scholarly journals 1184 Operation Note – Are We Documenting Accessibility to The Larynx

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
D Motter ◽  
H Williams
Keyword(s):  
Laser Therapy ◽  
Surgical Planning ◽  
Good Practice ◽  
Diagnostic Procedures ◽  
Tissue Samples ◽  
Theatre Staff ◽  
Retrospective Data Collection ◽  
Operation Note ◽  
Operative Findings ◽  
Operative Notes

Abstract Introduction Diagnostic laryngeal procedures are often done under general anaesthesia to aid in assessment and management of laryngeal lesions. Obtaining tissue samples for histology is an extremely important tool used to aid in further surgical planning. Documentation of accessibility to the larynx is paramount to patient care and future surgical planning. We aimed to highlight operative notes for those undergoing diagnostic procedures and assess whether sufficient detail is documented. The Royal College of Surgeons recommends that all operative notes must be comprehensive and “all problems/complications” must be documented for good practice. Method We carried out a 3-month retrospective data collection on patients who have undergone diagnostic laryngeal procedures at the Royal Glamorgan Hospital. We included microlaryngoscopies, panendoscopies and laser-specific procedures. We accessed the theatre booking system and retrieved the operation notes. Results During the 3-month period, 33 procedures were undertaken. 52% of the operative notes did not document level of accessibility. 48% of the operative notes included the level of accessibility, highlighting keywords such as “good access”, “difficult access” and “difficult access but possible for laser therapy”. Conclusions Documentation of intra-operative findings can aid further surgical management and help prepare the surgeon and theatre staff. It is especially important in patients who have vocal cord lesions that might benefit from laser therapy. We recommend documenting the intubation grade (Malampati Score) and accessibility to the larynx.

scholarly journals EP.FRI.489 Audit of emergency Operation notes (audit cycle)

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Nadia Gulnaz ◽  
Rami Oweis ◽  
Farooq Abdullah ◽  
Andrew Crumley ◽  
Sadia Tasleem
Keyword(s):  
Royal College ◽  
Wound Closure ◽  
Emergency Operation ◽  
Missing Information ◽  
Surgical Department ◽  
Operation Note ◽  
Operative Findings ◽  
Operative Notes ◽  
Recommended Guidelines ◽  
Incision Wound

Abstract The Royal College of surgeons has recommended guidelines for documenting operative surgical notes. An operation note must include ample information about the operation. In our initial audit, we found some areas for improvement. This re-audit of operative notes was aimed to review compliance with the guidelines by the Royal College of Surgeons and to identify areas of further improvement. Methods The notes of all patients who underwent emergency surgery from 1st of January to 15th of March 2020 under the General Surgical department were reviewed. Endoscopic procedures were not included in the study. Electronic records were used to review the operation notes. Results Notes of a total of 176 patients were included in the study. Significant improvement was seen in most of the domains. Compliance of 100% was seen in documenting operative findings, type of incision, wound closure technique, procedural details, documenting extra procedures, and post operative instructions. 17.6% notes did not clearly document the indication/diagnosis for surgery. 15.3% notes missed information about DVT prophylaxis. 25.57%notes did not include information about peri-operative antibiotics in the context of prophylaxis or post-op need. A significant number (71.6% ) of the notes were missing information about operative blood loss if there was any or none. Conclusion Overall operation notes detail most of the information expected by the Royal College of Surgeons. The key areas for improvement are to include specific details about the following:

Laser therapy in a soft-shelled turtle ( Pelodiscus sinensis ) for the treatment of skin and shell ulceration

2013 ◽  
Vol 41 (04) ◽  
pp. 261-266 ◽  
Author(s):  
W. Heuser ◽  
M. Lierz ◽  
S. Kraut ◽  
D. Fischer
Keyword(s):  
Case Report ◽  
Laser Therapy ◽  
Diagnostic Procedures ◽  
Differential Diagnoses ◽  
Pelodiscus Sinensis ◽  
Central Aspect ◽  
Underlying Causes

SummarySkin and shell diseases in aquatic turtles are often associated with several underlying causes. The presented case report describes aetiology including differential diagnoses, diagnostic procedures and therapy of a soft-shelled turtle (Pelodiscus sinensis) suffering from a septicaemic ulcerative dermatitis. Central aspect hereby is the positive curing effect of laser therapy on skin and shell lesions.

scholarly journals Eye-tunes: role of music in ophthalmology and vision sciences

2021 ◽  
Vol 13 ◽  
pp. 251584142110408
Author(s):  
Shruti Muralidharan ◽  
Parul Ichhpujani ◽  
Shibal Bhartiya ◽  
Rohan Bir Singh
Keyword(s):  
Surgical Procedures ◽  
Diagnostic Procedures ◽  
Well Being ◽  
Modern Medicine ◽  
Holistic Healing ◽  
Operation Theatre ◽  
Healing Effect ◽  
Theatre Staff

