Annals of the Royal College of Surgeons of England
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Between 1969-1992 there was a successful surgical registrar rotation in South Wales (1). This was a three-year rotation comprising two years general surgery, six months trauma and orthopaedics and six months surgical specialty. The rotation was aimed at those doctors who had completed senior house officer (SHO) posts in accident and emergency, 6-12 months general surgery and had already obtained the primary FRCS. ⋯ The previous registrar rotation was shortened to two years instead of three ensuring the pre-requirements for entry into HST and eligibility to sit the second part FRCS. The aim of this study was to assess whether the new senior SHO/BST rotation in South Wales is providing adequate training for our surgical trainees to enter into HST. We present our data as a potential basis for setting up a formal BST rotation.
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Ann R Coll Surg Engl · Jul 1996
Randomized Controlled Trial Comparative Study Clinical TrialComparison of diclofenac sodium and morphine sulphate for postoperative analgesia after day case inguinal hernia surgery.
Postoperative pain may be a significant reason for delayed discharge from hospital, increased morbidity and reduced patient satisfaction with ambulatory hernia surgery. This study compared two postoperative oral analgesic protocols after day case inguinal hernia repair; 30 mg morphine sulphate (MST) and 10 mg metoclopramide every 8 h for 48 h or 75 mg diclofenac twice daily for 48 h. ⋯ The time taken to walk, dress and leave home alone were achieved in a significantly shorter duration in patients taking diclofenac. We conclude that diclofenac provides effective analgesia, has a more acceptable side-effect profile than morphine sulphate and is the treatment of choice after ambulatory hernia surgery.
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Ann R Coll Surg Engl · Jul 1996
Administrative aspects of a general surgical firm: an audit of accuracy of operation lists and timeliness of discharge summaries.
A one-year audit of operation lists and discharge summaries of one surgical firm showed only 1.4 percent of operation lists contained errors or omissions and only 5 percent contained abbreviations. 74.2 percent of discharge summaries were dictated within one week of discharge. A high proportion of day cases allowed 44.7 percent of the discharge summaries to be dictated on the day of operation. Close consultant and secretarial involvement in the preparation of operating lists can ensure a high degree of accuracy. Day case operation notes should be combined with a discharge letter to optimise communication with general practitioners.
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Over a one-month period, 207 general surgical emergency admissions (excluding urology) to a district general hospital were audited. The potential to improve the delivery of emergency care and reduce inpatient stay was studied. During the year of study, 44 per cent of all surgical admissions were emergency patients who consumed 61 per cent of inpatient bed days. ⋯ Twelve patients were admitted for complications of previous procedures. Emergency patients accounted for over half the inpatient bed days. There is considerable scope for improving the process of delivery of emergency surgical care and reducing inpatient stay.