General

Question 1

NCEPOD Category 1

Answer 1

“Immediate”
- Immediate life-, limb- or organ saving intervention
- Within minutes of decision to operate
- Resuscitation simultaneous with surgical intervention
E.g. ruptured AAA, fracture with major NV deficit, trauma laparotomy

Question 2

NCEPOD Category 2

Answer 2

“Urgent”
Acute onset or deterioration of conditions that threaten life or limb survival
Within hours of decision to operate
Listed on emergency list
E.g perforated bowel with peritonitis, critical limb ischaemia

Question 3

NCEPOD Category 3

Answer 3

“Expediated”
Stable patient requiring early intervention
Within days of decision to operate
Elective list with spare capacity
E.g. tendon and nerve injuries, ORIF

Question 4

NCEPOD Category 4

Answer 4

“Elective”
Surgical procedure planned or booked in advance of route admission
E.g. elective AAA repair, laparoscopic cholecystectomy

Question 5

Name 6 never events?

Answer 5

1. Wrong site surgery/block
2. Retained throat pacl
3. Maladministration of potassium-containing fluid
4. IV administration of epidural local anaesthetic
5. Transfusion of ABO incompatible blood products
6. Misplaced nasogastric

Question 6

Principles of diabetic management

Answer 6

Individualised plan regarding usual diabetic medication
- Potential 20% dose reduction in basal insulin
- Continue some OHGA e.g. metformin but omit others e.g. gliclazide

Maintain BSL 6-10mmol/L

Check BSL prior to induction, 1hrly
intraop and post op

Maintain normal electrolytes

Use strategies to enable early return to normal diet and usual diabetic regimen e.g regional, TIVA, 1st on list

Avoid pressure damage to feet