Annals of the Royal College of Surgeons of England
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Ann R Coll Surg Engl · Jul 2007
Randomized Controlled TrialIs patient outcome affected by the administration of intravenous fluid during bowel preparation for colonic surgery?
We have previously shown that Picolax bowel preparation causes a significant dehydrating effect, which can be minimised by administering a calculated volume of intravenous fluid. The aim of this prospective study was to assess whether peri-operative outcome is affected by administering a calculated volume of intravenous fluid during bowel preparation. ⋯ This study indicates that a calculated volume of intravenous fluid administered during bowel preparation improves patient outcomes with respect to blood transfusion and postoperative oliguria. We advocate calculated intravenous fluid administration in all patients undergoing bowel preparation prior to colonic surgery.
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The surgical profession, more than any other medical specialty, is constantly in the limelight. Frequently, concerns are expressed about our colleagues. The concerns may be personality clashes rather than failure in behaviour or performance. ⋯ New proposals to modify the GMC procedures will reduce the standard of proof to one of 'balance of probabilities'. The surgical profession should be accountable to its patients and colleagues. Will our Royal College rise to the challenge to establish itself as the bulwark of the surgical profession?
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Ann R Coll Surg Engl · Jul 2007
Case ReportsPneumothorax, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum and subcutaneous emphysema following diagnostic colonoscopy.
Colonic perforation is an unusual complication of colonoscopy. We present a case of pneumothorax, pneumomediastinum, pneumoperitoneum and extensive subcutaneous emphysema resulting from a diagnostic colonoscopy. To our knowledge, only two such cases have been described previously.
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Ann R Coll Surg Engl · Jul 2007
Helicopter Emergency Ambulance Service (HEAS) transfer: an analysis of trauma patient case-mix, injury severity and outcome.
A retrospective review of all patients transferred by helicopter ambulance to the Great Western Hospital over a 20-month period between January 2003 and September 2004 was undertaken to establish the case-mix of patients (trauma and non-trauma) transferred and the outcome. ⋯ Helicopter ambulance transfer in the acute setting is of debated value. Triage criteria are at fault if as many as 41% of patients transferred are being discharged home from casualty having incurred the financial cost of helicopter transfer. We suggest that the triage criteria for helicopter emergency transfer should be reviewed.