Annals of the Royal College of Surgeons of England
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Ann R Coll Surg Engl · Jan 2001
Multicenter StudySmall bowel obstruction due to postoperative adhesions: treatment patterns and associated costs in 110 hospital admissions.
The workload and costs of the emergency admissions and treatment of adhesive small bowel obstruction (ASBO) are unclear. This review details and costs the admission workload of ASBO. All admissions over a 2-year period for ASBO at two district general hospitals were identified through ICD10 diagnostic codes. ⋯ Bed stay for these admissions represents the equivalent of almost one surgical bed per year and at least 2 days theatre time, impacting on surgical capacity and waiting lists. Adhesion prevention strategies may reduce the workload associated with ASBO. The review provides useful information for planning resource allocation.
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Ann R Coll Surg Engl · Jan 2001
A stratified response system for the emergency management of the severely injured.
A decade ago, there were justifiable criticisms of the delivery of emergency care for injured patients in accident and emergency departments in the UK. To address this, a trauma management system was developed in 1991 at Alder Hey Hospital, Liverpool. This includes a trauma team, communication system, management guidelines and quality assurance. ⋯ Regular modifications to the trauma system since its inception in 1991 have resulted in an efficient and effective management structure. Stratification of the trauma response has minimised unnecessary use of the multidisciplinary trauma team and ensures that mobilisation and use of hospital staff and resources are tailored to the needs of the injured patient. Although developed in a specialist children's hospital, the system could be adapted for any acute hospital.
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Ann R Coll Surg Engl · Jan 2001
Paediatric day-case surgery in a district general hospital: a safe option in a dedicated unit.
Currently, there is a trend towards the centralisation of paediatric surgery in specialist regional units. This study reports the results of 4 years' experience of paediatric day-case surgery in a dedicated unit within a district general hospital. ⋯ There were 7 (< 1%) known complications and 7 (< 1%) patients required admission postoperatively. These results compare favourably with those of specialist institutions.