Paediatric patient outcomes following sub-total and total tonsillectomy: a 10 year retrospective audit

2018 ◽  
Author(s):  
sara attard
Keyword(s):  
Paediatric Patient ◽  
Patient Outcomes ◽  
Retrospective Audit

EP.FRI.390 Improving care for patients with acute bowel obstruction: A closed loop audit

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Benjamin Clayphan ◽  
Anna Fairclough ◽  
Jeff Lim ◽  
Roderick Alexander
Keyword(s):  
Ct Scan ◽  
Patient Outcomes ◽  
Bowel Obstruction ◽  
Care Pathway ◽  
Imaging Modality ◽  
Ct Scans ◽  
Abdominal Ct ◽  
Retrospective Audit ◽  
Raising Awareness ◽  
Time To Diagnosis

Abstract Aims Acute Bowel Obstruction (ABO) accounts for 10% of emergency surgical admissions and when surgery is required mortality can exceed 10%. Early diagnosis is associated with improved patient outcomes and timely acquisition of abdominal CT scans can help prevent delays. The NCEPOD 2020 report on ABO identified ‘delays in imaging’ as a key area for improvement in the care of these patients, with these delays being exacerbated if an abdominal X-ray (AXR) was performed as well as an abdominal CT. This study looks at ways to expedite the diagnosis of patients presenting with ABO.   Methods A retrospective audit of 77 patients admitted from A&E or SAU with ABO from April 2019 to February 2020 was conducted. Imaging modality, time-to-CT scan and time-to-diagnosis was recorded. Results and recommendations were presented locally and an evidence based ABO care pathway was implemented and publicised. 20 patients were audited prospectively, post care pathway implementation.  Results 70.1% of patients from the initial audit received a CT-scan and 42% of these patients received an AXR before their eventual CT-scan. The average wait for a definitive radiological diagnosis was 27.8hr. After implementation of the pathway only 18% of patients audited received both modes of imaging and the average time to diagnosis has been reduced to 10.7hr.  Conclusions Raising awareness of the appropriate and timely use of CT-scans in the diagnosis of ABO has reduced the number of concomitant AXR for these patients, expediting the making of a definitive diagnosis and improving patient outcomes. 

scholarly journals 64 The Impact of Inadequate Pain Control Following Chest Trauma on The Incidence of Hospital Acquired Pneumonia and Hospital Admission Length

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
W Butterworth ◽  
O T Ong ◽  
O Magar ◽  
J Bird ◽  
R Scannell
Keyword(s):  
Patient Outcomes ◽  
Pain Control ◽  
Major Trauma ◽  
Chest Trauma ◽  
Trauma Patients ◽  
Permanent Disability ◽  
Retrospective Audit ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired ◽  
The Impact

Abstract Introduction The National Audit Office (2010) report estimated there was 20,000 cases of major trauma per year in England; of which 5,400 died and many others sustaining permanent disability. Blunt chest wall injuries are associated with high levels of morbidity and mortality, and we aimed to investigate the impact of poor pain control in patient outcomes. Method Compliance with trust guidelines was assessed via a retrospective audit of all chest trauma patients between October 2019-20. Results 28 chest trauma patients identified (M:F 15:13) with ages ranging from 47-94 yrs old (average age 73). Chest trauma was associated with high levels of morbidity (32%) and mortality (7%). 39% patients were found to have inadequate pain control. Only 17% patients eligible for regional anaesthetic blocks were performed within 24hrs. 33% patients developed hospital acquired pneumonias (HAP), of which 44% had received inadequate pain control. Average admission length of patients with a HAP was 15 days compared to 5 days without. 85% patients experienced either delayed or no assessment by specialist teams (i.e., physiotherapy, pain team). Conclusions Chest trauma patients often receive inadequate pain control and delayed specialist team input resulting in increased frequency of HAPs, admission length and morbidity/mortality.

scholarly journals A case report of an incidental finding of congenital oesophageal diverticulum in a patient presenting with stridor

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Raju Limbu ◽  
Sabrina Brar ◽  
Prince Modayil
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
Paediatric Patient ◽  
Patient Outcomes ◽  
Incidental Finding ◽  
Team Approach ◽  
Atypical Presentation ◽  
Chest Discomfort ◽  
Multidisciplinary Team Approach ◽  
Improve Patient

Abstract Congenital oesophageal diverticulum is incredibly rare and has not commonly been published in the literature. Oesophageal diverticulum can be asymptomatic; however, symptoms such as dysphagia, regurgitation and chest discomfort may be present. We describe the case of a paediatric patient presenting with biphasic stridor, respiratory distress and cyanosis at birth, who was found to have a supraglottic cyst and later the presence of an oesophageal diverticulum shown on ultrasound imaging. There has been one other case reported in the literature of an oesophageal diverticulum presenting with stridor, and we therefore believe this is one of only two cases to illustrate this atypical presentation of congenital oesophageal diverticulum. It highlights the importance of a meticulous multidisciplinary team approach to patient care, as well as conducting appropriate investigations to aid early diagnosis to improve patient outcomes.