Although the healing effect of music has been recognized since time immemorial, there has been a renewed interest in its use in modern medicine. This can be attributed to the increasing focus on holistic healing and on the subjective and objective aspects of well-being. In ophthalmology, this has ranged from using music for patients undergoing diagnostic procedures and surgery, as well as for doctors and the operation theatre staff during surgical procedures. Music has proven to be a potent nonpharmacological sedative and anxiolytic, allaying both the pain and stress of surgery. This review aims to explore the available evidence about the role of music as an adjunct for diagnostic and surgical procedures in current ophthalmic practices.

scholarly journals Dog poisoning with furadan 35-ST (carbamate insecticide)

2011 ◽  
Vol 65 (3-4) ◽  
pp. 277-285
Author(s):  
Jelena Aleksic ◽  
Drinka Mercep ◽  
Zoran Aleksic ◽  
Milijan Jovanovic
Keyword(s):  
Spinal Cord ◽  
Acute Pancreatitis ◽  
Motor Neurons ◽  
Diagnostic Procedures ◽  
World Health ◽  
Criminal Proceedings ◽  
Current Case ◽  
Tissue Samples ◽  
First Case ◽  
Carbamate Insecticide

The first case of poisoning of a dog with Furadan 35-ST in Serbia is described. The active ingredient of Furadan 35-ST is carbofuran (2,3-dihydro-2,2-dimethyl-7- benzofuranyl methyl carbamate), a carbamate insecticide, acaricide and nematocide. This highly poisonous substance is classified by the World Health Organisation into Class 1 b and in Serbia into Group 1 of The List of Poisons. Pathological assessment revealed hyperaemia and degenerative and necrotic changes in the liver, kidneys and heart. In addition, lysis of the nuclei in the motor neurons, loss of tigroid substance and pericellular oedema in the ventral horns of the spinal cord, and acute pancreatitis were found. In addition to the non-specific changes (hyperaemia, degenerative and necrotic changes in the parenchymal organs), the ones in the ventral horns of the spinal cord and acute pancreatitis may lead to carbamate poisoning being suspected. The diagnosis was established on the grounds of toxicological-chemical conformation of carbofuran by means of GC-MS in addition to the macroscopic, microscopic findings in tissue samples taken from the stomach and the liver, which confirmed the suspicion of the dog having been poisoned with the carbamate insecticide. In the current case the results of the diagnostic procedures provided foundations for the initiation of criminal proceedings.

scholarly journals Computerized tomography of the Thorax for surgical patients during the COVID-19 pandemic: Was it useful?

2021 ◽  
Author(s):  
Ahmed Ismail ◽  
Priya Sarkar ◽  
Balasundaram Muthiah ◽  
Nuha Yassin
Keyword(s):  
Surgical Planning ◽  
Statistical Significance ◽  
Diagnostic Value ◽  
Inclusion Criteria ◽  
Antibody Testing ◽  
Data Collection And Analysis ◽  
Retrospective Data Collection ◽  
Regulatory Bodies ◽  
Cost Implications ◽  
Negative Predictor

Objectives Diagnostic challenges during the COVID-19 pandemic forced the radiology regulating body to adopt the use of CT Chest as a triage and diagnostic tool, which was subsequently abandoned. The Royal Wolverhampton hospital followed both protocols. Here, we investigate the evidence behind this decision within the context of surgical admissions during the COVID-19 peak in our hospital. Methods Retrospective data collection and analysis of all surgical admissions between the 1st of March to the 31st of May. Data was collected from the radiology and electronic portal looking into patients undergoing CT chest to diagnose the presence of C-19 as well as swab results. Results 78 patients fulfilled our inclusion criteria. The scan either confirmed the presence or absence (4, 63 patients) of C-19 but was sometimes inconclusive (11 patients). Comparing these to the results of the swabs; CT showed sensitivity 42.86 %, Specificity 97.92%, and accuracy 90.91 %. In the inconclusive CT report group, chances of having a positive swab result were 45%: None of the scan results changed any of the surgical planning. Lymphocyte count in the context of surgical presentation did not have any statistical significance to predict the presence of C-19 (P=0.7). Cost implications on our cohort of patients for adding the chest CT is estimated to be around £31,000. Conclusion CT Thorax during the pandemic was a good negative predictor but had limited diagnostic value and did not change patient management. Newer, faster techniques of PCR swabs and antibody testing would be a better and cheaper alternative. Advances in knowledge This paper provides evidence to support the decision from the regulatory bodies not to use CT scan as a screening tool for COVID 19 diagnosis.

scholarly journals 607 A Close Loop Audit on Proper Documentation of Ventriculo-Peritoneal (VP) Shunt Valve Settings in Operation Note

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R Porag
Keyword(s):  
Sample Size ◽  
Medical Centre ◽  
Shunt Surgery ◽  
Shunt Valve ◽  
Vp Shunt ◽  
Shunt Procedure ◽  
Number Of Patients ◽  
Audit Result ◽  
Operation Note ◽  
Operative Notes

