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In part 1 @CleoKenington, ASGBI lead for Sustainability, told us about the huge problem healthcare has with greenhouse emissions and what to do about improving pathways to minimise healthcare impact, In this eposode Cleo tell us what each of us can do once the patient gets to theatre. Practical solutions for all surgeons to embrace. Be part of the solution!
Useful links:
Resources for how to offer lifestyle advice to prevent disease:
http://makingeverycontactcount.co.uk/training/healthy-lifestyle-information/
https://www.e-lfh.org.uk/programmes/making-every-contact-count/
To promote Shared decision making and improved perioperative see Centre for Perioperative care:
https://cpoc.org.uk/about-cpoc
Lean Healthcare pathways
https://sustainablehealthcare.org.uk/what-we-do/green-surgery-challenge
Companies that produce reusable kit:
Hybrid Laparoscopic Ports, scissors & Clip applicators
https://www.surginno.com/resposable-8-2/
Reprocessed Harmonic scalpels
https://www.vanguard-medical.com/harmonic-scalpel/
The zero waste operating theatre:
https://www.ecoquip.eu/procurement-projects/towards-zero-waste-operating-theatres.html -
In the UK, the National Health Service accounts for 5.4% of the carbon emissions for the whole country! Surgery accounts for 5-10% of this total. The target is an 80% reduction in greenhouse emissions by 2028. Find out what's going on and what you and your unit can do to save slow global warming in this podcast by @CleoKenington, Emergency Surgeon and ASGBI lead for sustainability.
This is everyone's problem - be part of the solution!
Links to helpful sites below:
Resources for how to offer lifestyle advice to prevent disease:
http://makingeverycontactcount.co.uk/training/healthy-lifestyle-information/
https://www.e-lfh.org.uk/programmes/making-every-contact-count/
To promote Shared decision making and improved perioperative see Centre for Perioperative care:
https://cpoc.org.uk/about-cpoc
Lean Healthcare pathways
https://sustainablehealthcare.org.uk/what-we-do/green-surgery-challenge
Companies that produce reusable kit:
Hybrid Laparoscopic Ports, scissors & Clip applicators
https://www.surginno.com/resposable-8-2/
Reprocessed Harmonic scalpels
https://www.vanguard-medical.com/harmonic-scalpel/
The zero waste operating theatre:
https://www.ecoquip.eu/procurement-projects/towards-zero-waste-operating-theatres.html -
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All you need to know about investigation and treatment of this common and serious condition. Indications for pneumatic or hydrostatic reduction, plus operative intervention and complications are all covered.
There are fantastic, beautifully handwritten notes to accompany both podcasts that you can download here: https://drive.google.com/file/d/1BTNoeYe-csn0X2mTsb3rGJ38o5KKyQdy/view?usp=sharing
Shalinder Singh is a consultant in Paediatric Surgery in Nottingham, UK, and David Kiely is a trainee in Paediatric Surgery in the East Midlands of the UK -
David Kiely asks Shalinder Singh about intussusception, a common and serious cause of abdominal pain in children aged 3 months to 3 years.
This podcast covers all you need to know about the incidence, history and examination of intussusception. Part 2 covers investigation and treatment.
Accompanying notes can be downloaded from here https://drive.google.com/file/d/1BTNoeYe-csn0X2mTsb3rGJ38o5KKyQdy/view?usp=sharing -
You'll need to operate on about 1/3 patients with SBO. Matt Lee tells you what approach is best and when, and how to look after your patients after the operation
Matt Lee is Clinical Lecturer in Surgery at the University of Sheffield and a recognised leader in the management of SBO -
Who's going to settle with drip and suck and who isn't? Matt Lee tells you how to tell, who to operate on and when and not to forget that patients with small bowel obstruction need feeding!
Further reading: https://bmjopen.bmj.com/content/9/7/e029235.abstract -
Once you've diagnosed small bowel obstruction, Matt Lee tells us the best initial management
Matt Lee is Clinical Lecturer in Surgery at the University of Sheffield and a world expert in small bowel obstruction -
Matt Lee talks about causes of small bowel obstruction, important points in the history and examination.
