elective surgery

Australia’s surgery backlog is expected to balloon to 500,000 people this year, but can struggling hospitals ever clear it?

Find out more about The Front podcast here and read about this story and more on The Australian's website or search for The Australian in your app store.

This episode of The Front is presented and produced by Kristen Amiet, and edited by Tiffany Dimmack. The multimedia editor is Lia Tsamoglou, and original music composed by Jasper Leak.

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We've only been living with Omicron for about a month, but already there are reports that hospitals around the country are at breaking point, forcing several states to postpone so-called 'elective' surgeries.

But what happens when even that isn't enough to stem the flow of patients, especially as more and more hospital staff test positive or have to isolate as a close contact themselves?

The Quicky speaks to an Intensive Care Unit doctor, a public health expert, and a woman who had to deliver and save the life of her own baby to find out what is going on inside our hospitals, and whether there is any Plan B for when the system completely breaks down.

CREDITS 

Host: Claire Murphy

With thanks to: 

Dr Belinda* - Doctor in an Australian Intensive Care Unit

Professor Bruce Thompson - Dean of the School of Health Sciences at Swinburne University of Technology, and an international expert on clinical respiratory measurement

Mel Moir - Recently had to use her midwifery skills to deliver her own baby at home after the Ambulance failed to arrive in time and her son wasn't breathing

*Name has been changed for privacy.

Producer: Claire Murphy

Executive Producer: Siobhán Moran-McFarlane

Audio Producer: Ian Camilleri

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New South Wales government to introduce new restrictions, Sydney nurse quit job over ‘chaotic and dangerous’ conditions, violent riots in Kazakhstan are threatening to topple the government, Novak Djokovic fans rally in support outside the hotel, Gordon Ramsay, The Kelly Clarkson Show, Nicolas Cage

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Theme: 
General Surgery

Participants: 

Dr Michael Haddock (ED consultant), Dr Sergei Tsakanov (general surgical Fellow), Sunny Rajput (ED trainee), Edgardo Solis (general surgical registrar), Andy Chen (general surgical registrar), Shreyas Iyer, Samoda Wilegoda Mudalige, Kit Rowe, Caroline Tyers, Harry Hong and Yelise Foon. 

Discussion:
Nepogodiev, D., Bhangu, A., Glasbey, J., Li, E., Omar, O., & Simoes, J. et al. (2020). Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. The Lancet, 396(10243), 27-38. https://doi.org/10.1016/s0140-6736(20)31182-x. 

Summary:

• This was a cohort study extending over 24 countries hit by the initial COVID-19 pandemic, conducted from January 1st to March 31st 2020.
• The aim of the study was to evaluate the effect of COVID-19 infection on post-operative recovery, with particular focus on 30-day mortality and pulmonary complication rates in patients with peri-operative COVID-19 infection.
• 1128 patients were included in the study, with 74% undergoing emergency surgery and 24% having elective surgery.
• 294 patients had a pre-operative diagnosis and 806 had a post-operative diagnosis of COVID-19. 
• 30-day mortality for the cohort overall was 23.8%.
• Post-operative pulmonary complications occurred in half of the patients with peri-operative COVID-19 infection and were associated with significantly higher mortality.
• This can be compared with data suggesting a pre-pandemic post-operative pulmonary complication rate of only 10% and 30-day mortality of up to 3%.
• Even in those patients undergoing elective procedures, the mortality rate was 18.9%.

 Take-Home Points:

• This data suggests that a diagnosis of peri-operative COVID-19 carries significant risk for higher rates of mortality and pulmonary complications. 
• This supports current practice within Australia where elective surgeries are not taking place. 
• However, as this pandemic continues to evolve and potentially becomes a part of the ‘new normal’, guidelines surrounding both emergency and elective surgery will need to be further developed and finessed.

Interlude:
Virtual Ward Rounds:
- https://open.spotify.com/show/5K2TdBc35lh77oWJFHWOuh

Credits:
This episode was produced by the ­­­­Emergency Medicine Training Network 5 with the assistance of Dr Kavita Varshney and, Deepa Dasgupta. 

Music/Sound Effects

• Medical Examination by MaxKoMusic | https://maxkomusic.com/, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution-ShareAlike 3.0 Unported, https://creativecommons.org/licenses/by-sa/3.0/deed.en_US. 
• Memories by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US. 
• One Wish by Roa Music | https://soundcloud.com/roa_music1031, Music promoted by https://www.free-stock-music.com, 
  Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US. 
• Sound effects from https://www.free-stock-music.com.
• Tropical Fever by LiQWYD & Luke Bergs | https://www.liqwydmusic.com, https://soundcloud.com/bergscloud, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution-ShareAlike 3.0 Unported, https://creativecommons.org/licenses/by-sa/3.0/deed.en_US. 

