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https://www.readbyqxmd.com/read/27917666/safety-of-out-of-hours-operating-in-trauma-and-orthopaedics-at-a-district-general-hospital
#1
M A Gulamhussein, S Chaudhry, S Noor, T Chaudhry, A Guha, R Knebel
INTRODUCTION According to the National Confidential Enquiry into Perioperative Deaths (NCEPOD), out-of-hours operating in trauma and orthopaedics should be reserved for life or limb threatening cases only. The aim of our study was to determine the nature of non-emergency work carried out in our trust at night in 2015. The overall efficacy and clinical safety of the services provided was evaluated. METHODS Surgical activity undertaken after 9pm was reviewed along with patient ASA (American Society of Anesthesiologists) grade, grade of operating surgeon and any complications that occurred following the procedure...
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27916009/insertion-of-a-tracheoesophageal-speech-valve-a-novel-approach-in-a-difficult-situation
#2
C P Yiannakis, R B Townsley, I G Smillie, G L Picozzi
BACKGROUND: Functional voice rehabilitation is becoming increasingly important following total laryngectomy and pharyngolaryngectomy. Tracheoesophageal voice via a shunt valve is currently regarded as the 'gold standard' for voice rehabilitation. Traditional techniques usually allow for the replacement of valves in the out-patient setting; however, patient factors such as altered anatomy may occasionally prevent this. OBJECTIVE: This paper describes a novel approach for speech valve insertion that is safe, quick and cost-effective, and which uses equipment commonly available in ENT wards and the operating theatre...
December 5, 2016: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/27914398/the-acoustic-environment-of-inpatient-hospital-wards-in-the-united-kingdom
#3
Bridget Shield, Nicola Shiers, Rosemary Glanville
Many hospital noise surveys have shown that patients are subject to high levels of noise, in excess of current World Health Organization guidelines. Much of the previous research has focused on areas perceived to be noisy, such as intensive care units and operating theatres. This paper presents the results of a comprehensive noise survey of five general inpatient hospital wards in the UK. The survey involved continuous noise monitoring over several days, including identification of noise sources, in 31 locations representing a range of typical patient accommodations including single rooms and multi-bed bays, and nurse stations...
September 2016: Journal of the Acoustical Society of America
https://www.readbyqxmd.com/read/27909117/when-is-the-ideal-time-to-operate-on-a-patient-with-a-fracture-of-the-hip-a-review-of-the-available-literature
#4
REVIEW
P M Lewis, J P Waddell
Fractures of the hip are common, often occurring in frail elderly patients, but also in younger fit healthy patients following trauma. They have a significant associated mortality and major social and financial implications to patients and health care providers. Many guidelines are available for the management of these patients, mostly recommending early surgery for the best outcomes. As a result, healthcare authorities now put pressure on surgical teams to 'fast track' patients with a fracture of the hip, often misquoting the available literature, which in itself can be confusing and even conflicting...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27908493/diagnostic-accuracy-of-the-kampala-trauma-score-using-estimated-abbreviated-injury-scale-scores-and-physician-opinion
#5
Andrew Gardner, Paa Kobina Forson, George Oduro, Barclay Stewart, Nkechi Dike, Paul Glover, Ronald F Maio
BACKGROUND: The Kampala Trauma Score (KTS) has been proposed as a triage tool for use in low- and middle-income countries (LMICs). This study aimed to examine the diagnostic accuracy of KTS in predicting emergency department outcomes using timely injury estimation with Abbreviated Injury Scale (AIS) score and physician opinion to calculate KTS scores. METHODS: This was a diagnostic accuracy study of KTS among injured patients presenting to Komfo Anokye Teaching Hospital A&E, Ghana...
November 21, 2016: Injury
https://www.readbyqxmd.com/read/27908275/does-standing-or-sitting-position-of-the-anesthesiologist-in-the-operating-theatre-influence-sevoflurane-exposure-during-craniotomies
#6
Péter Sárkány, Béla Tankó, Éva Simon, Judit Gál, Béla Fülesdi, Csilla Molnár
BACKGROUND: Exposure of the OR staff to inhalational anesthetics has been proven by numerous investigators, but its potential adverse effect under the present technical circumstances is a debated issue. The aim of the present work was to test whether using a laminar flow air conditioning system exposure of the team to anesthetic gases is different if the anesthetist works in the sitting as compared to the standing position. METHODS: Sample collectors were placed at the side of the patient and were fixed at two different heights: at 100 cm (modelling sitting position) and 175 cm (modelling standing position), whereas the third collector was placed at the independent corner of the OR...
