Surg J R Coll Surg E
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Surg J R Coll Surg E · Aug 2017
The impact of helipad designation on meeting the best practice tariff for fractured neck of femur cases in a major trauma centre.
Hip fractures represent a significant burden to the NHS: the cost for all UK hip fractures is approximately £2 billion and in 2013, 64 838 people were admitted to hospital with a fractured neck of femur (FNOF). In April 2010 St George's NHS Hospital was designated one of four Major Trauma Centres (MTC) in London. Following MTC designation, in April 2014 St George's Hospital opened a helipad. ⋯ Two samples were analysed: 'pre-helipad' (from October 2013 to March 2014) during which 125 patients presented with FNOF, and 'post-helipad' (from April 2014 to September 2014) during which 122 patients presented with FNOF. The percentage of cases receiving surgery within 36 h, receiving joint care of a consultant geriatrician and a consultant orthopaedic surgeon, and receiving assessment by a geriatrician in the perioperative period were found not to have been negatively impacted by the helipad. However, completion of routine recommended assessments including admission using the agreed assessment protocol (96.6% vs. 50%, p < 0.05) and completion of two Abbreviated Mental Test (AMT) scores (74.7% vs. 58%, p = 0.007) were found to have been compromised.
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Surg J R Coll Surg E · Aug 2017
ReviewManagement of pulmonary nodules in head and neck cancer patients - Our experience and interpretation of the British Thoracic Society Guidelines.
and purpose of the study: The frequency of lung nodules in the head and neck cancer population is unknown, currently the only guidance available recommends following local policy. The aim of this study was to determine the incidence of pulmonary nodules in our head and neck cancer group and interpret the recently updated British Thoracic Society (BTS) Lung Nodule Guidelines in a head and neck cancer setting. ⋯ The MDT in NHS Lothian has reviewed the BTS guidance and now has a local policy for the management of lung nodules in head and neck cancer patients. Lung Nodules in the head and neck cancer population are common >10%. Higher risk patients with larger nodules should be risk assessed with validated assessment tools. PET-CT has a place in the assessment of lung nodules when risk of malignancy is high.