Hazard Areas

Acute management of patients in the ward is a major part of internship. It is important that situations are handled in a calm and systematic matter. It is also important to know when and where to get help.

The most important question is: IS THIS CONDITION LIFE-THREATENING?

• Leaking or Symptomatic Abdominal Aortic Aneurysm
• Upper or Lower Gastrointestinal Haemorrhage
• Any other source of bleeding
• Trauma
• Septic Shock

REMEMBER ATLS principles - Treat LIFE THREATENING injuries before definitive diagnoses

The consultant on call MUST BE informed about any patients with potentially or actually life- threatening conditions admitted under his or her care

If an acute problem arises in a surgical patient, the surgical SHO/Registrar should be informed AT ONCE and in turn should discuss the problem with the Senior Registrar prior to seeking any advice from other services.

If an adverse event occurs in a patient in the Department of Surgery; the following steps which are in line with our usual practice must be undertaken

• The appropriate Consultant be informed

• The relatives be spoken to and invited to re-attend three to four weeks after the event for consultation with the appropriate Consultant and member of the team.

• The General Practitioner and the referring doctor to be informed at the earliest opportunity.

• Where appropriate the coroner should be informed after consultation with the Consultant in charge.