Dumile Thompson

1. 1. lack of specific guidance on angioedema types and risk factors

   “National Guidance and training for front line/emergency staff did not, and still does not, include specifics about the various types of angioedema (histamine/bradykinin mediated), the risk factors, and the diverging treatment pathways, including the need for speciality medicine input with certain types of angioedema.”

2. 2. absence of NICE guidance on emergency angioedema management

   “NICE does not currently publish guidance or a clinical knowledge summary on emergency management of angioedema.”

3. 3. risk factor for ACE inhibitor angioedema not published in BNF

   “ACE Inhibitor angioedema is more common, up to four to five times more, in individuals of Black African or African Caribbean origin. This increased risk factor is not published in the BNF.”

4. 4. lack of BNF highlight for ARB preference in Black patients

   “The NICE recommendation about using ARB as the preferred choice of medication in patients of Black African or African Caribbean origin is not highlighted in BNF, notwithstanding the BNF is the go-to source for medication management, contraindications, and cautions.”

5. 5. inability to access prior medical records across areas

   “Mr [name redacted] had transferred geographical areas such that clinicians were unable to access his previous medical records to determine why ARB's, an alternative to ACE Inhibitors, had been preferred by clinicians on a previous occasion.”

No published response was found on judiciary.uk.