y The SNAP-2: EPICCS collaborators are listed in Supplementary material. AbstractBackground: Decisions to admit high-risk postoperative patients to critical care may be affected by resource availability. We aimed to quantify adult ICU/high-dependency unit (ICU/HDU) capacity in hospitals from the UK, Australia, and New Zealand (NZ), and to identify and describe additional 'high-acuity' beds capable of managing high-risk patients outside the ICU/HDU environment. Methods: We used a modified Delphi consensus method to design a survey that was disseminated via investigator networks in the UK, Australia, and NZ. Hospital-and ward-level data were collected, including bed numbers, tertiary services offered, presence of an emergency department, ward staffing levels, and the availability of critical care facilities. Results: We received responses from 257 UK (response rate: 97.7%), 35 Australian (response rate: 32.7%), and 17 NZ (response rate: 94.4%) hospitals (total 309). Of these hospitals, 91.6% reported on-site ICU or HDU facilities. UK hospitals

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A ppendicitis is the most common surgical problem in pregnancy (occurs in 1/1500 pregnancies) and requires emergent abdominal surgery. Complications can include peritonitis, sepsis, and abscess formation, particularly for appendiceal rupture. The physiologic changes of pregnancy can make the diagnosis of appendicitis difficult. If the appendicitis is uncomplicated, prompt surgery can avoid the complications of perforation. If the appendix has ruptured, increases in maternal and fetal morbidity and mortality occur, and the method of optimal treatment is unclear. This report presents data on 2 patients with ruptured appendicitis treated without surgery but with antibiotics, bowel rest, and intravenous fluids.The first patient, at 32 4/7 weeks of gestation, reported 1 week of intermittent diarrhea and abdominal cramping. The right lower quadrant examination showed tenderness with rebound and her WBC was 22 Â 10 9 /L. Magnetic resonance imaging (MRI) confirmed the diagnosis of ruptured appendix with a phlegmon measuring 7 cm. She was treated with intravenous ampicillin, gentamicin, and clindamycin. Her WBC count peaked at 33 Â 10 9 /L with 9% bands. She remained clinically stable despite the development of peritoneal inflammation and ileus. Although premature uterine contractions developed, tocolysis and steroids were not administered. Over 2 to 3 days, the patient's clinical status and laboratory studies improved, with resolution of her ileus and uterine contractions. Fetal heart rate tracings were reassuring. A repeat MRI on day 5 revealed no change in the phlegmon size. On day 11, she was discharged home with a normal WBC count. At 38 5/7 weeks of gestation, she had an uncomplicated vaginal delivery of a 3544 g girl with Apgar scores of 8 and 9. The postpartum course was uncomplicated, and 2 months after delivery the patient had an interval laparoscopic appendectomy. Pathologic examination showed xanthogranulomatous appendicitis with partial obstruction of the appendiceal lumen.The second patient presented at 26 6/7 weeks of gestation with an 8-day history of right upper and lower quadrant pain. Her WBC count was 19 Â 10 9 /L. Pelvic ultrasound showed a noncompressible appendix with a phlegmon measuring 1.4 cm. MRI confirmed the presence of a ruptured appendix. Medical management was provided with ampicillin, gentamicin, and clindamycin, bowel rest, and intravenous fluids. She became afebrile and the WBC count returned to normal. She was discharged to home on day 9. At 32 weeks of gestation, her right lower quadrant pain recurred and another MRI showed no change in the appendix or phlegmon. Medical management remained the same. Despite the onset of preterm labor at 33 6/7 weeks, steroids and tocolytic drugs were not administered. She had a cesarean delivery by low transverse uterine incision for breech presentation at that time. A male neonate with Apgar scores of 8 and 9 and weight of 2005 g was delivered. The appendix was removed during the cesarean surgery. The postoperative course was uneventful, and the newbo...

AIMS An Awake Craniotomy is a neuro-surgical procedure where the patient remains awake for all or part of their surgery to allow a lesion to be maximally resected without damaging healthy brain functioning. An annual audit of our Patient Satisfaction Survey demonstrated that ‘Receiving Written Information’ was scoring below standard. A new leaflet was designed to address this and it was developed into a ‘Video Leaflet’ comprising a 10 minute audio-visual production, accessed by QR code. METHOD The team created a scripted description of the patient Awake Craniotomy experience. The script was coded into: audio narration, written information or video content. The areas covered were: consultations with the team; pre and intra-operative testing; fMRI scanning; hospital environments; and follow-up. The script was filmed with written consent from all involved and then collated by the Communications Department. There were several revisions made based on feedback from all involved resulting in the final product. RESULTS The Video Leaflet is ready to be demonstrated to and evaluated by patients using a structured questionnaire. The annual audit of Satisfaction Surveys will be compared prior to and post the introduction of the Video Leaflet to determine whether ratings for ‘Receiving Written Information’ have improved. Questionnaire results which are available by the conference date will be presented as preliminary findings. CONCLUSION It is anticipated that the Video Leaflet will further optimise patient preparation, facilitate informed consent and contribute to maximising coping and engagement from a patient perspective to improve patient experience for a complex and daunting procedure.