudd et al, 2020). Currently, around 20% of people who develop sepsis do not survive (Burki, 2018), and approximately 40% of survivors have cognitive or functional impairment (Prescott and Angus, 2018). In an effort to save lives and improve outcomes, the National Institute for Health and Care Excellence (NICE), in common with other international guidelines, has recommended that sepsis is treated within an hour with broadspectrum antibiotics (Academy of Medical Royal Colleges, 2022). On the 31 January 2024, NICE updated its NG51 guideline for the UK, which was originally published in 2016. The update includes recommendations on recognition and early assessment, initial treatment, escalating care, finding the source of infection, early monitoring, and information and support. This article updates readers on changes to the NICE guidance and how they affect clinical practice.

Necrotising fasciitis (NF) is a life-threatening condition, consisting of a soft-tissue infection with rapidly progressive, widespread fascial necrosis and sepsis. Prompt diagnosis and  treatment are essential, but in the early stages, it is difficult to differentiate from other skin conditions such as cellulitis. A high level of suspicion and a low threshold for surgical referral are essential to avoid significant mortality. Following often lengthy hospital treatment, patients will be discharged for management in the community — usually with extensive wound care needs. As part of recovery, supported self-care is an option for some patients and the benefits may help improve outcomes.

Rectal cancer is a common diagnosis which is often treated by surgical resection of the cancer. However, cancer treatment can result in changes in bowel function. Faecal incontinence can occur because of cancer treatment, as well as increased defecation. Although these symptoms will improve with time over a few months, making changes, such as dietary ones with nursing support, can help. Having a greater understanding of issues that can occur and ways in which to resolve them can improve both healthcare professional confidence and circumstances for patients with bowel dysfunction.

Hypertension is common and is a cause of morbidity and mortality around the world. Many affected are unaware that they have a problem, and it is found opportunistically when their blood pressure is recorded during a consultation for another problem. If the disease is inadequately treated, it can have potentially fatal outcomes. Nurses and non-medical prescribers are likely to come across patients with raised blood pressure readings during routine clinic appointments. This article hopes to give them a better understanding of the condition, its treatment and complications, with the aim of reducing the risk of serious problems and improving outcomes for all those affected by this potentially dangerous condition.

Coughs are extremely common and vary in duration and degree of severity. Coughs of any duration are a frequent reason for seeking medical advice and unresolved coughs lasting beyond eight weeks are a cause of patient anxiety and reduced quality of life. Chronic coughs are those lasting for more than eight weeks. There are many causes, some more common than others. This article hopes to give nurses and non-medical prescribers who are approached by patients asking for advice some insight into diagnosing and resolving the problem, with the aim of improving quality of life for those affected.

Diagnosing and managing lower urinary tract infections (UTIs) in women aged 65 years and over is important to ensure their health and wellbeing. This article explores how to diagnose lower UTI, considering alternative diagnoses especially in older adults, as their symptoms may mimic UTI but may indicate other underlying conditions. It also looks at how to manage and treat uncomplicated lower UTI and provides guidance on recurrent UTI, usually  defined as three or more episodes in a year.

Despite advances in knowledge, understanding, risk factors and treatment, cervical cancer continues to be a cause of death in women around the world. The disease is the fourth most frequent cancer type in women, with an estimated 342,000 deaths in 2020, with the majority of these (approximately 90%) occurring in low and middle-income countries (World Health Organization [WHO], 2022).

When patients present with red lower legs, the cause is often assumed to be cellulitis or erysipelas. There are, however, several alternative conditions which mimic the clinical signs of cellulitis or erysipelas, which can lead to misdiagnosis. It is important that the
cause is correctly diagnosed to prevent inappropriate prescribing of antibiotics. This article discusses the different potential causes of ‘red legs’, in addition to cellulitis and erysipelas, together with clinical signs and symptoms to enable community nurses to differentiate
between them and implement appropriate treatments. Systemic antibiotics may not be the most appropriate management, and with the current focus on reducing antibiotic usage, community nurses need to be confident that they are prescribing them appropriately
and safely, and only when required.