Annals of the Royal College of Surgeons of England
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The TRISS methodology was applied to identify preventable trauma deaths in a retrospective audit of 267 (M = 0.908) patients admitted to a teaching hospital through the resuscitation room of its accident and emergency department during a 1-year period. No unexpected survivors were identified; of the 44 deaths (Z = 5.35), 25 (56.8%) were judged preventable by the TRISS method. Those deaths deemed preventable were subjected to peer review by a panel of six consultants. The findings are discussed in respect of recommendations made for UK trauma centre provision by the Working Party Report of the Royal College of Surgeons of England on the management of patients with major injuries.
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Ann R Coll Surg Engl · Nov 1990
Randomized Controlled Trial Clinical TrialIntra-articular and subcutaneous prilocaine with adrenaline for pain relief in day case arthroscopy of the knee joint.
A randomised, double-blind study was conducted to assess the influence of intra-articular and subcutaneous prilocaine with adrenaline on postoperative pain in day case arthroscopy of the knee. The time to first dose of oral analgesia postoperatively was significantly prolonged in those patients receiving prilocaine but no significant difference in analgesic effect was demonstrated at 4, 8, and 12 h after operation between the two groups.
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Ann R Coll Surg Engl · Nov 1990
General surgical injuries in survivors of the M1 Kegworth air crash. Nottingham, Leicester, Derby, Belfast Study Group.
The general surgical consequences of the M1 Kegworth air crash are described. Considering the severe nature of the injuries sustained by the survivors, surprisingly few required general surgical intervention. ⋯ However, 30 (34%) of survivors demonstrated significant bruising from lap belts and 13 patients had haematuria. The majority of operations carried out were orthopaedic related.
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In Britain it is traditional that each operating theatre has an adjacent anaesthetic room (1). The implications for equipping current theatre suites and the design of new theatres are wide-ranging. There are no data available on the attitudes of anaesthetists in this country towards the necessity for anaesthetic rooms and the extent of the anaesthetic equipment found in them. This survey in the North West region suggests that all consultant anaesthetists regard the availability of an anaesthetic room as a necessity, and most consider that the current level of vital-signs monitoring equipment in the anaesthetic room is inadequate.
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Ann R Coll Surg Engl · Jul 1990
Theatre delay for emergency general surgical patients: a cause for concern?
The delay involved in operating on emergency general surgical patients is often excessive. This problem has been examined prospectively in a district general hospital with a catchment population of 450,000. Over a 16-week period, the details of 204 consecutive general surgical emergency operations were recorded and analysed. ⋯ Our results suggest that unnecessary theatre delay results in an unacceptable number of emergency general surgical operations occurring after midnight. It is important that routine afternoon lists do not overrun, as this contributes directly to evening theatre delay. If both theatre and anaesthetic availability could be ensured in the afternoon and early evening, the after midnight workload could be cut from 26% to 10%, and staff sleep deprivation reduced.