WTP1.04 Basic Surgical Skills in Emergency Department

Managing various types of wound is one of the most common challenges encountered acutely in the Emergency department. Relevant surgical skills is critical in the appropriate and timely management of wounds. The aim of the project was to capture weaknesses, strengths and recognize room for progress. Based on RCEM and NICE guidelines, clinicians in the emergency department were approached with Google Survey, and their expertise of surgical skills explored. Results showed:36 clinicians responded: foundation trainees (41.7%), registrars (27.8%), locally employed doctors (25%).When it came to surgical skills and suture materials, 55.6% incorrectly chose tapered needles for skin, and 38.9% chose cutting, reverse-cutting needles for fragile tissues like bowel and blood vessels. 63.9% correctly chose use of mono-multi filament and 88.9% identified types of absorbable suture materials.Regarding surgical tools, some clinicians were unable to differentiate proper usage of the instruments - tissue scissors vs suture scissors (58.3%), non-toothed vs toothed forceps (52.8%), artery forceps vs needle holder (50%).Suturing techniques, 60.5% erroneously answered holding needle midpoint. 57.9% failed to distinguish role of vertical and horizontal mattress sutures. 86.8% aptly identified use of primary sutures.There was uncertainty in choice of sutures (25%) and suture removal time (66.7%), In conclusion,There is much puzzlement about suture materials (needles, sutures, instruments) and their appropriate usage, Slight improvement in suture patterns and their applications. However, surgical skills questions demonstrated deficit in basic principles. The audit has highlighted there’s much room for improvement. Reaudit planned after teaching and workshops of basic surgical skills.