YAS crews may on occasions (rarely) bring us a Major Trauma patient that meets the criteria for bypass to the MTC because they have a problem that the crew cannot manage, or they won’t survive to LGI e.g. an unmanageable airway/ incompressible haemorrhage. In these instances we will get a pre-alert either from the crew or more likely the Major Trauma Triage Co-ordinator in EOC with some information but primarily the reason the patient is coming to us.
Category: Surgical
Paediatric Surgical Pathway
As there are now no longer a paediatric clinical team at HRI, the paediatric surgical pathway is up-dating, this is the current provisional pathway, to ensure care falls inline with GIRFT report.
Dental Abscess
Dental Abscess requires a Dentist for Definitive Treatment
Symptoms:
- Dental Pain
- Unpleasant taste
- Fever and Malaise
- Trismus
- Dysphagia
- Facial Swelling
- Regional Lymphadenopathy
- Tooth Decay
- Gum Swelling or tenderness
- Purulent Exudate
Octaplex – work fast its an EMERGENCY!
- Activate EARLY in head injury patients on warfarin.
- Order on EPR & Paper [see below]
- Infuse over no more than 30 min
- Recheck INR at 30 min after finished infusion
Indications
- EMERGENCY reversal of Warfain
- Factor II or X deficiency
Read more
Retrobulbar haemorrhage
What is retrobulbar haemorrhage?
- Rapidly progressing haemorrhage into the retrobulbar space which is rare but potentially sight threatening.
- Retrobulbar haemorrhage causes a rapid rise in intraorbital volume and pressure.
- If not treated it can quickly lead to retinal ischaemia and infarction resulting in permanent visual impairment or complete visual loss.
Snake Bites
In the UK approximately 100 people are envenomated by a snake each year.
So what do you need to do if your patient has received a venomous bite from a snake? (not the classic UK cocktail).
- Don’t Cut & Suck!
- Treat what you see
- Call Toxbase
Bilary Disease
Gallstones are common, with a prevalence of approximately 10–15% of adults in Europe and the U.S. Most of the time patients are asymptomatic. but there are several ways gallstone disease can present.
PEARS
Chest Trauma – WYMTN
Chest injury as part of major trauma, can range from painful to life threatening so prompt treatment and recognition is vital. Esp. in ‘Silver Trauma’ when ‘minor’ injuries may have devastating consequences – the full guidance can be found @WYMTN – HERE
Diverticulosis, diverticular disease and diverticulitis
The prevalence of diverticula Is unknown as most are asymptomatic. However, it is rare before the age of 40 and increases with age.
- Diverticulosis occurs in 5–10% of people aged 45 years and older.
- Diverticulosis occurs in about 80% of people aged 85 years and older.
For people with diverticulosis, the lifetime risk of developing acute diverticulitis is about 4–25%