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See you next time,
Caroline, Kit, Pramod, Samoda, and Shreyas.

~

Welcome to our new name--Texas Tech Health Check. Our new name reflects our goal to bring you evidence based health advice. Guests for this episode are TTUHSC Executive Vice President and Dean of the School of Medicine, Steven L. Berk, M.D., and Ron Cook, D.O., TTUHSC chief health officer and chair of the Department of Family and Community Medicine and Lubbock Health Authority. Topics: COVID-19 vaccines and booster shots, who should get a vaccine, when we can expect vaccines for young children and what we can do for frontline workers to show our appreciation.

Simon Parsons (Divisional Director of Surgery at Nottingham University Hospitals NHS Trust) joins Tom Clarke (Director, Mtech Access) to discuss how decisions, such as the postponement of non-urgent elective surgery, are made, the impact this has on patients and staff, and how the NHS might adapt to provide care for these patients.

In addition to his role as Divisional Director of Surgery at Nottingham University Hospitals NHS Trust, Simon Parsons is a Consultant Oesophago Gastric Surgeon. He works as part of the team of gastro-oesophageal surgeons in Nottingham carrying out a full range of cancer surgery on the stomach and oesophagus.

As Divisional Director, Simon is passionate about transformation of surgical services and believes technology plays a pivotal role in this transformation.

Simon is also a director of EIDO Healthcare Ltd., a company specialising in information for informed consent. EIDO has used technology to transform the way it delivers its services.

We were delighted to welcome Simon to the #WhispersWordsofWisdom series.

This podcast was first recorded as a video on 23rd October 2020.

Learn more about our NHS insights services at: https://mtechaccess.co.uk/uk-nhs-insights/ 

Subscribe to our newsletter to hear more news, insights and events from Mtech Access.

In this episode, Liz and I discuss how Medicine has changed over the last decade.  We lament a world where working in medicine was not only hugely rewarding but also fun.
Liz also gives her insightful perspective on the benefits for all in the UK, that having a thriving Private Sector provides and that instead of the UK remaining on of the global leaders in Health, the delayed recovery may, in fact, be a race to the bottom.

On July 1, 2020, Bill Prentice, ASCA chief executive officer, sat down with Dr. Tom Deas, a leading gastroenterologist who is board certified in both internal medicine and gastroenterology, to discuss some of the risks associated with delaying even common procedures such as colonoscopies.

Tom Deas practiced medicine for 20 years in the US Air Force before retiring as colonel. Over the course of his private sector career that followed, Tom has been the medical director of several specialty care facilities, held several distinguished academic positions and was active in several national medical specialty organizations, including a term as president of the American Society for Gastrointestinal Endoscopy (ASGE).

On April 22, 2020, Bill Prentice, ASCA chief executive officer, and Michael Patterson, president and chief executive officer of Mississippi Valley Health in Davenport, Iowa, recorded an episode of ASCA’s Advancing Surgical Care Podcast that looked prospectively at the resumption of elective surgeries. In this episode, recorded two months later, Bill and Michael rejoin their discussion about elective surgeries and provide a detailed update on the progress, as well as the continuing challenges, occurring in outpatient surgery.

Dr. Singh describes what it's like to contract the Coronavirus. He discusses how the disease effected his practice and how it enhanced his relationship with the COVID-19 patients he treats. He discusses COVID care, the safety of emergency facilities, and the balance of staff safety and health.

(2:00) What it's like to contract COVID-19. (6:00) The challenges of "opening society". (7:30) Shortages PPE. (9:15) Ventilators and the staff needed to operate them. (12:00) Heart Disease, Lung Disease, and the effect of COVID. (19:15) NYC 7pm Salute to Healthcare workers

Hosted by Ed Larson and Bill Curtis

Learn More: Politics: Meet Me in the Middle

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A CurtCo Media Production

Music by Celleste & Eric Dick

Produced by Mike Thomas

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Dr. Singh describes what it's like to contract the Coronavirus. He discusses how the disease effected his practice and how it enhanced his relationship with the COVID-19 patients he treats. He discusses COVID care, the safety of emergency facilities, and the balance of staff safety and health.

(2:00) What it's like to contract COVID-19. (6:00) The challenges of "opening society". (7:30) Shortages PPE. (9:15) Ventilators and the staff needed to operate them. (12:00) Heart Disease, Lung Disease, and the effect of COVID. (19:15) NYC 7pm Salute to Healthcare workers

Hosted by Bill Curtis and Dr. Steven Taback

Learn more: Medicine, We're Still Practicing

And Follow Us

Facebook | Instagram | Twitter

A CurtCo Media Production

Music by Celleste & Eric Dick

Produced by Mike Thomas

See omnystudio.com/listener for privacy information.