A fall of less than two metres is the most common mechanism of injury in older patients. Prehospital triage to aid early identification of severe injuries in older patients should be available to allow quick transfer from TU to a MTC for specialist investigation and intervention.92
Hospitals must have guidelines in place to ensure the safety of children admitted to hospital, to monitor injured children known to be at risk, and identify concerns arising from any injury or pattern of injuries.86 They must provide the appropriate training related to these guidelines.
Agreed internal referral pathways to other specialties should be in place for the minority of cases in which this may be required to expedite further investigation and patient optimisation. This should be done in close collaboration between the preoperative assessment lead and nominated representatives from appropriate specialties (e.g. cardiology, diabetes, renal, respiratory and geriatric medicine).
Nurturing a safety culture, learning from mistakes, preventing harm and working as part of a team are all part of the discipline of safety. To this end, shared learning and quality improvement that contribute towards improvements in safety, such as critical incident reporting with thematic analysis, and communication through morbidity and mortality meetings, could be undertaken.
Like Alexander of Macedon, the new curriculum has swept all before it. For Egypt, read regional anaesthesia; for the sacked cities of Tyre and Persepolis, read the subspecialties.
Although Pain may seem distant, much like Alexander reached India, the new curriculum has reached it.
In 2010 Pain featured as a module requiring a sign off (with 17 syllabus points) and Intermediate Level (18), and was optional at Higher and Advanced.
This has been replaced by compulsory HALOs at Stages 1, 2 and 3, with new and more generalised curriculum points.
