Communication Flashcards
Patient wants consultant to perform the operation?
Training hospital and opportunities need to provided to trainees
Consultant will be present for the surgery and adequately supervise them
Research shows that patients do just as well irrespective of whether it is consultant or trainee operating
Why can surgery not be done tongith?
Triage patients according to threat to life/limb
Operating overnight reserved for these injuries as it is associated with increased risk as there are fewer staff, people are more tired at night
When a mistake happens?
Duty of candour
State what happened
Apologies
Explain what will be done to mediate the problem
DATIX
PALS
Consequences of the mistake
What to say if the patient wants full escalation despite not being appropriate?
Try to empathise
Offer second opinion
Re explain
If intra op cardiac event it would be appropriate to restart the heart
Doctor decision but we want them to be involved
Arrange to revisit the discussion in the morning
How to break bad news?
Introduce
Confirm details + consent to talk
Explain purpose
SPIKES
Setting- anyone else you want there
Perception- what do they understand by the situation?
Invitation- can I explain what happened to you?
Knowledge- chunk and check, no anacronynms
Emotion
Stratergy and summerise
How to perform Team brief for theatre
All team members present and introduce ourselves and roles.
Confirm patient details, operation and laterality, relevant comorbidities
Patient positioning
Kit
Blood management- Tourniquet, TXA, Cell salvage
Abx?
II needed?
Critical Steps
Post op plan
