rnDione Lother has completed her Medical Training at University of Birmingham, England. She has subsequently commenced Surgical Training and is a Member of Royal College of Surgery, England. She has presented her work in a number of both national and international conferences.rn
Airway emergencies are a common clinical presentation. Surgical doctors (especially those working within ENT surgery) may be involved in cases requiring invasive interventions such as cricothyroidotomy. Furthermore, junior trainees in ENT may be required to provide emergency on-call airway services, sometimes without immediate senior supervision or support. Despite this, currently, no formal curriculum around airway management exists within the core surgical training program. SBME offers an opportunity for trainees to learn within a safe, controlled environment without compromising patient safety and in addition, enables exposure to rare clinical scenarios as well as assessment and feedback. Aim of this study is to design a SBME program utilizing intermediate-fidelity simulation to teach junior medical staff the clinical skills required to manage airway emergencies and non-technical/human factors required to function safely as a member of the wider team. Trainees will rotate through three skills stations that provide the opportunity for hands-on practice in basic airway skills (simple adjuncts) and intubation, surgical airways (both cricothyroidotomy and tracheostomy) and fibro-optic nasoendoscopy. These stations will be followed by a series of simulation scenarios using a SimMan patient simulator; all with the common theme of management of patients with rapidly deteriorating airways. SBME is proving to be important in airway management education and as such may be an invaluable adjunct in higher surgical ENT training. Within core surgical training however, SBME in airway management may offer the only opportunity for formal teaching around this topic before junior trainees are faced with a real life patient with airway compromise.
Dione Lother has completed her Medical Training at University of Birmingham, England. She has subsequently commenced Surgical Training and is a Member of Royal College of Surgery, England. She has presented at a number of conferences at both national and international level.\r\n\r\n
Introduction: Clinical trials have shown that GES is an effective and safe treatment for intractable nausea and vomiting in adults. However, less is known about the efficacy and safety of this treatment in the pediatric population.\r\n\r\nAim: We performed a small prospective study to assess the feasibility and effectiveness of GES in children with refractory nausea and vomiting.\r\n\r\nMethod: Six children underwent surgical insertion of gastric stimulators for chronic unexplained nausea and vomiting; all were females. Median duration of symptoms prior to GES insertion was 2.25 years (range 1.25-11 years). Median age at the insertion was 15.5 (range 13-18 years). Five of six patients had proven gastroparesis on gastric emptying studies. Electro-gastrography showed gastric dysrhythmias in all six patients (increased episodes of tachygastria in three, bradygastria in one and mixed dysrhythmias in two). None were diabetics. Surgical approach was via laparotomy in two patients and laparoscopic surgery in the remaining four patients (two robotic-assisted laparoscopic). \r\n\r\nResults: Statistically significant reduction in symptoms (nausea, vomiting, abdominal pain and early satiety) and requirement for nutritional support following GES insertion was observed. There were no peri or immediate/early post-operative complications.\r\n\r\nConclusion: Our study shows GES to be an effective and safe treatment in children with intractable nausea and vomiting. However, the small sample size is a significant limitation of the study. Despite this, the results show that further investigation of this novel treatment is required.\r\n