Michaels J A, Galland R B
Royal Berkshire Hospital, Reading, UK.
Br J Surg. 1991 Oct;78(10):1271-2. doi: 10.1002/bjs.1800781040.
A prospective clinical audit was carried out to assess the volume and distribution of workload generated by vascular surgical emergencies over a 3-month period in a single health district in the UK. Of 53 consecutive patients referred as surgical emergencies with peripheral vascular problems, 45 were referred to a single vascular surgeon, 36 directly from a general practitioner or other specialist and nine from another general surgeon. A total of 39 operations and six radiological procedures were carried out, including 26 vascular reconstructions. To accommodate the 27 non-urgent operations, nine were performed 'out of hours' and 17 planned cases were cancelled. A median of five general surgical beds were required throughout the period studied and 11 patients required intensive therapy unit admission for a total of 39 days. It is concluded that vascular surgical emergencies constitute a substantial workload and are being dealt with mainly by a single vascular surgeon who effectively works a one in one rota. Inadequate facilities for urgent vascular surgery lead to a large number of cases being dealt with out of hours and frequent cancellation of routine operations.
在英国一个单一健康区进行了一项前瞻性临床审计，以评估血管外科急诊在3个月期间产生的工作量及其分布情况。在连续转诊的53例患有周围血管问题的外科急诊患者中，45例被转诊给一名血管外科医生，其中36例直接来自全科医生或其他专科医生，9例来自另一名普通外科医生。总共进行了39台手术和6项放射学检查，包括26例血管重建手术。为了安排27例非紧急手术，9例在“非工作时间”进行，17例计划手术被取消。在整个研究期间，平均需要5张普通外科病床，11例患者需要入住重症监护病房，总计39天。结论是，血管外科急诊构成了大量工作量，主要由一名血管外科医生处理，该医生实际上是在进行一对一的轮流值班。紧急血管外科手术设施不足导致大量病例在非工作时间处理，常规手术频繁取消。
