scholarly journals SP2.1.10Prescription of regular medications to surgical patients within 24 hours of admission:Is it being done?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Anil Rai ◽  
Rhea Singh ◽  
Katherine Brown
Keyword(s):  
Retrospective Analysis ◽  
General Surgery ◽  
Family Members ◽  
Time Limit ◽  
Surgical Patients ◽  
Age Group ◽  
History Taking ◽  
Medication History ◽  
Time Of Admission ◽  
Careful History

Abstract Aim Prescription of necessary regular medications to patients within 24 hours of admission to the hospital is vital for better healthcare. Our aim was to analyse whether regular medications were prescribed to all general surgical patients within that time limit, to find the rationale behind the shortcomings and to suggest a more efficient way to overcome them. Materials and Methods A retrospective analysis of 186 surgical patients in the month of February 2020 who stayed in the hospital for more than 24 hours in General Surgery (167) and Urology (19) were analysed. Out of these, 100 were females and 86 males with the maximum in age group of 31-60 years (80) and 75 patients were more than 6o years. 11 groups of medications were analysed. Findings Conclusion More attention needs to be paid towards prescribing medications at the earliest. This could be improved by careful history taking and prescribing medications at the time of admission itself; GP to include all the medication history while referring a patient, liaising with pharmacist and family members for confirming the patients’ medications and providing portable bedside computers for doctors while they are seeing patients.

EP.FRI.461 Management of acutely ill surgical patients NICE guidance CG50: a complete audit cycle

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Shrinivas Kalaskar ◽  
Mathew Bonomoully
Keyword(s):  
General Surgery ◽  
Surgical Patients ◽  
Initial Assessment ◽  
Audit Tool ◽  
Trigger System ◽  
Nice Guidelines ◽  
Suboptimal Care ◽  
Nice Guidance ◽  
Audit Cycle ◽  
Time Of Admission

Abstract Aim NICE CG50 guidelines are a response to evidence suggesting patients who are, or become, acutely unwell may receive suboptimal care. The guidelines suggest: After previously unsuccessful audits a fourth re-audit was designed to re-assess compliance with the CG 50 guidelines. Method After implementing previous recommendations like, keeping a poster of recommendations in the handover room and making these guidelines as part of surgical induction, a re-audit was planned. A prospective random sample of 40 patients admitted during the general surgery was taken. Using the audit tool the following parameters were recorded for each patient in the sample: Results The compliance was 100% for patients who have had their physiological observations recorded at the time of admission or initial assessment, the percentage of patients monitored using a physiological track and trigger system, and the percentage whose physiological observations were monitored at least every 12 hours. The compliance was 95% for the percentage of patients with a clear written monitoring plan. Conclusions Following the interventions detailed above, there is now 95 to 100% compliance with NICE guidelines in the documentation.

scholarly journals Fluctuating Palmar Erythema in a Toddler during COVID-19 Pandemic: Do You Know the Offender?

2021 ◽  
Vol 67 (1) ◽  
Author(s):  
Prateek Kumar Panda ◽  
Indar Kumar Sharawat
Keyword(s):  
Contact Dermatitis ◽  
Atypical Presentation ◽  
Irritant Contact Dermatitis ◽  
History Taking ◽  
Hand Sanitizer ◽  
The Past ◽  
Palmar Erythema ◽  
Complete Reversal ◽  
Bright Color ◽  
Careful History

Abstract Palmar erythema in children can be due to various reasons, such as chronic liver disease, rheumatological disorders, medications, irritant contact dermatitis and atopic dermatitis. Recently, there are few reports about contact dermatitis caused by frequent, daily use of hand sanitizers during this COVID-19 pandemic. A 3-year-old toddler brought with the concern of waxing-waning bilateral palmar erythema for the past 2 weeks. The parents revealed that the child liked the bright color of a recently bought hand sanitizer bottle so much he used to wash his hands every 20–30 min throughout the day. The atypical presentation of contact dermatitis might be because the child was using the sanitizer more frequently during the daytime. The dermatitis resolved with stopping excessive use of the hand sanitizer by the toddler. Clinicians should be aware of contact dermatitis during these pandemic times. Instead of investigating them extensively, careful history taking and merely advising them to judicially utilize the sanitizer can lead to complete reversal of symptoms.