December 1, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27905664/video-ethnography-during-and-after-caesarean-sections-methodological-challenges
#7
Jeni Stevens, Virginia Schmied, Elaine Burns, Hannah G Dahlen
AIMS AND OBJECTIVES: This paper will describe the challenges of, and steps taken to successfully collect video ethnographic data during and after caesarean sections. BACKGROUND: Video ethnographic research utilises real-time video footage to study a cultural group or phenomenon in the natural environment. It allows researchers to discover previously undocumented practices, which in-turn provides insight into strengths and weaknesses in practice. This knowledge can be used to translate evidence-based interventions into practice...
December 1, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27905183/mini-c-arm-faster-cheaper-safer
#8
Tom J Gieroba, Nicole Williams, Georgia Antoniou, Peter J Cundy
BACKGROUND: Mini C-arm image intensifiers (IIs) are promoted to permit lower radiation dose than traditional IIs with a lower purchase price and without the need for a radiographer, saving time. In real-world usage, radiation dose is not always lower. METHODS: A retrospective review of prospectively collected data for 620 children undergoing forearm fracture reduction in theatre was undertaken. Imaging was performed with the Fluoroscan mini C-arm or a comparison traditional II...
November 30, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27904224/estimation-of-drug-absorption-in-antibiotic-soaked-bone-grafts
#9
Manish Ramesh Shah, Rukesh R Patel, Randhirsinh V Solanki, Shailendra H Gupta
INTRODUCTION: There is paucity of literature about antibiotic uptake in bone grafts soaked in antibiotic solutions at room temperature in the operation theatre. We hypothesized that if bone grafts are dipped in different strengths of antibiotic solutions for sufficient period, their utilization at the target site helps in localized release of antibiotics in adequate inhibitory concentration to achieve the bacterial regression. The purpose of the study was to find out: (1) Optimum duration, strength, and volume of antibiotic solution required for dipping bone grafts at room temperature prior to the use...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27901283/gastric-cancer-from-operating-theatre-to-bench-in-korea
#10
H-K Yang
No abstract text is available yet for this article.
December 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27883104/-radiation-induced-cataracts
#11
Bjørn Helge Østerås, Kristin Jensen, Hilde Kjernlie Andersen, Anne Catrine T Martinsen
The dose limit for the lens of the eye for occupationally exposed workers that is stipulated in the Norwegian Regulation on radiation protection is based on outdated threshold doses for radiation-induced cataracts. Recent studies have shown that injuries may occur at significantly lower radiation doses than previously assumed. The results from the new studies will impact upon future legislation and recommendations regarding radiation hygiene for personnel in x-ray laboratories and operating theatres who may be exposed to significant radiation doses in the course of their work...
November 2016: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
https://www.readbyqxmd.com/read/27878620/the-role-of-single-shot-metronidazole-in-the-prevention-of-clostridium-difficile-infection-following-ileostomy-reversal-surgery
#12
Roland Fernandes, Paul Robinson, Karan Rangarajan, Sophie Scott, Laura Angco
PURPOSE: Symptomatic infection with Clostridium difficile is strongly linked to antibiotic use and rates are higher for colorectal surgery. In February 2015, trust policy for antibiotic prophylaxis of ileostomy reversal surgery was changed from three doses of metronidazole plus cefuroxime to single-dose metronidazole, in a bid to reduce rates of Clostridium difficile infection. METHODS: A retrospective cohort study was conducted at a single, large hospital trust between February 2014 and February 2016, before and after change in antimicrobial policy...
November 23, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27876547/scheduling-terminology-for-oral-and-maxillofacial-surgery-are-we-speaking-a-universal-language
#13
T E Howe, I Varley, J E Allen, A Glossop, A McKechnie
Use of a universal vocabulary to assist with the scheduling of operations has been shown to considerably reduce delays and improve the use of theatre resources. Within the UK the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) has established a classification to assist with the triage of both emergency and non-emergency operating lists. We completed a survey to assess the uptake and understanding of this classification when scheduling maxillofacial operations. From a list of eight scheduling terms, respondents had to choose one each for 20 different clinical situations (that represented equally) immediate, urgent, expedited, and elective operations as defined by them...
