Morning or afternoon emergency list? Effects on service provision and training

Trompetas, Vasileios; Sandison, A. J. P.; Saunders, Mike; Gurjar, Shashank

doi:10.1016/j.ijsu.2008.10.001

Cited by 4 publications

(3 citation statements)

References 4 publications

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“…4 Having daily emergency lists improves access, and, in hospitals where use is a concern, half-days have been an effective alternative. 4 , 17 , 18 Running rooms later into the evening or protecting time on the end of rosters are other approaches. 17 At present, there is still no protected emergency time at our centre.…”

Section: Discussionmentioning

confidence: 99%

Major morbidity and mortality associated with delays to emergent surgery in children: a risk-adjusted analysis

Butterworth

Živković

Kim

et al. 2023

cjs

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Background: Delay of emergency surgery contributes to morbidity and mortality, and physiologic status affects outcomes of patients requiring emergent surgery. Our purpose was to determine whether delays to emergent surgery in children were associated with increased major morbidity or mortality in a risk-adjusted population. Methods: We performed a retrospective review of class 1 (≤ 60 min to operating room) surgical procedures from July 11, 2011, to July 30, 2016, at BC Children’s Hospital, Vancouver. Data sources included the operating room database, patient charts, American Society of Anesthesiologists classification, Neonatal Acute Physiology (SNAP II) and Pediatric Risk of Mortality (PRISM III) scores, time from booking to operating room and outcome. Patients were classified as being at low or high risk for death. We defined major morbidity as unintended loss of an organ, limb or function related to surgery, and delay to surgery as more than 60 minutes from booking to in room. We used the χ 2 test for univariate analysis and logistic regression for multivariate analysis. Results: There were 384 cases (367 patients), 223 high-risk and 161 low-risk. The median age was 4 years (range 0 d–18 yr). Overall, 184 cases (47.9%) were delayed. Major morbidity occurred in 94 cases (24.5%), and 28 patients (7.6%) (all in the high-risk group) died. The mean time to the operating room was 1.46 hours for patients with major morbidity/mortality and 1.17 hours for those without. After adjustment for risk level, multivariate analysis showed delay to surgery to be associated with 85% increased odds of morbidity and/or mortality (adjusted odds ratio 1.85, 95% confidence interval 1.20–2.94) compared to no delay. Conclusion: Delay to emergent surgery was associated with a significant increase in major morbidity and/or mortality. Children who require emergency surgery need their care prioritized by not only operating room teams but also hospitals and government; otherwise, they will continue to experience unintended consequences.

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Section: Discussionmentioning

confidence: 99%

Major morbidity and mortality associated with delays to emergent surgery in children: a risk-adjusted analysis

Butterworth

Živković

Kim

et al. 2023

cjs

View full text Add to dashboard Cite

show abstract

“…In order to increase availability of daytime operative availability and meet caseload demands, hospitals can create capacity for emergency cases on elective lists, use evening and weekend theatre sessions for semi-urgent cases, and physically separate emergency and elective operating teams. [1][2][3][4][5][6]9,20 However, it is recognised that it is not always possible to delay a procedure until the next morning.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6] Acute surgical care models and emergency general surgery (EGS) units have been developed with the aim of increasing consultant-led patient care, dedicated in-hours emergency theatre lists and improved surgeon satisfaction. 1,3,[6][7][8][9] These have led to reductions in time to definite operative management, as measured by benchmark emergency procedures such as appendicectomy, cholecystectomy and hip joint replacements for femoral fractures.…”

Section: Introductionmentioning

confidence: 99%