March 2014

A 5-year-old patient presents for a myringotomy and grommet insertion as a day case. During your pre-operative assessment you notice that the patient has a nasal discharge.

a) Why would it be inappropriate to cancel the operation on the basis of this information alone? (25%)

b) List the features in the history (35%) & examination (25%) that might cause you to postpone the operation due to an
increased risk of airway complications in this patient.

c) What social factors would preclude this child’s treatment as a day case? (15%)
Pass Rate 44.7%

This question was answered poorly considering the issue is “meat and drink” to paediatric day case practice. The majority of candidates did not mention; emotional aspects, financial losses, parental work absence, school absence and inefficient use of hospital resources in the answer. The history section was poorly answered although examination features were more typically known. Surprisingly, social factors were infrequently given although these have a major impact on suitability as a daycase. Overall, there seem to be few candidates thinking about the organisational and logistical aspects of bringing a child in for daycase surgery.
September 2010

a) List the advantages of day case surgical management compared with inpatient care. (25%)

b) What are the prerequisites that make a surgical procedure suitable for day case management? (30%)

c) Summarise the discharge criteria that a patient needs to meet following a day case procedure. (35%)
Question11 Critical care/management of airway problem/tracheostomy

76.6% pass rate

In the main was a well-answered question