The choice of anaesthetic in shoulder surgery is an evolving field of research which has important implications for patient outcomes. We have performed a prospective study to assess the usability of an interscalene brachial plexus block (ISBPB) with sedation as the primary anaesthetic and analgesic for arthroscopic shoulder surgery. Our study assessed the requirements of analgesia peri-operatively and post operatively and found that patients had no requirement (n ¼ 30) and minimal requirements with a low pain score (visual analogue score; mean 2.4, range 2e5) respectively. We also found that patients spent a short amount of time in recovery (31 min mean, range 21e48 min) and were able to be discharged on the same day. Our findings suggest that ISBPB with sedation is a viable option in arthroscopic shoulder surgery for a variety of procedures with positive effects for patient outcomes and mobility.
Background: Non-adherence to antimicrobial guidelines is a major factor leading to emergence of antimicrobial drug resistance. Objective: This study was carried out to investigate the adherence to local antimicrobial guidelines in the Emergency Department (ED) at Al Wakra Hospital in the state of Qatar. Materials and methods: This cross-sectional, retrospective study was carried out in the Emergency Department of Al Wakra Hospital in Qatar. Prescriptions of 219 patients were investigated to study the adherence to antimicrobial guidelines. The relation of sex, age and emergency unit type to antimicrobial adherence as well as the appropriateness of antimicrobial prescribed on discharge were also evaluated. Results: Overall adherence and non-adherence to local antimicrobial guidelines was found to be 41% and 59% of prescriptions respectively (P-value = 0.007). Participants had mean age of 42 ± 15.5. More adherence to guidelines was found among female patients and in critical care units. Furthermore, antimicrobial prescribed to patients on discharge was found to be appropriate in 60% of patients (P-value = 0.04). Conclusion: Education of physicians and additional studies should be conducted in order to further investigate and improve adherence to antimicrobial guidelines.
Aim To recognise if there is a discrepancy between contact information on our electronic system and those obtained by the clinician. Introduction Patients are clerked during the orthopaedic on-call and discharged with the possibility of requiring urgent outpatient surgery. These patients are contacted by the trauma co-ordinator prior to their operation date. It is common practice in orthopaedics for the clinician to obtain the most up to date contact information during the on-call clerking. There are occasions where patients are unable to be contacted prior to surgery due to insufficient contact information. This audit is to identify if there is a discrepancy between contact information on the electronic system compared to that obtained during the clerking. Method Contact information for all patients clerked by the on-call team over 14 days during Nov 2019 were reviewed. They were categorised into 3 groups; ‘clinician obtained further information’, ‘electronic system had more information’ and ‘no discrepancy’. Results Data was collected for 71 patients. The results showed that the clinician obtained further information for 18 patients (25.3%). The electronic system had more information in 16 patients (22.5%). There was no discrepancy in 37 patients (52.1%). Discussion This audit has highlighted an issue, as the results show 25% of patient contact information is incomplete. Given these patients are seen in the emergency setting, this is the only opportunity to obtain correct information to continue the management of patient care. This is paramount to streamline theatre flow and optimise the use of available theatre slots.
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