Annals of the Royal College of Surgeons of England
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Critical illness is an emergency because the inflammatory response has redundant multiple pathways; once triggered, it is difficult to control or suppress. Infection is a potent precursor of critical illness and increasing organ dysfunction has a synergistic, rather than purely additive, adverse effect on mortality. The longer the inflammatory process continues unabated, the more advanced and unrecoverable the pathophysiological processes become resulting in a high mortality. ⋯ Formalising measurement of physiological (in)stability on the general ward using Early Warning Scores improves recognition of unstable and potentially critically ill patients. Prompt intervention will either reverse further physiological decline or facilitate timely referral to the critical care service for further, more invasive, organ support.
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A study into how pre-operative skin preparation varies between surgical units and surgeons. ⋯ There is variation in the method of skin preparation employed between surgical units and surgeons. There is limited evidence-based research on this topic. Recommendations are made as to best practice.