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EP-589 Acute Surgical Referrals from Emergency Department - A Retrospective Audit


 
 
 Emergency Department (ED) is a major source of admission for patients presenting with acute surgical issues. The Royal College of Surgeons of England recommends that a patient requiring an emergency surgical assessment, will receive an appropriate assessment within 30 minutes of referral being made in the case of life- or limb- threatening emergencies, and within 60 minutes for a routine emergency referral. However, there is a huge challenge to achieve this, given the limited time, capacity and resources, in ED and inpatient services. We aim to evaluate abdominal pain referral to general surgery from ED, with an emphasis on the initial diagnosis, admission rate, time from referral to assessment and operative management.
 
 
 
 All patients with abdominal pain who were referred to general surgeons, were retrieved from a local electronic database. Primary outcomes include the diagnosis for abdominal pain, admission rate, time from referral to surgical review and operative management.
 
 
 
 81 patients with abdominal pain were referred to general surgeons within a period of seven days. 56 patients (69.1%) had a surgical diagnosis, and 25 patients (30.9%) had a non-surgical diagnosis. 63 patients (77.8%) were admitted as inpatients and 16 patients (19.8%) were discharged. The time from referral to surgical review ranged between 5 minutes to 476 minutes (mean = 103 minutes). 16 patients (19.8%) had surgical intervention.
 
 
 
 The mean time from referral to surgical assessment is 103 minutes, which is longer than the standard recommendation from RCS England. Measures should be taken to expedite surgical assessment following referral from ED.
