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Airway and head and neck high dependency unit: a single-centre experience

Published online by Cambridge University Press:  07 July 2016

M Bannister ,
P Trotter ,
A Jawad  and
D Y Veitch
M Bannister*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Aberdeen Royal Infirmary, Scotland, UK
P Trotter
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Aberdeen Royal Infirmary, Scotland, UK
A Jawad
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Aberdeen Royal Infirmary, Scotland, UK
D Y Veitch
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Aberdeen Royal Infirmary, Scotland, UK
*
Address for correspondence: Mr Miles Bannister, Department of Otolaryngology – Head and Neck Surgery, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB25 2ZN, Scotland, UK E-mail: [email protected]
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Abstract

Objective:

Dedicated otolaryngology high dependency units are uncommon. This paper reports the first experiences of such a facility in the UK, assessing reason for admission, duration of stay, occupancy rate and need for care escalation. The study sought to assess the presence of similar units in the UK.

Methods:

A retrospective review of high dependency unit admissions over an 18-month period and a national survey of otolaryngology departments in the UK were conducted to establish the overall presence and location of similar high dependency units.

Results:

A total of 128 patients were admitted during the study period, mainly following surgery and because of airway compromise. The average duration of stay was 2–3 days (range, 1–12 days). The occupancy rate was 31.7 per cent. No patients required their care to be escalated to the intensive care unit. Seven similar high dependency units were identified in the UK.

Conclusion:

The care provided prevented the need for escalation of care to an intensive care unit. This challenges the need for patient management on intensive care units following major surgery or airway compromise for those not requiring assisted ventilation. High dependency units similar to ours are not widespread.

Keywords

Wounds And Injuries; Tracheostomy; Perioperative Care; Reconstructive Surgical Procedures; Oral Surgical Procedures; Laryngectomy; Neck Dissection
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 8 , August 2016 , pp. 777 - 780
Copyright
Copyright © JLO (1984) Limited 2016 

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Footnotes

Presented at the ENT Scotland Winter Meeting, 21 November 2014, Stirling, Scotland, UK.

References

1 Crosby, DL, Rees, GA. Post operative care: the role of the high dependency unit. Ann R Coll Surg Engl 1983;65:391–3Google Scholar
2 Houghton, PW, Donaldson, LA, Crumplin, MK. The role of the intensive care unit in a district hospital. Ann R Coll Surg Engl 1984;66:46–8Google Scholar
3 Nehra, D, Crumplin, MK, Valijan, A, Edwards, AE. Evolving role of intensive and high-dependency care. Ann R Coll Surg Engl 1994;76:9–13 Google Scholar
4 Batra, GS, Molyneux, J, Scott, NA. Colorectal patients and cardiac arrhythmias detected on the surgical high dependency unit. Ann R Coll Surg Engl 2001;83:174–6Google Scholar
5 Robertson, SA, Skipworth, RJ, Clarke, DL, Crofts, TJ, Lee, A, De Beaux, AC et al. Ventilatory and intensive care requirements following oesophageal resection. Ann R Coll Surg Engl 2006;88:354–7Google Scholar
6 Chong, JL, Pillai, R, Fisher, A, Grebenik, C, Sinclair, M, Westaby, S. Cardiac surgery: moving away from intensive care. Br Heart J 1992;68:430–3Google Scholar
7 Ghosh, S, Steyn, RS, Marzouk, JF, Collins, FJ, Rajesh, PB. The effectiveness of high dependency unit in the management of high risk thoracic surgical cases. Eur J Cardiothorac Surg 2004;25:123–6Google Scholar
8 Thompson, FJ, Singer, M. High dependency units in the UK: variable size, variable character, few in number. Postgrad Med J 1995;71:217–21Google Scholar
9 Marsh, M, Elliott, S, Anand, R, Brennan, PA. Early postoperative care for free flap head & neck reconstructive surgery--a national survey of practice. Br J Oral Maxillofac Surg 2009;47:182–5Google Scholar
10 Godden, DR, Patel, M, Baldwin, A, Woodwards, RT. Need for intensive care after operations for head and neck cancer surgery. Br J Oral Maxillofac Surg 1999;37:502–5Google Scholar
11 Mathew, SA, Senthilnathan, P, Narayanan, V. Management of post-operative maxillofacial oncology patients without the routine use of an intensive care unit. J Maxillofac Oral Surg 2010;9:329–33Google Scholar
12 Harréus, U. Surgical errors and risks - the head and neck cancer patient. GMS Curr Top Otorhinolaryngol Head Neck Surg 2013;12:Doc04Google Scholar
13 Ghosh, S, Torella, F, de Cossart, L. The surgical high dependency unit: an educational resource for surgical trainees. Ann R Coll Surg Engl 2004;86:44–6Google Scholar