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RCEM Clinical Standards

RCEM Clinical Standards

Quality strategy & clinical standards

RCEM Standards

Welcome to the Royal College of Emergency Medicine Standards page. Here you will find resources including clinical sign off and information on sepsis.

The clinical standards for Emergency Departments (EDs) below have been produced by the Quality in Emergency Care Committee of the Royal College of Emergency Medicine (CEM). The standards are developed by consensus from emergency physicians with relevant expertise and with input from other relevant stakeholders. The standards are regularly reviewed and provide the criteria for RCEM audits.

Clinical Standards

RCEM had in the past set clinical standards but now recommends that you refer to national standards organisations such as NICE, SIGN, BTS, or other as relevant in your area.

Additional reference documents regarding clinical standards are available to download below:

Consultant Sign-off

RCEM standard for senior review prior to discharge (Consultant Sign-Off)

In December 2010 the Royal College of Emergency Medicine published a new standard for Consultant “sign off” of selected high risk patients being discharged from the Emergency Department.

This standard was updated in June 2016, introducing adults aged 70 years and over with abdominal pain as a new high-risk patient group. The age range for adults with atraumatic chest pain has been revised from 17 years and over to 30 years and over.

We welcome comment and feedback on the revised standard.


Archive and further information


Staff working in Emergency Departments (ED) should be familiar with the significant morbidity and mortality associated with sepsis and possess the knowledge and skills to recognize it early and initiate resuscitation and treatment. The ED provides a key role in identifying patients with sepsis, followed by risk stratification for severe sepsis and septic shock, initiating resuscitation and treatment, and ensuring the correct onward management of patients identified with sepsis. EDs are vital to the success of collaborative care pathways for the seamless management of patients with sepsis from the prehospital environment, through the ED, and to admission in either a ward bed or the Critical Care Unit. Sepsis responds well to early treatment and, if required, rapid escalation of therapy.

Statement on the initial antimicrobial treatment of sepsis V2.0 – Academy of Medical Royal Colleges (

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