scholarly journals EP.WE.190Post-operative Hypocalcaemia: Analysis of factors influencing and predicting hypocalcaemia post total thyroidectomy

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Javier Ash ◽  
Tylan Lucas ◽  
Naveed Kirmani
Keyword(s):  
Length Of Stay ◽  
Total Thyroidectomy ◽  
Patient Outcomes ◽  
Calcium Supplementation ◽  
District General Hospital ◽  
Inpatient Stay ◽  
Percentage Difference ◽  
Retrospective Audit ◽  
Patient Morbidity ◽  
Severe Hypocalcaemia

Abstract Aims Hypocalcaemia is a severe complication post total thyroidectomy leading to increased morbidity, length of inpatient stay and associated costs. The leading cause is damage or de-vascularisation of the parathyroid glands intra-operatively however this is not always easy to identify and is usually inadvertently performed. Prompt identification of patients likely to become severely hypocalcaemia is difficult for clinicians but is of interest as timely management of hypocalcaemia in these patients is crucial to reduce length of stay and worsening/development of symptoms. Methods A retrospective audit of 42 patients who were admitted for a total thyroidectomy at a district general hospital was performed. Data was collected on demographics, indication, post-operative diagnosis and pre- and post- electrolyte levels and calcium supplementation. Results Eight patients were identified with severe hypocalcaemia post operatively. Age, indication, post-operative diagnosis or pre-operative electrolyte levels were not statistical significant predictors of post-operative hypocalcaemia. Percentage difference between pre and immediate post-operative calcium levels was a significant predictor of subsequent severe hypocalcaemia and increased length of inpatient stay (p < 0.05). Conclusions Reducing patient morbidity and length of stay is of crucial importance to clinicians and patients alike. Commonly post-operative calcium levels are interpreted independently to determine need of supplementation. However, using pre-operative calcium levels in conjunction with the immediate post-operative levels has lead to a better prediction of patients likely to suffer from this complication. We theorise that prospectively identifying these patients and starting treatment early as appropriate will lead to improved patient outcomes.

Laryngeal Manifestations of Autoimmune Diseases

2020 ◽  
Vol 5 (2) ◽  
pp. 439-456
Author(s):  
Jenny L. Pierce
Keyword(s):  
Autoimmune Disease ◽  
Autoimmune Diseases ◽  
Patient Outcomes ◽  
Correct Diagnosis ◽  
Upper Airway ◽  
Clinical Implications ◽  
Laryngeal Function ◽  
The Past ◽  
Referral Practices ◽  
Timely Referral

Purpose This review article provides an overview of autoimmune diseases and their effects on voice and laryngeal function. Method A literature review was conducted in PubMed. Combinations of the following keywords were used: “autoimmune disease and upper airway,” “larynx,” “cough,” “voice,” “dysphonia,” and “dyspnea.” Precedence was given to articles published in the past 10 years due to recent advances in this area and to review articles. Ultimately, 115 articles were included for review. Results Approximately 81 autoimmune diseases exist, with 18 of those highlighted in the literature as having laryngeal involvement. The general and laryngeal manifestations of these 18 are discussed in detail, in addition to the clinical implications for a laryngeal expert. Conclusions Voice, breathing, and cough symptoms may be an indication of underlying autoimmune disease. However, these symptoms are often similar to those in the general population. Appropriate differential diagnosis and timely referral practices maximize patient outcomes. Guidelines are provided to facilitate correct diagnosis when an autoimmune disease is suspected.

Measuring patient outcomes

2001 ◽  
Vol 33 (1) ◽  
pp. 138-138
Author(s):  
Jane H. Barnsteiner
Keyword(s):  
Patient Outcomes

Intravascular ultrasound in the diagnosis and treatment of central venous diseases

VASA ◽  
2021 ◽  
Vol 50 (1) ◽  
pp. 2-10 ◽  
Author(s):  
Xin Li ◽  
Giuseppe D’Amico ◽  
Cristiano Quintini ◽  
Teresa Diago Uso ◽  
Sameer Gadani ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Patient Outcomes ◽  
Controlled Trials ◽  
Ivc Filter ◽  
Venous Anatomy ◽  
Central Venous ◽  
Detailed Measurement ◽  
Filter Placement ◽  
Randomized Controlled ◽  
Venous Diseases

Summary: Intravascular ultrasound (IVUS) has been used extensively in coronary applications. Its use in venous applications has increased as endovascular therapy has increasingly become the mainstay therapy for central venous diseases. IVUS has been used for both diagnostic and therapeutic purposes in managing venous stenotic disease, venous occlusive disease, and IVC filter placement and removal. IVUS has been proven to be effective in providing detailed measurement of the venous anatomy, which aid in determining the appropriate size and the approach for venous stent placement. In IVC filter placement, IVUS can provide detailed measurement and guide IVC filter placement in emergent and critical care settings. It also has certain utility in filter removal. At any rate, to date there are only a few studies examining its impact on patient outcomes. Prospective randomized controlled trials are warranted in the future.

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