First and second wave of COVID-19: A comparative study of tertiary care hospitalized patients in Jalgaon, Maharashtra

2021 ◽  
Vol 19 (3) ◽  
pp. 23-29
Author(s):  
Yogita G Bavaskar ◽  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical History ◽  
Care Hospital ◽  
Age Group ◽  
Number Of Patients ◽  
The Mean ◽  
Collection Form ◽  
Time Of Admission ◽  
Second Wave

Background: Most of the countries including India have witnessed two or more waves of Covid 19 pandemic. The present study was conducted to compare the differences in clinico-demographic characteristics and outcomes of Covid 19 patients admitted in first and second wave of Covid 19 pandemic in a tertiary care hospital at Jalgaon, Maharashtra. Methods: A retrospective observational study was conducted at a tertiary care Dedicated Covid hospital for Covid 19 at Jalgaon, Maharashtra. All microbiologically proven corona positive patients were included in the study. The demographic records and clinical history was extracted from the case history sheets of the patients from first as well as second wave using standardized data collection form. Clinical outcome of the patients, i.e., development of complications, death or discharge was also recorded for each enrolled subject. Results: 3845 patients of Covid-19 admitted in the hospital during the first wave of epidemic and 2956 patients during second wave of the epidemic were included in the study. The mean age of patients admitted in the second wave was significantly lower as compared to first [48.77(15.31) years vs 50.23 (14.33) years, P<0.005]. There is increase in proportion of patients in the age group of < 15 years in second wave as compared to first wave (74/2956, 2.5% vs 52/3845, 1.3%). The number of patients requiring admission in ICU at the time of admission increased by 13% in second wave as compared to first wave. [827/2956 (28%) vs 577/3845(15%), P<0.0001]. More than half of the patients who got admitted for Covid 19 in first as well as second wave were having one or more comorbidities.But the proportion of the patients with previous co-morbities was significantly higher in second wave (1684/2956, 57% vs 1960/ 3845, 51%, P= 0.0004). The mortality was also higher in second wave (533/2956, 18.03% vs 541/3845, 14%, P=0.0004). Conclusions: The demographic, clinical characteristics and outcome of Covid 19 patients was different in first and second wave of pandemic with involvement of younger patients, increased rates of admission to ICU and more mortality in the second wave as compared to first wave of the pandemic.

scholarly journals Gambaran Pasien yang Menjalani Prosedur Bedah Emergensi di RSUP Prof. Dr. R. D. Kandou Manado Periode Januari - September 2019

e-CliniC ◽  
2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Utrecht Suleman ◽  
Angelica M. J. Wagiu ◽  
Stephanus J. Ch. Tangel
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Surgical Procedures ◽  
Emergency Surgery ◽  
Medical Records ◽  
Health Centers ◽  
Surgical Patients ◽  
Age Group ◽  
Adult Age ◽  
Epidural Hemorrhage

Abstract: Emergency surgery is performed to avoid further complications of the disease or to save the patient's life. Albeit, there are lack of data in various health centers in Indonesia regarding the evaluation of emergency surgical patients, This study was aimed to obtain the profile of patients undergoing emergency surgical procedures in the Emergency Department of Surgery at Prof. Dr. R. D. Kandou Hospital Manado from January to September 2019. This was a retrospective and descriptive study using patients’ medical records. The results showed that there were 540 patients in this study. Most of the patients were adult age group (18-59 years) as many as 343 patients (63.5%), males 366 patients (67.8%), and non-traumatic cases 436 patients (80.4%). The most common cases of trauma was epidural hemorrhage as many as 23 patients (4.3%) meanwhile the most common non-traumatic cases was chronic kidney disease as many as 122 patients (22.6%). According to the type of surgery, CDL insertion and laparotomy were performed on 131 patients each (24.3%). In conclusion, most patients undergoing emergency surgical procedures were 18-59 years old, males, and non-traumatic cases.Keywords: emergency surgery, traumatic cases, non-traumatic cases Abstrak: Bedah emergensi dilakukan dalam keadaan sangat darurat untuk menghindari komplikasi lanjut dari proses penyakit atau untuk menyelamatkan jiwa pasien. Data mengenai pasien bedah emergensi di berbagai pusat kesehatan di Indonesia masih sangat kurang. Penelitian ini bertujuan untuk mendapatkan gambaran pasien yang menjalani prosedur bedah emergensi di IGD Bedah RSUP Prof. Dr. R. D. Kandou Manado periode Januari sampai September 2019. Jenis penelitian ialah deskriptif retrospektif, menggunakan data rekam medik pasien. Hasil penelitian menunjukkan bahwa dari 540 pasien, didapatkan pasien terbanyak dari golongan usia dewasa (18-59 tahun) yaitu 343 pasien (63,5%), jenis kelamin laki-laki 366 pasien (67,8%), dan kasus non-trauma 436 pasien (80,4%). Kasus trauma terbanyak yaitu epidural hemorrhage pada 23 pasien (4,3%) sedangkan kasus non trauma terbanyak chronic kidney disease pada 122 pasien (22,6%). Menurut jenis tindakan operasi yang terbanyak ialah insersi CDL dan laparotomy, masing-masing 131 pasien (24,3%). Simpulan penelitian ini ialah pasien yang menjalani prosedur bedah emergensi terbanyak ialah usia 18-59 tahun, jenis kelamin laki-laki, dan jenis kasus non-trauma.Kata kunci: bedah emergensi, kasus trauma, kasus non-trauma

scholarly journals Clinical profile and outcome of pediatric surgical patients in a rural tertiary centre

