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Tonight we started with a waiting list prioritisation exercise.
Your consultant is away.
The waiting-list manager comes to see you.
The following patients have been listed by junior staff.
The waiting-list manager wants you to:
confirm the appropriateness of the proposed treatment,
decide the degree of urgency,
confirm the appropriateness of the proposed venue,
decide any special requirement(s) for each patient.
| Name | Age | Clinical Problem | Proposed operation | Venue | Special Needs | Urgency |
| JK | 5 | chronic discharge. ? foreign body | EUA | Main theatre | | |
| JM | 32 | 1ry. infertility | Laparoscopy + tubal patency tests | Main theatre | | |
| GN | 77 | Vulval cancer. Coronary thrombosis x 2. Unstable angina. | Radical vulvectomy agreed at MDT. | Main theatre | | |
| RU | 55 | PMB x1. Weight 20 stones. (127 kg.) 1 kg. = 2.2 lb. 1 stone = 14 lb. | D&C. | DCU. | | |
| LD | 32 | Menorrhagia. Fibroids. Anaemia. | Vaginal hysterectomy. | Main theatre. | | |
| DT | 22 | Does not want children. | Lap. Steril. | DCU | | |
| HB | 14 | Unwanted pregnancy at 10/52. | TOP | DCU. TOP list. | . | |
| JY | 44 | GSI. | Anterior colporrhaphy. | Main theatre. | | |
| JS | 23 | Vaginal discharge. Cervical ectropion. | Diathermy to cervix. | DCU | | |
| DT | 55 | 3 cm. ovarian mass. | Laparoscopy ? proceed to Hyst + BSO. | Main theatre. | | |
| EV | 32 | CIN3. | Cone biopsy. | DCU | | |
| UW | 34 | Endometriosis | Laparoscopic ablation | DCU | | |
| HT | 88 | Cystocoele/ rectocoele/ 2nd. degree uterine prolapse | Manchester Repair. | Main theatre. | | |
| KN | 58 | Haematuria | Cystoscopy | DCU | | |
| JW | 18 | Menorrhagia & copes badly with menstrual hygiene. Has Down’s syndrome. Sexually active. | Hysterectomy | Main theatre | | |
| TB | 30 | Menorrhagia. 2nd. degree uterine descent. Been sterilised. Jehovah’s witness. | Vaginal hysterectomy and repair. | Main theatre. | | |
| BM | 55 | Stage Ib cancer cervix. Been discussed at MDT. For Wertheim’s hysterectomy. Factor V Leiden. VTE on Pill. On warfarin. | Wertheim’s hysterectomy. | Main theatre. | | |
| NU | 60 | Recurrent rectocoele. | Posterior colporrhaphy. | Main theatre. | | |
We discussed sterilisation, particulrly consent issues.
We talked again about audit, this time in relation to the work of the audit department.
Then we discussed uterine perforation while doing evacuation of retained products after incomplete miscarriage.
If you send your answers, I'll send mine.
Regards,
Tom.
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