61 - 65 SBAs for the Final FRCA
Question 61
You are the CEPOD anaesthetist and it is currently 02:30 on a drizzly Sunday.
The orthopaedic registrar presents you with a slightly stained booking form for a twenty three year old man who has fallen off a motorbike and sustained a fracture dislocation of his left ankle.
The patient is at present cardiovascularly stable and GCS 15, however the foot is pale with no palpable pulse.
Which of the following NCEPOD classifications best describes this case?
- Emergency
- Immediate
- Elective
- Urgent
- Expedited
Answer
- Urgent
Immediate = life, limb or organ saving surgery, within minutes of decision to operate, resuscitation ongoing.
Urgent = acute potentially life or limb-threatening condition, within hours of decision to operate, resuscitation first.
Expedited = no immediate threat to life, limb or organ, within days of decision to operate, pre-operative optimisation first.
Elective = planned procedure with routine hospital admission, at a convenient time.
Emergency isn't an NCEPOD classification any more.
The point is not to operate out of hours for something that can wait until the safety of daytime operating conditions with the full complement of staff available, and the decision needs to be made by the most senior surgeon involved in the case.
Check out the full classification here.