Organisation of emergency general surgical services and the early assessment and investigation of the acute abdomen

Paterson-Brown, Simon

doi:10.1016/b978-0-7020-4964-4.00005-5

Cited by 5 publications

(7 citation statements)

References 82 publications

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“…They are significantly more common in women than men with a 4:1 ratio 2 . 40% of all femoral hernia will present as a surgical emergency with strangulated contents 1 …”

Section: Figmentioning

confidence: 99%

“…Despite being the third most common primary hernia in adults, femoral hernias only account for up to 4% of all groin hernias. 1 They are significantly more common in women than men with a 4:1 ratio. 2 40% of all femoral hernia will present as a surgical emergency with strangulated contents.…”

mentioning

confidence: 99%

“…2 40% of all femoral hernia will present as a surgical emergency with strangulated contents. 1 The most common contents of a femoral hernia include fat or small bowel although some rarer contents have included caecum, appendix, Meckel's diverticulum and ovary. 3 To our knowledge there have only been two other case reports in the literature with a bladder diverticulum contained within a femoral hernia.…”

mentioning

confidence: 99%

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Bladder containing femoral hernia

Beatty

Iswariah

2023

ANZ Journal of Surgery

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“…They are significantly more common in women than men with a 4:1 ratio 2 . 40% of all femoral hernia will present as a surgical emergency with strangulated contents 1 …”

Section: Figmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Bladder containing femoral hernia

Beatty

Iswariah

2023

ANZ Journal of Surgery

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“…A recurrence rate of less than 1% has been reported after indirect inguinal hernia repair, with 80% of recurrences noted within the first post-operative year [1]. Recurrence in the form of a direct hernia may result from injury to the floor of inguinal canal.…”

Section: Introductionmentioning

confidence: 99%

Acute de Garengeot Hernia Masquerading as a Recurrent Inguinal Hernia – A Diagnostic Dilemma

Shah

Planche

Souza

et al. 2016

BJMMR

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“…Emergency patients require urgent diagnosis and intervention with early decision making and intervention by senior, experienced members of the surgical team ensures correct resource allocation or triage (The Royal College of Surgeons of England Emergency Surgery London RCS, 2011;McNeill et al, 2009;Paterson-Brown, 2009). The Royal College of Surgeons of England (2011) report on standards for unscheduled surgical care suggested how safe, rapid, responsive and high-quality treatments for emergency patients should best be provided.…”

Section: Introductionmentioning

confidence: 99%

A clinical decisions unit improves emergency general surgery care delivery

Johnstone

Harwood

Gilliam

et al. 2015

Clinical Governance: An International Journal

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Purpose – Early access to senior decision makers and investigations has improved outcomes for many conditions. A surgical clinical decisions unit (CDU) was created to allow rapid assessment and investigation by on-call senior surgical team members to facilitate decision making and, if appropriate, discharge within a set time frame (less than four hours). The purpose of this paper is to compare outcomes for unscheduled general surgery admissions to the hospital before and after commissioning this unit. Design/methodology/approach – Prospectively collected hospital episode statistics data were compared for all general surgical admissions for one year prior to (July 2010-June 2011) and two years after (July 2011-June 2013) the introduction of the CDU. Statistical analysis using the Mann Whitney U-test was performed. Findings – More patients were discharged within 24 hours (12 per cent vs 20 per cent, p < 0.001) and total hospital stay decreased (4.6 days vs 3.2 days, p < 0.001) following introduction of CDU. Admission via A & E (273 vs 212, p < 0.01) was also decreased. Overall there was a 25.3 per cent reduction in emergency surgical admissions. No difference was noted in 30-day readmission rates (47 vs 49, p=0.29). Originality/value – The introduction of a CDU in has increased early discharge rates and facilitated safe early discharge, reducing overall hospital stay for unscheduled general surgical admissions. This has decreased fixed bed costs and improved patient flow by decreasing surgical care episodes routed through the emergency department (ED). In all, 30-day readmission rates have not been influenced by shorter hospital stay. Service redesign involving early senior decision making and patient investigation increases efficiency and patient satisfaction within unscheduled general surgical care. Not original but significant in that the model has not been widely implemented and this is a useful addition to the literature.

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Organisation of emergency general surgical services and the early assessment and investigation of the acute abdomen

Cited by 5 publications

References 82 publications

Bladder containing femoral hernia

Bladder containing femoral hernia

Acute de Garengeot Hernia Masquerading as a Recurrent Inguinal Hernia – A Diagnostic Dilemma

A clinical decisions unit improves emergency general surgery care delivery

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