Matt Lee (@wannabehawkeye) is a Clinical Lecturer in Surgery at the University of Sheffield -
If the National Audit of Small Bowel Obstruction was a car, Matt Lee is the engine and most of the other moving parts. In this podcast Matt (@wannabehawkeye) talks about NASBO and its main findings and recommendations.
Further reading here: https://academic.oup.com/bjsopen/article/3/3/354/6060819 -
All you need to know about the management of this complex abdominal wall defect of the newborn. Similar to but different from exomphalos (listen to our other episode on that condition).
With David Kiely and Shalinder Singh -
All you need to know about the management of this complex abdominal wall defect of the newborn.
With David Kiely and Shalinder Singh -
Learn about pre-operative resuscitation and operative management of pyloric stenosis. Essential listening for anyone who is learning to operate on children.
With David Kiely and Mike John. -
All you need to know about the aetiology, history, examination and investigation of pyloric stenosis. Essential listening for anyone who treats children, be you surgeon, paediatrician, ED doctor or GP/family doctor.
With David Kiely, Mike John and those squeaky chairs again -
All you need to know about management of the acute scrotum in children.
With David Keily, Mike John and 2 squeaky chairs! -
All you need to know about the diagnosis and management of hydrocoele in children. How it is different from hydrocoeles in adults and the central importance of the processus vaginalis, differential diagnosis, investigations and treatment are all covered. Special cases of hydrocoele of the Canal of Nuck and the abdomino-scrotal hydrocoele are also covered, as well as the acute hydrocoele and implications. In addition, learn about the fantastically named "spring back balls sign"!
With David David Keily and Shalinder Singh. -
In part 2 of this podcast learn how to deal with emergency presentations of inguinal hernia in children, top tips on how to reduce an inguinal hernia in children, indications and timing of surgery and what to tell parents. Operative approach and special considerations for females with inguinal hernia are also discussed. Essential listening for trainees in paediatric surgery and emergency department doctors.
David Keily is a trainee in paediatric surgery in the East Midlands, UK, and Shalinder Singh is a consultant paediatric surgeon and FRCS(Paed) examiner working at University Hospitals Nottingham, UK -
Inguinal hernias are one of the most common conditions in paediatric surgery and this podcast is essential listening for anyone dealing with hernais in children in primary of secondary care. How paediatric hernias different are from adult hernias, predisposing factors for hernia and the central importance of the patient processus vaginalis are discussed, along with presentation, tricks to aid diagnosis in children and the differential diagnosis of lumps on the groin of a child. Complications of inguinal hernia in children are classified and explained.
David Keily is a trainee in paediatric surgery in the East Midlands, UK, and Shalinder Singh is a consultant paediatric surgeon and FRCS(Paed) examiner working at University Hospitals Nottingham, UK -
Now you know how much fluid to give, Shalinder Singh tells David Keily what fluid to use and why in a range of settings from trauma to pyloric stenosis to maintenance fluids in children. When and why to use crystalloid or colloid is explained. Side effects of using the wrong fluids are also covered, including acid/base balance problems and ARDS. Essential listening for anyone prescribing IV fluids for children.
David Keily is a trainee in paediatric surgery in the East Midlands, UK, and Shalinder Singh is a consultant paediatric surgeon and FRCS(Paed) examiner working at University Hospitals Nottingham, Uk -
Prescribing fluids in paediatric surgical patients can be daunting. This podcast tells you easy to remember ways of recognising the degree of fluid loss, why signs like diastolic hypertension are important and a method of calculating how much fluid to prescribe whatever the age of your patient. David Keily talks to Shalinder Singh about dehydration, on going fluid loss and maintenance fluids in children. After this podcast you will never be daunted again.
David Keily is a trainee in Paediatric Surgery in the East Midlands of the UK, and Shalinder Singh is a consultant Paediatric Surgeon and Examiner for FRCS(Paed) working in University Hospitals, Nottingham, UK -
How to recognise and interpret a normal ECG, with Dr. Julia Baron. All you need to know
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