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384 What Proportion of Pyelonephritis Admissions Under Urology Care Have Surgical Pathology. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
To identify the proportion of pyelonephritis patients admitted with true urological pathology
Method
Retrospective audit
Results
The majority of adults admitted with diagnosis of pyelonephritis (80%) remain under urology team from 1st day of admission Of the 80% only 9% had an underlying urological pathology confirmed by imaging AND requiring invasive intervention
Conclusions
High rate of inappropriate admission to surgical / urological ward with subsequent pressure on beds and inevitable cancellations on some occasions Acute pyelonephritis should not be routinely admitted under urology unless there is clear evidence of underlying obstructing pathology or no obvious improvement on antibiotics Consider imaging in terms of US/CT KUB in first instance before making any referral to urology
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1580 Introduction of Dedicated Boarder’s Bleep and Registrar for Improved Clinical Communication, Management, And Care of Boarder Surgical Patients. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
Surgical patients are often placed within non-surgical wards due to shortage of beds, however the care of these patients remains under the parent surgical team. Unfortunately, patients outwith surgical areas can frequently feel neglected, with staff often unsure who to contact for reviews. This project aims to improve communication between boarding wards and the surgical team, as well as improving patient care and management.
Method
This prospective study was based on the Model for Improvement Framework approach to quality improvement. Data was gathered using questionnaires from various staff members on non-surgical wards. Outcomes were measured on a qualitative basis.
Results
Qualitative data was collected from 45 nursing staff (NS). Prior to introduction of a designated boarder’s bleep, 25% of NS felt they knew who to contact for queries and reviews, whereas 46% contacted the parent ward and 29% contacted the on-call surgical registrar. Only 46% of boarded patients received daily reviews. Following introduction of a dedicated surgical registrar for boarders, 62% of NS felt they knew who to contact with 48% aware of surgical boarder’s bleep. Daily reviews of patients increased to 65% over the course of the cycles of this project.
Conclusions
Bed shortages can play a vast role in patient care and treatment. This study has effectively demonstrated an improvement in provision of patient care, demonstrating an increase in NS knowing who to contact, as well as a 19% increase in daily patient reviews. Introduction of a dedicated boarder’s bleep-holder has shown improvement in clinical communication and management.
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865 Variation in the Branching Pattern of the Anterior Branches of the External Carotid Artery. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aims
The external carotid artery (ECA) shows a variable branching pattern of its stemming vessels. The aim of this study is to investigate the origin of the three primary anterior branches of the external carotid artery (ECA): the superior thyroid (STA), lingual (LA), and facial arteries (FA).
Method
The branching pattern of the external carotid artery was studied on 15 Thiel embalmed cadavers of Scottish population (7 males and 8 females). The carotid triangle was dissected bilaterally in order to assess the origin sites of the main anterior branches of the ECA (STA, LA and FA) in relation to the carotid bifurcation (CB).
Results
The STA arises more frequently from the ECA (60%) than from the CCA (40%). The STA, LA and FA emerged as individual branches in 90% of cases. The distances from the origin site to the CB were (8.11 ± 2.77), (19.38 ± 8.85) and (27.95 ± 10.15), for the STA, LA, and FA respectively.
Conclusions
In-depth knowledge of the branching pattern of the external carotid artery is of great importance. The current findings have confirmed that the ECA branching pattern is highly variable. Therefore, considering some radiological imaging before conducting any invasive procedure in the neck region is vital to prevent iatrogenic injuries.
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