The Emergency Surgical Team – The Way Forward in Emergency Care?

Abstract

INTRODUCTION With reduced working hours and shift patterns, surgical training and continuity of patient care is being put at risk. We have devised a system for managing the emergency surgical patients in an effort to counteract these perceived problems. This study describes the emergency surgical team and audits its activity. PATIENTS AND METHODS The emergency surgery team concept is described in detail. Over a 2-week period, general surgical referral data, patient management and operative activity were audited. RESULTS A total of 229 patients were referred to the emergency surgical team with 159 treated conservatively, 45 underwent operative intervention and 25 were discharged without admission. Of the emergency surgical team referrals, 58% had gallstone pathology, appendicitis or constipation/non-specific abdominal pain. Average daily number of patients under the care of the emergency surgical team was 26 (range, 10-40). CONCLUSIONS The consultant-led emergency surgical team look after many of the acutely sick surgical patients. Our system not only provides good teaching opportunities but ensures optimal continuity of patient care in a busy district general hospital. Such an approach to emergency surgical care has been successfully developed to optimise training opportunities and improve patient care in a setting of reduced working hours and shift systems in our hospital.

Acute Care Surgery Models Worldwide: A Systematic Review

“…The majority of the articles described a dedicated team operating within an independent (sub)unit, with daytime on‐site attending coverage provided by a surgeon without elective duties, night‐time on‐call attending coverage, and round‐the‐clock coverage by dedicated residents. Four articles reported dedicated OR access, predominantly via a shared or attending‐controlled OR list [59, 60, 62, 63]. One article reported attending coverage of the ED [61], but another article described a Surgical Assessment Unit (SAU) where patients are assessed by the attending [62].…”

“…Five articles described ACS models in the UK [59][60][61][62][63]. Two articles described the same Emergency Surgical Unit (ESU) model [59,60].…”