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Trauma

ATLS

Videos

Scenario 1

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  • You are the Urology SHO on call overnight and your patient has a testicular torsion. You have informed Urology registrar who has agreed the patient needs an operation. You believe that the registrar is not competent to perform this procedure unsupervised. What do you do?
    Answer: The key issue here is patient safety. Any answer you give must have this key piece of information. Your patient needs an urgent operation and it is important that this happens as soon as possible. Your job is to make sure this happens safely. Doubts about this should be discussed with the registrar
  • Is there anyone else you can discuss this with overnight?
    Answer: This is testing your knowledge of your “out of hours” support system. These include: Senior nurses, anaesthetic team, escalate if necessary – consultant
  • The registrar proceeds with the procedure and you are in the middle of the operation. You notice they are about to perform something unsafe, what do you do?"
    Answer: Again, patient safety is your primary concern. If you believe the operating surgeon is about to cause harm you must clearly and firmly ensure they stop. You then speak to your registrar and explain why you asked them to stop. Your patient remains anaesthetized and potentially compromised due to their diagnosis. You must speak to your anesthetist and, at this point, either ask your registrar to speak to the consultant or ask if you can descrub to discuss with them.
  • Your consultant comes in and completes the operation. Your registrar thanks you for your assistance and for preventing a complication. Over the next few weeks is there anything that you would like to do?
    Answer: This is an opportunity for you to show your knowledge of how to act after an event has occurred. This is something that you should reflect on – informally with your Supervisor and formally on your ISCP/ Datix (if required). To prevent this happening in the future, it may be useful for you to perform an audit into what registrars feel comfortable with doing/ not doing overnight. Procedures highlighted as requiring improvement can be discussed in the audit meeting with teaching sessions arranged to bring all the registrars up to a required level.
Scenario 1

Scenario 2

lungs.jpg
  • You are the Urology SHO on call overnight and your patient has a testicular torsion. You have informed Urology registrar who has agreed the patient needs an operation. You believe that the registrar is not competent to perform this procedure unsupervised. What do you do?
    Answer: The key issue here is patient safety. Any answer you give must have this key piece of information. Your patient needs an urgent operation and it is important that this happens as soon as possible. Your job is to make sure this happens safely. Doubts about this should be discussed with the registrar
  • Is there anyone else you can discuss this with overnight?
    Answer: This is testing your knowledge of your “out of hours” support system. These include: Senior nurses, anaesthetic team, escalate if necessary – consultant
  • The registrar proceeds with the procedure and you are in the middle of the operation. You notice they are about to perform something unsafe, what do you do?"
    Answer: Again, patient safety is your primary concern. If you believe the operating surgeon is about to cause harm you must clearly and firmly ensure they stop. You then speak to your registrar and explain why you asked them to stop. Your patient remains anaesthetized and potentially compromised due to their diagnosis. You must speak to your anesthetist and, at this point, either ask your registrar to speak to the consultant or ask if you can descrub to discuss with them.
  • Your consultant comes in and completes the operation. Your registrar thanks you for your assistance and for preventing a complication. Over the next few weeks is there anything that you would like to do?
    Answer: This is an opportunity for you to show your knowledge of how to act after an event has occurred. This is something that you should reflect on – informally with your Supervisor and formally on your ISCP/ Datix (if required). To prevent this happening in the future, it may be useful for you to perform an audit into what registrars feel comfortable with doing/ not doing overnight. Procedures highlighted as requiring improvement can be discussed in the audit meeting with teaching sessions arranged to bring all the registrars up to a required level.
Scenario 2
Scenario 3

Scenario 3

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  • You are the Urology SHO on call overnight and your patient has a testicular torsion. You have informed Urology registrar who has agreed the patient needs an operation. You believe that the registrar is not competent to perform this procedure unsupervised. What do you do?
    Answer: The key issue here is patient safety. Any answer you give must have this key piece of information. Your patient needs an urgent operation and it is important that this happens as soon as possible. Your job is to make sure this happens safely. Doubts about this should be discussed with the registrar
  • Is there anyone else you can discuss this with overnight?
    Answer: This is testing your knowledge of your “out of hours” support system. These include: Senior nurses, anaesthetic team, escalate if necessary – consultant
  • The registrar proceeds with the procedure and you are in the middle of the operation. You notice they are about to perform something unsafe, what do you do?"
    Answer: Again, patient safety is your primary concern. If you believe the operating surgeon is about to cause harm you must clearly and firmly ensure they stop. You then speak to your registrar and explain why you asked them to stop. Your patient remains anaesthetized and potentially compromised due to their diagnosis. You must speak to your anesthetist and, at this point, either ask your registrar to speak to the consultant or ask if you can descrub to discuss with them.
  • Your consultant comes in and completes the operation. Your registrar thanks you for your assistance and for preventing a complication. Over the next few weeks is there anything that you would like to do?
    Answer: This is an opportunity for you to show your knowledge of how to act after an event has occurred. This is something that you should reflect on – informally with your Supervisor and formally on your ISCP/ Datix (if required). To prevent this happening in the future, it may be useful for you to perform an audit into what registrars feel comfortable with doing/ not doing overnight. Procedures highlighted as requiring improvement can be discussed in the audit meeting with teaching sessions arranged to bring all the registrars up to a required level.
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