Annals of the Royal College of Surgeons of England
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Mean anaesthetic, surgical and turnover times were used to predict finishing times for elective general surgical operating lists. A predicted early finish was correct in 70 per cent, a predicted on-time finish in 19 per cent, and a predicted late finish in 56 per cent. ⋯ Over-runs, caused by too many cases, and early finishes, owing to insufficient cases were reliably predicted. It is suggested that mean procedure times can be used to identify under or over utilisation caused by under or over-booking but indiscriminate use will not improve list utilisation.
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A work schedule is presented for a single team of three consultant general surgeons which has a rotating three-week timetable with two of them doing routine work only while the other just does the emergencies. It is suggested that this way of working may have widespread application.
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An increased incidence of severe hyponatraemia in an orthopaedic unit led to an investigation into the possible causes. Routine perioperative administration of 'hypotonic' intravenous fluid to an elderly population emerged as the most important aggravating factor. Care is necessary in prescribing intravenous fluid regimens in order to avoid potentially serious complications.