Prioritisation 4

You have 10 minutes for the following scenario.

Scenario

You are the ST3 working the night shift in a major trauma centre and have been asked to organise the theatre list for the following day. You have one theatre (half day) with a consultant present supervising an ST3.

Patients

Patient

Details

1

45 Year old male with a clavicle fracture, distal radius fracture and ankle fracture

2

70 Year old female with a neck of femur fracture

3

30 Year old male with a groin abscess

4

85 Year old male with a red hot swollen knee

5

77 Year old female with a distal radius fracture

  • Location – Major Trauma centre
  • II – Available for ½ day list
  • Consultant – Lower limb surgeon happy to do total hip arthroplasty
  • COVID + MRSA – All patients negative
  • Consented + marked – all patients
  • Kit – all kit available
  • Allergies – No patients have latex and iodine allergies

Patient

Details

 

1

45YO Clavicle fracture, distal radius fracture and Ankle fracture

Patient is stable

Lactate 1,  pH and base excess normal

Distal radius normal height, angle, inclination – non operative treatment

Clavicle middle 1/3rd closed, NV intact

Ankle, not swollen, Webber’s C, closed

 

2

70YO NOF

Intracapsular NOF

Isolated injury

Presented this morning (must be done 36 hours)

Been reviewed by Orthogeriatrics

Mobilise independently

AMTS 9/10

No anticoagulation

No significant past medical history

 

3

30YO Groin abscess

Located middle of groin

Patient not septic

HIV/Hep/viral screen -ve

No ultrasound performed

Not discussed with General surgery

 

4

85YO red hot swollen knee

Patient septic

Not on Abx

Aspirate performed Gram stain +ve

CRP 300, WCC 17.2

 

5

77YO distal radius fracture

Isolated

Patient otherwise fit and well

Displaced

Extra-articular

Occurred 3 days ago

 

Life threatening over night

  • Patient 3, the 85YO red hot swollen knee

Next day theatre list

  • 70 YO neck of femur fracture. Ensuring performed within BPT
  • 45 YO ankle fracture

CEPOD

  • 30 year old groin abscess possibly performed by general surgeons

Cancelled

  • 77YO distal radius according to BOAST guidelines it must be performed within 1 week.