Abstract Aim Re-audit the practice of proper documentation of shunt type and settings in VP shunt surgery in Queen's Medical Centre, Nottingham for the period of 1st November 2019 – 31st October 2020. It is very important as programmable shunt setting could get changed during MRI, causing shunt failure. Method It was a retrospective collection of data of patients admitted to Queens medical Centre, Nottingham who had undergone VP shunt procedure. Exceptions: 4 files were excluded from study as they did not undergo VP shunt procedure. Results Total number of patients: 98. 4 patients were excluded. Actual sample size 94. Total VP shunt procedure done: 107. In 96 out of 107 procedures the shunt valve type and settings were properly documented. In 11 out of 107 procedures the shunt valve type and settings were not documented. In 33 out of 107 procedures programmable shunt valves were used. All 33 procedures had proper documentations. Previous audit result Duration of data collection: 2 years (from March 2016 to February 2018). Sample size 200. Total VP shunts done 247. Proper documentation of shunt valve type and settings were done in 209 out of 247 procedures. In 38 out of 247 procedures shunt valve type and settings were not documented. In 55 out of 247 procedures programmable shunt valves were used. 3 out of these 55 procedures (programmable shunt valves) lacked proper documentation. Conclusions There is an overall improvement in the practice of documentation of VP shunt valve type and settings in operative notes after implementing the plan of actions decided on first audit.

scholarly journals Improving Operation Notes to Meet British Orthopaedic Association Guidelines

2009 ◽  
Vol 91 (3) ◽  
pp. 217-219 ◽  
Author(s):  
David Morgan ◽  
Noel Fisher ◽  
Aman Ahmad ◽  
Fazle Alam
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Good Practice ◽  
District General Hospital ◽  
Total Knee Replacements ◽  
Postoperative Flexion ◽  
Data Points ◽  
Total Knee ◽  
Operation Note ◽  
British Orthopaedic Association

INTRODUCTION Operation notes are an important part of medical records for clinical, academic and medicolegal reasons. This study audited the quality of operative note keeping for total knee replacements against the standards set by the British Orthopaedic Association (BOA). PATIENTS AND METHODS A prospective review of all patients undergoing total knee replacement at a district general hospital over 8 months. Data recorded were compared with those required by the BOA good-practice guidelines. Change in practice was implemented and the audit cycle completed. Data were statistically analysed. RESULTS A total of 129 operation notes were reviewed. There was a significant improvement in the mean number of data points recorded from 9.6 to 13.1. The least well recorded data were diagnosis, description of findings, alignment and postoperative flexion range. All had a significant improvement except description of findings. The operating surgeon writing the note improved from 56% to 67%. Detailed postoperative instructions also improved in quality. CONCLUSIONS Surgeon education and the use of a checklist produce better quality total knee replacement operation notes in line with BOA guidelines. Further improvements may be made by making the data points part of the operation note itself.

Iatrogenic colonoscopic perforations: a review of 8 158 patients

2012 ◽  
Vol 19 (1) ◽  
pp. 37-43
Author(s):  
Darius KAZANAVIČIUS ◽  
Narimantas Evaldas SAMALAVIČIUS
Keyword(s):  
Sigmoid Colon ◽  
Primary Repair ◽  
Rare Complication ◽  
Abdominal Distension ◽  
Diagnostic Procedures ◽  
Endoscopic Polypectomy ◽  
Diagnostic Colonoscopy ◽  
Therapeutic Procedures ◽  
Vilnius University ◽  
Operative Findings

Purpose. The aim of the study is to determine the incidence of perforation after colonoscopy (CP) in our institution, and to evaluate the endoscopic information, clinical presentation, diagnosis workup, intra-operative findings, management and outcomes of patients with CP. Methods. All colonoscopies performed between January 2005 and December 2011 at the Oncology Institute of Vilnius University, Lithuania, searched for colonoscopic perforations. Medical records of all CP patients were reviewed. Incidence of CP, patients’ characteristics, endoscopic information, intra-operative findings, management and outcomes were analyzed. Results. A total of 8,158 colonoscopies (7,467 diagnostic and 691 therapeutic) were performed in our hospital over a 7-year period. Five patients (0.061%) had CP: 2 from diagnostic colonoscopy (incidence 0.027%) and 3 from therapeutic one (0.43%). In two cases, perforation was noticed by the endoscopist through visualization of extra-intestinal tissue during the procedure. Other perforations (n = 3, 60%) were diagnosed after the procedure. The most consistent symptom was abdominal pain followed by tenderness, abdominal distension, leukocytosis. The most common site of perforation was in the sigmoid colon (n = 3, 60%). Perforations were caused by direct trauma from the endoscope (n = 2, 40%) and endoscopic polypectomy (n = 3, 60%). All patients with CP underwent surgical management: primary repair. The mortality rate was 0% and the postoperative complication rate was 40%. Conclusions. CP is a serious but rare complication of colonoscopy. Incidence of CP was 0.061%. Therapeutic procedures have a higher perforation risk than diagnostic procedures. The sigmoid colon is the area at the greatest risk of perforation. Surgery is still the mainstay of CP management.

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