![]() System-related delays include waiting for routine medical consultations or the unavailability of operating rooms or surgeons. Reasons for operative delay can be grouped into system-based or medical-based delays. Surgery beyond the 48-hour period has been shown to more than double the risk of postoperative complications such as pneumonia, urinary tract infections, deep vein thrombosis and pulmonary embolism 4, whilst earlier surgery results in reduced mortality and postoperative complications 5. Several large systematic reviews of neck of femur fracture (NOF) surgery have demonstrated that operative delays beyond 48 hours results in increased morbidity and mortality 1-3. Patient has never had an echocardiogram before. Patient is breathless at rest or on low level exertionĬ. Patient has a previous history of ischaemic heart diseaseī. In this case, the 2011 AAGBI guidelines recommend a preoperative echocardiogram is indicated if:Ī. ![]() On examination of a patient with a NOF fracture, you have discovered a heart murmur.Haemoglobin concentration less than 8 g/ dL Which of the following do the 2011 Association of Anaesthetists of Great Britain and Ireland (AAGBI) guidelines consider to be an unacceptable reason for delaying surgery?Ī.Delayed surgery for neck of femur fractures (NOFs) beyond what period of time is associated with increased mortality and morbidity?.The answers can be found at the end of the article, together with an explanation. Before continuing, try to answer the following questions.
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