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Authors: Simon Paterson-Brown MBBS MPhil MS FRCS

Core Topics in General & Emergency Surgery: Companion to Specialist Surgical Practice (95 page)

BOOK: Core Topics in General & Emergency Surgery: Companion to Specialist Surgical Practice
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N

Nasoenteric tubes,
315
National Association of EMS Physicians (NAEMSP), Air Medical Taskforce,
229–230
National Association of Health Authorities and Trusts (NAHAT) (UK),
17
National Association for the Welfare of Children in Hospital,
52–53
National Confidential Enquiry into Patient Outcome and Death (NCEPOD),
18
,
298–299
,
301–302
Knowing the Risk
,
298–299
Report of a confidential enquiry into perioperative deaths
,
298
National Day Surgery Programme,
41
,
42–43
National Health Service (NHS) (UK),
5
,
12
,
26
,
42
,
81
,
229
2001 plan,
41
Central R&D Committee,
17
,
17b
Economic Evaluation Database (NHS EED),
5
Institute for Innovation and Improvement,
50
Management Executive’s value-for-money unit,
42
The New NHS
(DOH),
2
NHS Evidence (internet),
4
Quality Improvement Scotland,
12
Research and Development (R&D) Programme,
1
National Healthcare system, day surgery,
50
National Institute of Health and Clinical Excellence (NICE),
2
,
4
,
12
,
280
,
338
Clinical Guideline 92 - venous thromboembolism (VTE),
274b
Diagnostic Assessment Programme (DAP),
12
economic evaluation,
33
,
35
,
37
inguinal hernia repair,
69–71
,
69b
Interventional Procedures Programme (IPP),
5
Medical Technologies Evaluation Programme (MTEP),
12
Medical Technology Guidance 3,
304
surgical procedures,
2–3
,
286–287
,
287t
National Institute for Health Research (NIHR),
5
Health Technology Assessment programme (HTA),
5
National Library of Medicine (USA),
4
National Service Frameworks,
2
Natural orifice transluminal endoscopic surgery (NOTES),
53
Neck procedures, head and,
51
Necrosis, pancreatic,
151
Necrotising enterocolitis (NEC),
222–223
Necrotising infection,
208
Neonatal period, surgical emergencies,
215–224
Neoplastic disease,
121
Neostigmine,
187
Neutropenic enterocolitis (typhlitis),
193
,
193f
Nifedipine,
210
Nissen’s double-layer closure technique,
104
Nitrogen
balance,
313
disturbances,
319b
sources,
318
Non-invasive positive pressure ventilation (NIPPV),
300–301
Non-specific abdominal pain (NSAP),
84–86
Non-steroidal anti-inflammatory drugs (NSAIDs),
46
,
48
,
49–50
,
121
,
128
,
135–136
ulcers,
102–103
,
105
Norfloxacin,
147
North American Symptomatic Carotid Endarterectomy Trial,
3
Nottingham Health Profile (NHP),
28
Nuffield Department of Clinical Medicine,
2
Numerical indication of risk,
288
Nutrients
solutions,
316
,
318–319
supplementation,
322–325
combinations,
323–325
,
323f
,
324f
Nutrition risk index,
313
See also
Surgical nutrition
Nutritional deficiencies,
356–357

O

Obesity,
271
causes,
344–345
Octreotide,
120
,
340
Oesophageal atresia,
218
Oesophageal injury scale,
259t
Oesophageal perforation,
105–110
classification,
105
diagnosis,
105–107
,
106f
,
107f
endoscopic stenting,
108
,
108f
management, non-operative,
107–108
surgical intervention,
108–110
immediate resection,
109–110
oesophageal exclusion/diversion,
109
primary repair,
109
,
109f
Oesophagitis,
121
Ogilvie’s syndrome,
185
Omega-3 fatty acids,
322
Omental necrosis,
353–354
Omental repair technique,
102
Omeprazole,
120
,
125
‘On the balance of probabilities’, defined,
15
Onlay technique, mesh repair,
74
OPCS (classification of interventions and procedures) code,
42–43
O-POSSUM (oesophagogastric),
289
Opportunity cost, concept,
32
Opsite® sandwich technique,
240
Organ injury scaling systems,
240
Outcome, in healthcare delivery,
18
Outcome measures,
23–30
condition-specific,
25–26
health-related quality of life,
27–28
mortality,
24–25
pain,
26–27
patient-reported (PROMs),
26
quality-adjusted life-years (QALYs),
28–30
Ovary injury scale,
265t
Oxygen delivery,
300–301

