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One Stop Wide Awake Surgery
One Stop Wide Awake (OSWA) is a surgical model which was initially developed for hand surgery in the United Kingdom. It is recognized as effective by the Royal Society of Medicine. The model centres on complete surgical care within one management stop, and with reduced risks due to the avoidance of general anesthesia, regional anaesthesia, sedation, and tourniquets. This approach to surgery is particularly cost-effective and efficient. It enables complex procedures such as for Dupuytren's contracture to be performed as outpatient procedures under local anaesthesia. With the changes in UK healthcare commissioning and the evolution from primary care trusts to clinical commissioning groups from 2013, this model of surgery is likely to be increasingly important, and may secure the funding of some NHS The National Health Service (NHS) is the term for the publicly funded health care, publicly funded healthcare systems of the United Kingdom: the National Health Service (England), ...
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Surgery
Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery such as gastric bypass), to reconstruct or alter aesthetics and appearance (cosmetic surgery), or to remove unwanted tissue (biology), tissues (body fat, glands, scars or skin tags) or foreign bodies. The act of performing surgery may be called a surgical procedure or surgical operation, or simply "surgery" or "operation". In this context, the verb "operate" means to perform surgery. The adjective surgical means pertaining to surgery; e.g. surgical instruments, operating theater, surgical facility or surgical nurse. Most surgical procedures are performed by a pair of operators: a surgeon who is the main operator performing the surgery, and a surgical assistant who provides in-procedure manual assistance during surgery. Modern surgical opera ...
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Hand Surgery
Hand surgery deals with both surgical and non-surgical treatment of conditions and problems that may take place in the hand or upper extremity (commonly from the tip of the hand to the shoulder), American Society for Surgery of the Hand. Retrieved on 2011-02-24. including injury and infection. Hand surgery may be practiced by post graduates of orthopedic surgery and plastic surgery and MCh Hand surgery. Plastic surgeons and orthopedic surgeons receive significant training in hand surgery during their residency training. Also, some graduates do an additional one-year hand fellowship. Board certified general, plastic, or orthopedics surgeons who have completed approved fellowship training in hand surgery and have met a number of other practice requirements are qualified to take the "Certificate of Added Qualifications in Surgery of the Hand" examination, formerly known as the CAQSH, it is now known as the SOTH." Now super speciatity training called MCh Hand Surgery required to be ...
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Royal Society Of Medicine
The Royal Society of Medicine (RSM) is a medical society based at 1 Wimpole Street, London, UK. It is a registered charity, with admission through membership. Its Chief Executive is Michele Acton. History The Royal Society of Medicine (RSM) was formed in 1907 when 17 individual medical societies merged with the Royal Medical and Chirurgical Society of London (RMCS), reflecting the growing acceptance of medical specialties at that time. Key figures in its founding included John MacAlister, the resident librarian at the RMCS since 1886, and his supporters Sir Richard Douglas Powell, Sir William Selby Church and Sir William Osler. 19th century Although the Society became the RSM in 1907, it is generally accepted by its historians that the origins date back to 1805, when John Yelloly, Alexander Marcet and William Saunders left the Medical Society of London (MSL) as a protest against its president James Sims, and created the Medical and Chirurgical Society of Lon ...
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General Anesthesia
General anaesthesia (UK) or general anesthesia (US) is medically induced loss of consciousness that renders a patient unarousable even by painful stimuli. It is achieved through medications, which can be injected or inhaled, often with an analgesic and neuromuscular blocking agent. General anaesthesia is usually performed in an operating theatre to allow surgical procedures that would otherwise be intolerably painful for a patient, or in an intensive care unit or emergency department to facilitate endotracheal intubation and mechanical ventilation in critically ill patients. Depending on the procedure, general anaesthesia may be optional or required. No matter whether the patient prefers to be unconscious or not, certain pain stimulus, pain stimuli can lead to involuntary responses from the patient, such as movement or muscle contractions, that make the operation extremely difficult. Thus, for many procedures, general anaesthesia is necessary from a practical point of view. The p ...
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Regional Anaesthesia
Local anesthesia is any technique to induce the absence of sensation in a specific part of the body, generally for the aim of inducing local analgesia, i.e. local insensitivity to pain, although other local senses may be affected as well. It allows patients to undergo surgical and dental procedures with reduced pain and distress. In many situations, such as cesarean section, it is safer and therefore superior to general anesthesia. The following terms are often used interchangeably: * ''Local anesthesia'', in a strict sense, is anesthesia of a small part of the body such as a tooth or an area of skin. * ''Regional anesthesia'' is aimed at anesthetizing a larger part of the body such as a leg or arm. * ''Conduction anesthesia'' encompasses a great variety of local and regional anesthetic techniques. Medical A local anesthetic is a drug that causes reversible local anesthesia and a loss of nociception. When it is used on specific nerve pathways (nerve block), effects such as an ...
