Clinician awareness of tetanus prophylaxis guidelines in trauma wound management
Authors: Alan Quinn, Alastair McKay, Tristan McMillan
Journal: International Journal of Surgery (2013)

s / International Journal of Surgery 11 (2013) 686e745 703 ABSTRACTS Method: First on-call doctors covering ENT in hospitals in Oxford and Wessex deaneries were contacted by telephone on a weekend in January 2013. Information on stage of training, primary specialty, ENT experience, senior support and confidence in managing emergencies was obtained. Results: 14 doctors from 9 hospitals participated in the survey. Their grades were FY1 (1), FY2 (7), CT1 (2), CT2 (2) and CT3 (2). Their experience in ENT varied from 0 to 16 months. 14% did not know how to do anterior nasal packing for epistaxis and had little confidence (score of less than 5 out of 10) in managing simple ENT emergencies. 29% had no specific ENT induction andwere only given information on ENTemergencies as part of a generic induction handbook. They all had a middle grade as second on-call for support. Conclusions: This regional snapshot analysis shows that ENT is still covered by trainees with little or no experience. It is important that proper ENT induction is given to cross-cover SHOs because of the implications on patient safety. A comprehensive regional analysis is recommended to ascertain the full extent of this problem. 1241: CLINICIAN AWARENESS OF TETANUS PROPHYLAXIS GUIDELINES IN TRAUMA WOUND MANAGEMENT Alan Quinn, Alastair McKay, Tristan McMillan. Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, Glasgow, UK. Introduction: Tetanus is a potentially fatal disease that may result from minor wounds as well as from those caused by major trauma and burns. Tetanus immunization and prophylaxis in the acute injury setting is frequently misunderstood and subsequently misused with well-documented poor guideline compliance. Methods: A questionnaire was compiled based on the Department of Health's Green Book of Immunisation to assess awareness of tetanus prophylaxis guidelines. Subjects were recruited from AE University of Sheffield, Sheffield, UK. Aims: Having developed a higher trainee-led procedural skills programme for core surgical trainees, we aimed to assess feasibility and outcomes of this novel programme. Methods: Competencies, learning outcomes and appropriate simulators were identified or devised. A pool of trainers, mainly HSTs, was identified and a website was created including a sign-up mechanism and access to learning resources. Written feedback was obtained for each session and an electronic survey used to explore experiences of simulation and outcomes. Results: 6 half-day practical wet and dry lab sessions were run, including comprehensive basic surgical skills, laparoscopy, general, orthopaedic and vascular skills. Trainees completed simulated workplace assessments (sWPAs) encouraging individualised structured feedback from trainers. Feedback revealed median overall satisfaction was 90%, including: opportunity to practice 92%, level of pitch 90%, realism of models 88% and trainer knowledge 90%. 32 electronic survey responses (59%) found 81% of CSTs agree that simulation benefits their training and 81% agreed that it improves confidence. 69% of CSTs found sWPAs to be beneficial. Conclusions: CST satisfaction of the trainee-led procedural skills programme was high. This pilot supports the cascade model of teaching and engaged senior trainees with simulation and teaching. The majority of CSTs valued the use of sWPAs. 1256: THE E-CRABEL SCORE: AN UPDATED METHOD FOR AUDITING MEDICAL RECORDS Tharsika Karunakaran, Oliver Turner, Bijan Doostdar. University College