2021 ◽  
Author(s):  
Sunil Pathak ◽  
R. V. Mhapsekar ◽  
Neeraj Gupta ◽  
Karthik Surabhi ◽  
Shruchi Bhargava ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Clinical Profile ◽  
Surgical Patients ◽  
Curative Therapy ◽  
Tertiary Centre ◽  
Number Of Patients ◽  
Important Means ◽  
Surgical Conditions ◽  
Time Of Admission ◽  
Surgical Condition

Background: Pediatric surgery is a sub-speciality involving the surgery of foetuses, infants, children and adolescents. Congenital malformations, trauma and childhood cancers are their three major concerns requiring the focus of their attention. Rural pediatric population in India still remains devoid of such facilities. Little is factually known about the burden of surgical disease globally. Surgical treatment is an essential component of basic medical care and an important means of providing preventive and curative therapy. Pediatrician has a significant role in caring for surgical patients. There is a need to know the spectrum of diseases that warrant admission into the pediatric surgical units. Current study was conducted to find out the clinical profile and immediate outcome of the various pediatric surgical conditions. Methods: This prospective observational study was conducted at Vadodara. All the patients 0-18 years, with surgical condition were enrolled in the study. Patients were followed from the time of admission to discharge.  All the clinical data from admission to discharge were recorded and analyzed.Results: Total 127 (3%) patients were enrolled in the study. Males were 93 (73.2%). One to 5 years 45 (35.4%) was the largest age group folowed by infants 23 (18.1%). Largest number of patients were from Gastro Intestinal Condition 52 (40.9%) and congenital causes forms 83 (65.35%) of admissions. Commonest congenital anomaly was inguinal hernia 23 (27.7%). Complications were recorded in 46 (36.22%) patients. The average duration of stay was 7.7 days. The 124 patients were discharged successfully.Conclusions: Surgical conditions are important part of pediatric and neonatal care. Management of congenital surgical condition is important to decrease infant and under five mortality and other comorbidities as well.

scholarly journals 1229 Standardising Consent for General Surgical Patients

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M Mamun ◽  
E Charles
Keyword(s):  
Informed Consent ◽  
Hernia Repair ◽  
General Surgery ◽  
Case Note ◽  
Surgical Patients ◽  
Standards Of Care ◽  
Retrospective Case ◽  
Incision And Drainage ◽  
Consent Forms ◽  
Surgical Practice

Abstract Aim Informed consent requires all material risks to be discussed, as per Montgomery vs Lanarkshire 2015. This audit was based on the latest RCS England guidelines on consenting patients. We aimed to assess our adherence and to introduce standardised procedure-specific consent stickers to ensure the highest standards of care, which were reproducible. Method We undertook two retrospective case note reviews of patients undergoing emergency and elective general surgery procedures from 01/01-15/06 and 01/10-30/11 in 2020. RCS Good Surgical Practice 3.5.1 “Consent” details the standards for this audit. We included patients undergoing appendicectomy, cholecystectomy, incision and drainage and hernia repair (inguinal, umbilical, and incisional). We did not audit laparotomy due to variability in procedural risks precluding a specific sticker and we excluded patients unable to give consent. Results Our initial audit of 82 patients highlighted the variability between practitioners in the material risk discussion. Different patients undergoing the same procedures were being consented differently with significant omissions. We designed procedure specific-consent stickers to be used when consenting to address this imbalance and made these stickers available on surgical wards. A re-audit of 50 patients showed increase from 41% to 88% in documentation of material risks. While only 34% of the audited consent forms featured the stickers, those forms that did have the stickers on had 100% material risk documentation. Conclusions We saw an improvement in material risk discussion by implementing procedure-specific consent stickers. This supports the growing need for standardising consent across General Surgery to reduce variability. We will next aim to design laparotomy stickers.

Clinical approach to the diagnosis of skin disease

2010 ◽  
pp. 4586-4592
Author(s):  
Vanessa Venning
Keyword(s):  
Skin Disease ◽  
Diagnostic Process ◽  
Clinical Approach ◽  
History Taking ◽  
Medical Specialities ◽  
The Impact ◽  
Careful History

As in most medical specialities, the diagnosis of skin disease relies on careful history taking, and a thorough examination, supported in some cases by appropriate investigation. Astute physicians will also be aware that management outcomes are improved by taking account of the impact of skin disease on patients’ lives, whether through discomfort, disfigurement, or disability. This section, however, is chiefly concerned with aspects of history taking and examination that inform the diagnostic process....

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