rcs-report-the-highrisk-general-surgical-patient--raising-the-standard--december-2018
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rcs-report-the-highrisk-general-surgical-patient--raising-the-standard--december-2018
The High-Risk General Surgical Patient: Raising the StandardThe High-Risk General SurgiContentsCONTRIBUTORS page4Approving organisations _____________ rcs-report-the-highrisk-general-surgical-patient--raising-the-standard--december-2018______________________page5SUMMARY ____________________________________________________page7KEY RECOMMENDATIONS page 8THE HIGH-RISK GENERAL SURGICAL PATIENT: RAISING THE STANDARD page 11Background page 11 Introduction page 11 Setting the standard page 12DEFINING -HIGH-RISK'page 16RISK ASSESSMENT ___ rcs-report-the-highrisk-general-surgical-patient--raising-the-standard--december-2018_________________________________________page17Frailty page18Perioperative neurocognitive disorderspage19Multimodal assessment of risk page 20 Failingrcs-report-the-highrisk-general-surgical-patient--raising-the-standard--december-2018
to assess risk page20Reassessing risk—_— —. page 20Assessing risk in patients whose disease is managed non operativety _ page 21Using risk assessmentThe High-Risk General Surgical Patient: Raising the StandardThe High-Risk General SurgiContentsCONTRIBUTORS page4Approving organisations _____________ rcs-report-the-highrisk-general-surgical-patient--raising-the-standard--december-2018neurocognitive disorders page 24 Consultant-delivered care page 25 Goal-directed fluid therapy page 27SEPSIS page 28Recognition page 28 Delivery of the Sepsis 6 care bundle page 29 Antimicrobial therapy page 29 Source control ______________________________________________________page 30RADIOLOGY____ rcs-report-the-highrisk-general-surgical-patient--raising-the-standard--december-2018______________________________________________________________page 32Diagnostic radiology page 32 Interventional radiology page 34CRITICAL CARE page 3rcs-report-the-highrisk-general-surgical-patient--raising-the-standard--december-2018
6 DEPARTMENTAL RESOURCES page 39 QUALITY ASSURANCE AND IMPROVEMENTpage 43High-risk emergency care bundles page 43AREAS FOR FURTHER RESEARCH page 46 COThe High-Risk General Surgical Patient: Raising the StandardThe High-Risk General SurgiContentsCONTRIBUTORS page4Approving organisations _____________ rcs-report-the-highrisk-general-surgical-patient--raising-the-standard--december-2018isk General Surgical Patient, 20183The High-Risk General Surgical Patient. Raising the StandardContributorsThe Royal College of Surgeons of England Working Group on the Perioperative Care of the High-risk General Surgical Patient.NP LeesConsultant General and Colorectal Surgeon. Salford Royal NHS Fo rcs-report-the-highrisk-general-surgical-patient--raising-the-standard--december-2018undation Trust. Clinical Reference Group member. National Emergency Laparotomy Audit on behalf of Royal College of Surgeons of England. Clinical Champrcs-report-the-highrisk-general-surgical-patient--raising-the-standard--december-2018
ion for General Surgery Reconfiguration, NHS Greater Manchester Health and Social Care Partnership. (Chair, Editor).CJ PedenProfessor. Department of AThe High-Risk General Surgical Patient: Raising the StandardThe High-Risk General SurgiContentsCONTRIBUTORS page4Approving organisations _____________ rcs-report-the-highrisk-general-surgical-patient--raising-the-standard--december-2018mergency Laparotomy Audit. QI lead for the Enhanced Peri-Operative Care for High-risk patients (EPOCH) study and QI advisor. Emergency Laparotomy Collaborative.JK DhesiConsultant Geriatrician. Clinical Lead Proactive Care of Older People undergoing Surgery. Guy's and St Thomas' NHS Foundation Trust. rcs-report-the-highrisk-general-surgical-patient--raising-the-standard--december-2018 London Honorary Reader. Kings College London. Clinical Reference Group member. National Emergency Laparotomy Audit Vice President, Clinical Quality.rcs-report-the-highrisk-general-surgical-patient--raising-the-standard--december-2018
British Geriatrics Society. President. Age Anaesthesia Association.N QuineyConsultant Anaesthetist. Royal Surrey County Hospital. Guildford. Clinical The High-Risk General Surgical Patient: Raising the StandardThe High-Risk General SurgiContentsCONTRIBUTORS page4Approving organisations _____________The High-Risk General Surgical Patient: Raising the StandardThe High-Risk General SurgiContentsCONTRIBUTORS page4Approving organisations _____________Gọi ngay
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