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Sedation
Sedation is the reduction of irritability or agitation by administration of sedative drugs, generally to facilitate a medical procedure or diagnostic procedure. Examples of drugs which can be used for sedation include isoflurane, diethyl ether, propofol, etomidate, ketamine, pentobarbital, lorazepam and midazolam. Medical uses Sedation is typically used in minor surgical procedures such as endoscopy, vasectomy, or dentistry and for reconstructive surgery, some cosmetic surgeries, removal of wisdom teeth, or for high-anxiety patients. Sedation methods in dentistry include inhalation sedation (using nitrous oxide), oral sedation, and intravenous (IV) sedation. Inhalation sedation is also sometimes referred to as "relative analgesia". Sedation is also used extensively in the intensive care unit so that patients who are being mechanical ventilation, ventilated tolerate having an endotracheal tube in their vertebrate trachea, trachea. It can also be used during a long term brain EEG ...
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Tourniquet
A tourniquet is a device that is used to apply pressure to a limb or extremity in order to create ischemia or stopping the flow of blood. It may be used in emergencies, in surgery, or in post-operative rehabilitation. A simple tourniquet can be made from a stick and a rope, but the use of makeshift tourniquets has been reduced over time due to their ineffectiveness compared to a commercial and professional tourniquet. This may stem the flow of blood, but side effects such as soft tissue damage and nerve damage may occur. History During Alexander the Great’s military campaigns in the fourth century BC, tourniquets were used to stanch the bleeding of wounded soldiers. Romans used them to control bleeding, especially during amputations. These tourniquets were narrow straps made of bronze, using only leather for comfort. In 1718, French surgeon Jean Louis Petit developed a screw device for occluding blood flow in surgical sites. Before this invention, the ''tourniquet' ...
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Outpatient Procedure
A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health care provider. Etymology The word patient originally meant 'one who suffers'. This English noun comes from the Latin word , the present participle of the deponent verb, , meaning , and akin to the Greek verb ( ) and its cognate noun (). This language has been construed as meaning that the role of patients is to passively accept and tolerate the suffering and treatments prescribed by the healthcare providers, without engaging in shared decision-making about their care. Outpatients and inpatients An outpatient (or out-patient) is a patient who attends an outpatient clinic with no plan to stay beyond the duration of the visit. Even if the patient will not be formally admitted with a note as an outpatient, their attendance is s ...
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Local Anaesthesia
Local anesthesia is any technique to induce the absence of sensation in a specific part of the body, generally for the aim of inducing local analgesia, i.e. local insensitivity to pain, although other local senses may be affected as well. It allows patients to undergo surgical and dental procedures with reduced pain and distress. In many situations, such as cesarean section, it is safer and therefore superior to general anesthesia. The following terms are often used interchangeably: * ''Local anesthesia'', in a strict sense, is anesthesia of a small part of the body such as a tooth or an area of skin. * ''Regional anesthesia'' is aimed at anesthetizing a larger part of the body such as a leg or arm. * ''Conduction anesthesia'' encompasses a great variety of local and regional anesthetic techniques. Medical A local anesthetic is a drug that causes reversible local anesthesia and a loss of nociception. When it is used on specific nerve pathways (nerve block), effects such as an ...
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Primary Care Trust
Primary care trusts (PCTs) were part of the National Health Service in England from 2001 to 2013. PCTs were largely administrative bodies, responsible for commissioning primary, community and secondary health services from providers. Until 31 May 2011, they also provided community health services directly. Collectively PCTs were responsible for spending around 80 per cent of the total NHS budget. Primary care trusts were abolished on 31 March 2013 as part of the Health and Social Care Act 2012, with their work taken over by clinical commissioning groups. Establishment In 1997 the incoming Labour Government abolished GP Fundholding. In April 1999 they established 481 primary care groups in England "thereby universalising fundholding while repudiating the concept." Primary and community health services were brought together in a single Primary Care Group controlling a unified budget for delivering health care to and improving the health of communities of about 100,000 people. A ...
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Clinical Commissioning Group
Clinical commissioning groups (CCGs) were National Health Service (England), National Health Service (NHS) organisations set up by the Health and Social Care Act 2012 to replace Strategic health authority, strategic health authorities and NHS primary care trust, primary care trusts to organise the delivery of NHS services in each of their local areas in England. On 1 July 2022, they were abolished and replaced by integrated care systems as a result of the Health and Care Act 2022. Establishment The announcement that GPs would take over this commissioning role was made in the 2010 white paper "Equity and Excellence: Liberating the NHS". This was part of the government's stated desire to create a clinically driven commissioning system that was more sensitive to the needs of patients. The 2010 white paper became law under the Health and Social Care Act 2012 in March 2012. At the end of March 2013 there were 211 CCGs, but a series of mergers had reduced the number to 135 by April 2 ...
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