November 19, 2016: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/27872015/self-hardening-and-thermoresponsive-alpha-tricalcium-phosphate-pluronic-pastes
#14
Yassine Maazouz, Edgar B Montufar, Julien Malbert, Montserrat Espanol, Maria-Pau Ginebra
: Although calcium phosphate cements (CPCs) are used for bone regeneration in a wide range of clinical applications, various physicochemical phenomena are known to hinder their potential use in minimally invasive surgery or in highly vascularized surgical sites, mainly because of their lack of injectability or their low washout resistance. The present work shows that the combination of CPCs with an inverse-thermoresponsive hydrogel is a good strategy for finely tuning the cohesive and rheological properties of CPCs to achieve clinical acceptable injectability to prevent phase separation during implantation and cohesion to avoid washout of the paste...
November 18, 2016: Acta Biomaterialia
https://www.readbyqxmd.com/read/27863620/paediatric-airway-foreign-body-the-human-factors-influencing-patient-safety-in-our-hospitals
#15
O C Okonkwo, A Simons, J Nichani
Foreign bodies in the pediatric airway are an uncommon emergency with a high morbidity and mortality rate. Morbidity ranges from 10 to 20% worldwide and this pathology accounts for up to 7% of accidental deaths in children under 4. Dealing with this emergency safely and effectively is complex, requiring a tight coupling of procedures and processes and optimal anesthetic and operating conditions to prevent errors. These factors are recognized by the World Health Organization as 'Human Factors'. We perform a multi-center assessment of human factors pertinent to this emergency...
December 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27848403/reasons-for-delayed-patient-discharge-following-day-surgery-a-literature-review
#16
Alison Rae
Aim The aim of this literature review was to explore the reasons why some patients are not suitable for discharge following day surgery. Method A pragmatic, mixed-methods approach was used to undertake a critical evaluation of the literature and current practice to determine what is already known about discharge following day surgery. Thematic analysis was used to identify the main themes and issues, enabling recommendations to be made to reduce the incidence of patients unable to be discharged following day surgery...
November 9, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27845471/the-need-to-develop-a-multidisciplinary-expertise-for-the-microbiological-safety-of-operating-theatres
#17
Alessandro D'Amico, G M Fara
No abstract text is available yet for this article.
November 2016: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/27842634/a-review-of-the-peri-operative-management-of-paediatric-burns-identifying-adverse-events
#18
H Rode, C Brink, K Bester, M P Coleman, T Baisey, R Martinez
BACKGROUND: Burn injuries are common in poverty-stricken countries. The majority of patients with large and complex burns are referred to burn centres. Of the children who qualify for admission, according to burn admission criteria, about half require some kind of surgical procedure to obtain skin cover. These range from massive full-thickness fire burns to skin grafts for small, residual unhealed wounds. Burn anaesthetic procedures are of the most difficult to perform and are known for high complication rates...
November 2, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27826627/-complications-and-costs-in-primary-knee-replacement-surgery-in-an-endoprosthetics-centre-influence-of-state-of-training
#19
C Windisch, S Brodt, E Röhner, G Matziolis
BACKGROUND: This work examines the hypothesis that in endoprosthesis implantation there are differences between experienced primary and senior caregivers (S-Op) and less experienced follow-up assistants (T-Op) with respect to process-relevant parameters. The main hypothesis is that compared to S‑Op, T‑Op cause significantly longer surgery times and thus additional operating theatre costs. As sub-hypotheses, differences in various perioperative (p-o) parameters between T‑Op and S‑Op were examined...
November 8, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27821625/hippocrates-ca-460-375-bc-introducing-thoracotomy-combined-with-a-tracheal-intubation-for-the-parapneumonic-pleural-effusions-and-empyema-thoracis
#20
Gregory Tsoucalas, Markos Sgantzos
Hippocrates was the first physician to describe in accuracy pleural effusion and pneumonia. To treat empyema thoracis he had introduced a combined method of tracheal intubation with a simultaneously thoracotomy. The surgical incision was used for the pus to be progressively drainaged. If the patient was too weak to eat, he had suggested for nutritional mixtures to be administered through an oral-gastric tube. Thus Hippocrates composed in his operating theatre, an icon similar to modern surgical operations.
December 2016: Surgical Innovation
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