Surgical Training for Austere Environments

Transcription

1 Surgical Training for Austere Environments Programme Course Director: Mr Vascular and Trauma Surgeon, St Marys Hospital, London

2 Acknowledgements The Royal College of Surgeons of England is a charitable organisation funded by our members and the generous support of donors and sponsors, receiving no government funding for our educational activities. As such we are incredibly grateful to the following for their support: For providing surgical instruments and sponsoring the Professor of Surgical Education For their generous provision of equipment to support RCS Education For providing essential equipment and consumables for the course For more information on how you can help to support and advance surgical education please visit:

3 Course Programme Surgical Training for Austere Environments Day One: Airway, Breathing and Circulation Time Content Room Registration and Refreshments RECP Introduction and Course Themes LT Damage Control LT Anaesthetics in the Austere Environment LT 0900 Changing and moving to lab Management of the Airway Cricothyroidotomy Tracheostomy THORACOTOMY FOR CHEST INJURIES Left Anterolateral Thoracotomy Clamshell Thoracotomy Repair of Atrial and Ventricular Injuries The Hilum Pulmonary Injuries Closure and Drains Coffee 4FRA Vascular Didactic Neck Injuries Carotid Patching Techniques Lunch Exposure of Subclavian artery Exposure of Axillary artery Brachial Vessels Patch Repair Brachial Artery Arm Fasciotomy

4 Exposure of Groin Vessels Shunting of Groin Vessels Refreshments Thigh and Leg Fasciotomy End to End Anastomosis Vein Patch Reversed Vein Bypass Vascular Shunts Surgical Training for Austere Environments Refreshments 4FRA Paediatric Surgery and anaesthesia LT 1900 Finish

5 Day Two: General Surgery and Facial Trauma Time Content Room 0750 Signing in & Refreshments Ballistics LT Appendicectomy Hernia Repair Trauma Laparotomy: Supracoeliac compression Pelvic Trauma: Internal iliac ligation Stomach Injuries, Splenectomy Management of Liver Injuries Duodenal Injury Pancreatic Injury Refreshments R to L Visceral Medial Rotation/IVC Repair Renal Repair and Nephrectomy Small Bowel Resection and Anastomosis Lunch Right Hemicolectomy and anastomsis Left hemicolectomy and Hartmanns procedure Rectal Injuries Stomas, Ileostomy and Colostomy Demo: component separation Neurosurgery Refreshments Maxillo facial Injuries Teeth wiring Maxillary wiring Eye Injuries 1800 Finish

6 Day Three: Plastic Surgery Time Content Room Signing in & Refreshments Programme overview Burns Flaps lecture - key points Defects you need to be able to fill SKIN GRAFT : split skin Full thickness Pinch Grafts LOWER LIMB 1: Defect upper third leg medial gastroc flap Refreshments LOWER LIMB 2: Defect middle third leg fasciocutaneous perforator flap soleal flap LOWER LIMB 3: Defect Lower Third Saphenous flap Cross leg flap Sural Flap Lunch

7 HAND: groin flap Upper limb: Defect arm/forearm adhoc perforator flap Refreshments 4FRA Upper limb/shoulder/chest defect lat dorsi flap Deltopectoral flap WSSC Lecture: Random pattern flaps for face / small defects Rhomboid/Bilobe/ Z plasty LT Tendon repair Large nerve repair 1800 Finish

8 Day Four: Orthopaedic Trauma Time Content Room Signing in & Refreshments Orthopaedic lecture Management of upper limb and lower limb injuries s When to use plastering and skin traction Examples How to do it Fracture management When to do traction, when to do external fixation s Examples How to do it Lunch Damage Control Pelvic Trauma and ex fix Internal Fixation sign nail s Management of fracture using K wires Examples How to do it Management of Osteomyelitis and Chronic Wounds Advanced Wound Debridement Refreshments Amputations Digit BKA AKA Forequater s

9 Hindquarter Surgical Training for Austere Environments 1730 Course conclusion: What happens next?

10 Day Five: Obstetrics and Gynaecology Registration and refreshments Welcome and introduction Managing the difficult Caesarean Section Caesarean Hysterectomy Ruptured Uterus Break Order of training rotations You will be split into 3 groups (A, B and C). Your group will be identified by the colour of your badge. The station names will be up on the wall outside each room. Group A Red Group B Green Group C Blue Normal Delivery Stations Fully Dilated Section Post Partum Haemorrhage A B C C A B B C A Lunch

11 Difficult Delivery C-section floating head and Breech Stations Perineal Trauma Destructive Craniotomy A B C C A B B C A Break Gynaecology Stations Neonatal Resuscitation 10 cases A B C C A B B C A Feedback and Close Meeting Key to Rooms Manchester Surgical Skills and Simulation Centre, 3 rd Floor RECP Ground floor reception, Stopford Building LT