Surgical Admission Basics for the OSCE

Because surgeons like failing people who don’t list everything off

Bloods everyone gets

  1. FBP
  2. UEC
  3. CRP
  4. LFT – sepsis deranges LFTs and is a useful cover-all if asked to justify the test
  5. Coags – pre-operative standard, also if warfarin or liver pathology
  6. Group and hold +/- cross match – preoperative standard
  7. B-HCG – every female with an acute abdomen gets this
  8. Lipase and amylase

Other Ix everyone gets

  1. ECG – Pre-operative standard in anyone >50yo as per ASA guidelines. Everyone with epigastric pain scores this.
  2. CXR – Pre-operative standard in anyone >75yo as per ASA guidelines. Everyone with epigastric pain scores this. Every ? perforation gets this.
  3. CT abdomen – if oyung, don’t order unless they really need one
  4. U/S for biliary pathology
  5. AXR for obstruction

What You Need To Say You Would Do As A JMO

  1. Admit
  2. Resuscitate
  3. Call the surgeon
  4. IVC and fluids if needed
  5. Drugs
    1. Analgesia
    2. Antiemetics
    3. Antibiotics
  6. Anticoagulation
    1. Heparin and TEDS
  7. NPO + PPI
  8. Patient’s regular medication – ‘I would go through the patient’s regular medications and rationalise them’
  9. Adjuncts
    1. IDC
    2. NGT
  10. Discussion with surgeon about operation +/- consenting the patient
  11. Diabetic sliding scale if needed
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