Position Papers
12 Point Plan - Emergency General Surgery
Historically, a large proportion of a surgeon’s prestige is measured by prowess in elective surgical practice. Nonetheless, in General Surgery up to one third of surgical workload relates to management of emergencies.
Emergency General Surgery has been the “poor cousin” of elective General Surgery. It has often been relegated to out-of-hours and may have been performed by unsupervised junior staff. There is a wealth of international and Australian data demonstrating that this is associated with poor patient outcomes.
GSA, in conjunction with the membership, developed a consensus document relating to emergency General Surgery in the Australian context.
Twelve key points were identified and agreed upon resulting in the 12 Point Plan for Emergency General Surgery.
Incidence of testicular torsion has a bimodal age distribution, occurring in neonates, adolescents and young adults. In most cases, presentation occurs between the ages of 12 and 18 though age should not be used in making a diagnosis. Rotation of the spermatic cord results in ischaemia and subsequently infarction of the testis if perfusion is not re-established. If suspicion of testicular torsion exists, emergency assessment by the nearest available surgeon is mandatory.
The following Acute Scrotal Pain and Suspected Testicular Torsion Guidelines have been developed in conjunction with the RACS, NZAGS, ANZAPS, and USANZ.
Acute Scrotal Pain & Suspected Testicular Torsion
Surgery in Children and Adolescents
Access to specialised surgical care for children is a critical issue in Australia and Aotearoa New Zealand, where isolated populations can face long travel times to tertiary facilities. Surgery in children is provided by all nine surgical specialities of the Royal Australasian College of Surgeons (RACS). Aside from paediatric surgery, which is wholly concerned with the paediatric age group, each of these specialities performs a range of procedures within the paediatric age group, where perioperative care and admission needs differ in comparison to adult patients. Some of these conditions can be safely treated in regional and metropolitan centres; however, some require admission to tertiary and quaternary paediatric facilities.
The following Surgery in Children Position Paper has been developed in conjunction with the RACS, ANZAPS, and USANZ.
The position of the Royal Australasian College of Surgeons, which has been endorsed by GSA, is that surgeons and hospitals should employ the principles of effective waste management and sustainability in order to reduce the impact of surgery on the environment (RACS 2018). One suggested approach is to revisit and implement the simple principles of the ‘waste hierarchy’, which is underpinned by the five Rs – reduce, reuse, recycle, rethink and refuse.
Reusable Surgical Gowns
Decision Tree for Surgeons
In 2020, GSA developed a Decision Tree for Surgeons in response to the COVID-19 global pandemic.
- in contexts where only emergency or urgent procedures should be performed, two separate groups of patients must be taken into consideration – the delivery of emergency/urgent surgery for COVID-19+ve patients and COVID-19 –ve patients
- decisions need to deliver services equally to both groups