Prioritisation 6

You have 10 minutes for the following scenario 

Scenario

You are the ST3 working the night shift in a district general hospital 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.

Patient

Details

1

51YO male with ankle fracture

2

65YO male with back pain, saddle anaesthesia, MRI pending

3

44YO female with neck of femur

4

5YO child with a distal radius and median nerve symptoms

5

90YO neck of femur fracture, PPM, Hb 70.

  • Location – District General Hospital
  • II – Available for ½ day list
  • Consultant – Lower limb surgeon happy to do any type of case
  • COVID + MRSA – All patients negative
  • Consented + marked – All patients
  • Kit – All kit available
  • Allergies – No patients have latex and iodine allergies

Patient

Details

 

1

51M ankle fracture

When did the injury occur? Today

Not swollen

Isolated injury

In a backslab and in joint

Closed injury

2

65M back pain, saddle anaesthesia

Post void bladder scan 300ml

Has not been discussed with the spinal unit

MRI will not occur over night in this hospital

Bilateral symptoms

3

44F with NOF

Intracapsular

Isolated injury/ATLS has been done

No anticoagulation

No PMH

Closed injury

4

5YO with distal radius and median nerve

Currently in backslab

Symptoms improve when backslab removed

5 degrees dorsal angulation

Repeat backslab placed reduced angulation no further symptoms

5

90YO NOF

No Pacemaker check

CXR, ECG pending

Orthogeries review pending

Intracapsular

AMTS 7/10

Injury occurred today arrived in A+E 1 hour ago

PPM check and bipolar diathermy

Emergency referral to spinal unit

  • 65M Back pain, saddle anaesthesia

Theatre list for tomorrow

  • 44F with NOF (inform consultant on call)
  • 51 Ankle fracture

Discussion in MDT

  • 5YO with distal radius fracture

Not ready for surgery

  • 90YO Neck of Femur