P

PACE (Promoting Action on Clinical Effectiveness),
17
Paediatric Appendicitis Score,
225
,
225t
Paediatric day case surgery,
52–53
,
53b
Paediatric surgical emergencies,
215–228
neonatal period,
215–224
prenatal diagnosis,
215
infancy,
224–225
hypertrophic pyloric stenosis (HPS),
224
,
224f
intussusception,
224–225
children,
225–227
appendicitis,
225–226
,
225t
,
226f
fluid resuscitation,
226
trauma,
226–227
Pain, measurement,
26–27
Pancreas injury
management,
245–246
,
246b
scale,
259t
Pancreatectomy,
152–153
Pancreatic abscess, defined,
142b
Pancreatic necrosis, defined,
142b
Pancreaticobiliary emergencies,
132–157
acute acalculous cholecystitis (ACC),
139–140
iatrogenic,
151–153
ERCP-related complications,
151–152
,
152f
Parathyroid surgery,
51
Para-umbilical hernias,
61
,
62–63
Parenteral nutritional (PN) support,
317–319
access routes,
317–318
complications,
319
,
319b
delivery/administration,
319
nutrient solutions,
318–319
perioperative,
320–321
Pathological Society of London,
194
Patient assessment
See
Surgical risk
Patient Assessment Questionnaires (ePAQ),
26
Patient information,
294
leaflets,
47
Patient-related risk,
287
Patient-reported outcome measures (PROMs),
26
Pedicle omentoplexy,
102
,
102f
Pelvic abscess,
175
Pelvic fracture, complex,
247–248
,
248b
,
250–251
Pelvic haemorrhage,
234
,
246
,
248b
Penetrating injury,
233
,
249
,
250b
Penicillin,
332
Penis injury scale,
266t
Peptic ulcer perforation,
87–88
,
88f
,
100–105
,
101f
cyclo-oxygenase-2 (COX-2)-specific inhibitor,
103
gastric ulcers,
105
giant duodenal ulcers,
104
,
104f
Helicobacter pylori
,
102–103
laparoscopic vs open repair,
104
non-steroidal anti-inflammatory drugs (NSAIDS),
102–103
prognosis,
100–101
Peptic Ulcer Perforation (PULP) score,
101
Peptic ulcers, bleeding
endoscopic management,
122–125
stigmata,
122
,
122f
,
123f
,
123t
endoscopic treatment,
122–124
Hemospray®,
124
injection,
123
limit,
124
mechanical methods,
124
second-look,
124–125
single vs combined methods,
124
thermal methods,
123
pharmacological management,
125
acid suppression,
125
recurrent,
126–128
selective mesenteric embolisation,
127–128
,
127f
surgical management,
125–126
procedure, choice,
125–126
,
126f
Percutaneous transhepatic cholangiography (PTC),
141–142
Perfloxacin,
147
Perianal abscess,
204–209
,
205f
,
205t
children,
208–209
clinical features,
205
radiological imaging,
205–206
,
206f
secondary sepsis,
208
inflammatory bowel disease (IBD),
208
malignant disease,
208
necrotising infection,
208
treatment,
206–208
fistula-in-ano,
207–208
technical tips,
206–207
,
207f
Perioperative/intensive care management,
298–306
cardiac response,
299
high-risk patients, defined,
299
,
299b
mortality rate,
298–299
outcomes, strategies for improvement,
300–302
cardiac output,
300–301
fluid resuscitation,
301–302
,
302f
oxygen delivery,
300–301
protocol-driven therapy,
301
,
302
,
302b
,
302f
postoperative complications,
300
splanchnic circulation,
300
Peripheral vascular organ injury scale,
267t
Peripheral venous access,
318
Peritonitis,
164–167
generalised,
196
Pethidine,
48
Phlegmasia caerulea dolens,
275
Physical fitness classification,
45b
,
46t
Physiological function, assessment,
314
PICO (population, intervention, comparison, outcome), for questioning,
3
Piperacillin,
141
Plain radiology,
87
,
87f
,
88f
PLIP (Purchaser Led Implementation Projects),
17
Polymeric diets,
316
Polyribonucleotides,
322
Polytetrafluoroethylene (PTFE) mesh,
58
,
59f
Port problems,
353
infection,
353
leakage,
353
migration,
353
skin erosion,
353
,
353f
Portsmouth predictor equation for mortality (P-POSSUM),
288–289
,
288b
,
290b
POSSUM (Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity),
288
,
288b
CR-POSSUM (colorectal),
288–289
O-POSSUM (oesophagogastric),
289
P-POSSUM (Portsmouth formula),
288–289
,
288b
,
290b
RAAA-POSSUM (ruptured abdominal aortic aneurysms),
289–290
V-POSSUM (vascular),
289–290
Postoperative complications
nausea and vomiting (PONV),
47–48
,
49
,
52
variables,
300
Post-site hernias,
76
P-POSSUM (Portsmouth formula),
288–289
,
288b
,
290b
Pre-albumin,
313
Pregnancy,
139
,
174
,
272
,
277–278
Prenatal diagnosis,
215
Prilocaine,
49
,
49t
Pringle’s manoeuvre,
244
Probabilistic sensitivity analysis (PSA),
36–37
Probiotic therapy,
150
Procedural-related risks,
286–287
Process, in healthcare delivery,
18
Prolactine,
309b
PROPATRIA trial,
150
Prostatectomy,
51
Protein,
308–309
,
310
assessment,
314
C deficiency, inherited,
270
metabolism,
308–309
S deficiency,
270
Prothrombin gene mutation,
270
Protocol-driven therapy,
301
,
302
,
302b
,
302f
Proton-pump inhibitors,
340
Pseudomonas
spp,
140
Puerperium, venous thromboembolism (VTE),
272
Pulmonary embolism (PE),
276
clinical presentation,
276
diagnostic methods,
278
investigations,
277–278
chest X-ray (CXR),
277
computed tomography pulmonary angiography (CTPA),
277
echocardiography,
277
magnetic resonance imaging (MRI),
277
pregnancy,
277–278
ventilation/perfusion (V/Q) scanning,
277
pretest probability,
276
,
277t
See also
Venous thromboembolism (VTE)
Pyloroplasty, Finney,
104
PYTHON trial,
149–150
BOOK: Core Topics in General & Emergency Surgery: Companion to Specialist Surgical Practice
11.22Mb size Format: txt, pdf, ePub
ads

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