Surgery, unscheduled: organisation

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Objectives

A clear pathway for managing a children requiring unscheduled (emergency) neurosurgery preoperatively in the ward.

Scope

Children requiring unscheduled (emergency) neurosurgery.

Audience

The multidisciplinary team involved in care of children presenting with a neurosurgical emergency. 

Where the need for surgery has been determined by the neurosurgical consultant, the organising resident clinician should:

1. Notify the Anaesthetic Registrar - page 8602

2. Book patient with emergency theatre nursing staff (Theatre 2) - page 8092

 

The anaesthetic team will wish to know the patients fasting status. Normal fasting requirements are:

• 6 hours for solids or anything containing cow's or formula milk

• 4 hours for breast milk

• 2 hour fast for clear fluids

 

These will be applied except where the patient is in extremis i.e. requires emergency intubation. The patient should have up to date blood results

• FBC

• U&Es

• CRP

• Coagulation screen may be required depending on case ask anaesthetist or surgeon if unsure.

 

Group and Save or cross match may be required depending on case - ask anaesthetist or surgeon if unsure.

Consent – this will normally be done by the Neurosurgical Consultant: parents must remain available to do this prior to their child going to theatre.

HDU or PICU post op admission – if this will be required the organising clinician should ensure that PICU staff are aware of the patient.

 

Useful numbers to remember

Theatre 2 extension - 86902 or 86912

Theatre coffee room - 80189

Editorial Information

Last reviewed: 01 March 2014

Next review: 01 March 2016