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Stress, Compassion Fatigue, and Burnout
Published in Lisa Zammit, Georgeanne Schopp, Relational Care, 2022
Lisa Zammit, Georgeanne Schopp
CF and BOS affect all healthcare providers. In 2018, the Canadian Medical Association’s survey of physicians revealed a 30% rate of BOS with 8% suicidal ideation within that year (Rozario, 2019). Numerous studies indicate that BOS is high in specific specialties with rising numbers and severity. Certain specialties – anesthesia, psychiatry, general practice, and general surgery – are at higher risk (Dutheil et al., 2019). The meta-analysis indicated an increase of cases in women. Despite good preventative care, both CF and BOS are persistent risks.
Trauma Systems, Centres and Teams
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
In both MTCs and TUs, if the patient requires surgery, there should be 24-hour access to a fully staffed and equipped emergency theatre that will allow the appropriate consultant surgeon to operate. General surgery and orthopaedic senior trainees must be on site 24 hours a day, with a consultant available to attend within 30 minutes. Vascular and neurosurgical consultants must be able to attend an MTC within 30 minutes. Any patient with a head or spinal cord injury should be treated in a specialist neurosciences centre.
Acute Care Emergency Surgery
Published in Mansoor Khan, David Nott, Fundamentals of Frontline Surgery, 2021
Marcelo A. F. Ribeiro, Mansoor Khan
Inguinal hernia repair is among the most common procedures performed by the general surgeon. There are two types: indirect and direct. Indirect hernias develop at the internal ring, where the spermatic cord or the round ligament enter the inguinal canal. They originate lateral to the inferior epigastric vessels – in contrast to the direct hernias which protrude through Hesselbach’s triangle (rectus abdominis muscle medially, the inguinal ligament inferiorly, and the inferior epigastric vessels laterally) medial to the inferior epigastric vessels.
Sixth Annual Enhanced Recovery After Surgery Symposium highlights: work in progress or standard care?
Published in Baylor University Medical Center Proceedings, 2023
Lucas Fair, Elizabeth Duggan, Evan P. Dellinger, Nicole Bedros, Kimberly Godawa, Cynthia Krusinski, Rachel Curran, Charlette Hart, Alex Zhu, Walter Peters, James Fleshman, Alessandro Fichera
There are challenges with interpretation of the available literature as it pertains to enhanced recovery pathways for nonelective, emergency abdominal surgeries. When considering the existing literature, the data pertaining to ERAS after emergency general surgery has demonstrated associations with reduction in postoperative complications, mortality, and length of stay.41 However, there are difficulties in applying protocolized recovery pathways to the wide variety of abdominal surgical pathologies and to the acutely ill emergency general surgery patient in the nonelective setting. Recently, guidelines for preoperative care in emergency laparotomy were published by the ERAS Society. These guidelines included strong recommendations for early resuscitation and correction of physiologic derangements, validated sepsis scores, early imaging, early surgery and source control of sepsis, validated risk assessments, age-related evaluations of frailty and cognitive function, reversal of antithrombotic medications when indicated, appropriate assessment of venous thromboembolism risk, avoidance of preoperative sedatives, multimodal analgesia, preoperative nasogastric tube intubation, and shared decision making with patients and families.41 In conclusion, while enhanced recovery has certainly seeded itself as the standard of care in the management of the elective surgical patient, despite its extrapolated potential benefits to the emergency general surgery patient, more investigation and insight is needed.
Relationship between medical programme progress test performance and surgical clinical attachment timing and performance
Published in Medical Teacher, 2023
Andy Wearn, Vanshay Bindra, Bradley Patten, Benjamin P. T. Loveday
Year 4 of the programme is 44 weeks, with 3 weeks of vacation and 4 weeks of non-attachment learning. The remaining time is divided between eight clinical discipline contexts (general medicine, geriatrics, specialty medicine, general practice/primary care, general surgery, emergency medicine, anaesthetics, and musculoskeletal) ranging from 1 to 6 weeks in duration. The GSA is 6 weeks long and students may be assigned to general, paediatric or vascular surgery teams. There are three assessment components: two clinical supervisor’s reports (CSR), a logbook (documents history taking, clinical examination, and self-directed learning from cases), and critical appraisal of a published study to answer a surgery-related question (CAT). Students receive a categorical grade for each component, based on standards, and a rubric is then used to combine them into four outcomes (distinction, pass, borderline performance, fail).
Doing More with Less: Surgical Training in the COVID-19 Era
Published in Journal of Investigative Surgery, 2022
Triantafyllos Doulias, Gaetano Gallo, Ines Rubio-Perez, Stephanie O. Breukink, Dieter Hahnloser
The Surgical Council on Resident Education (SCORE) Portal© is an educational web portal supporting the curriculum of American General Surgery Resident during their training [14–16]. It focuses on all areas of general surgery and related subspecialties. It is linked with an online surgical curriculum giving a quick access to 800 module topics, book chapters and multiple-choice questions for self-assessment. eSurgery is an e-learning platform developed by The Royal College of Surgeons of England and the Health education England to support trainees in the early years of their training. It offers interactive e-learning sessions that are structured in modules and are mapped to the Intercollegiate Surgical Curriculum Programme. With more that 1 million registered users, it delivers more than 210 e-learning programmes playing an important role in enhancing and supporting traditional teaching methods [17].