Almost all operations, are completely successful. This is in no small part due to the skill of the surgeons, however, inevitably errors can occur. As a procedure there is a requirement to fit surgical clips, the surgeon clips the cystic duct in two places. One is near the cystic duct’s juncture with the gallbladder, and the second is at the cystic duct’s juncture with the common bile duct. The surgeon similarly also clips the cystic artery. The surgeon then transects (cuts) the cystic duct and artery between the two clips. By transecting the cystic duct and artery, the surgeon releases the gall bladder for removal from the abdominal cavity.It’s a lot easier to say than it is to do. It is plan which relies on all parts to go correctly or it will fail utterly. The surgeon must find and identify the cystic duct’s juncture with the gall bladder and the cystic duct’s juncture with the common bile duct before transecting the cystic duct.
The surgeon achieves this by finding the gall bladder and the cystic duct juncture; and then meticulously tracing the cystic duct to its junction with the common bile duct. The objective is to identify the cystic duct conclusively. The surgeon must not clip the cystic duct or transect it before making conclusive identification of the cystic duct.
The most common area for fault as you can probably guess, is that the surgeon clips or cuts the patient’s common bile duct instead of the cystic duct. This injury usually requires extensive, complicated and painful surgery to reconstruct the patient’s biliary system.
The biggest issue here is often the patient is actually discharged without a recognition that the injury has occurred. Once the injury is diagnosed, the patient is often in extreme pain and discomfort. Once the patient’s biliary anatomy has been reconstructed, there will be a long period of convalescence.
If the patient is not diagnosed quickly the results can often be fatal.
Often the gall bladder surgery litigation in which we are involved focuses on that one issue – that the surgeon failed to conclusively identify the cystic duct and or did not diagnose the injury caused by that failure. As a result, the surgeon may have placed clips across the common bile duct, obstructing the flow of bile or transected the patient’s common bile duct, resulting in the flow of bile into the patient’s abdomen with consequent sepsis.
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What is a community nurse?
Community nurse roles and responsibilities
A community nurse is responsible for performing many of the same duties as a district nurse. These include basic care (checking temperature, blood pressure and breathing), wound management, administering injections, setting up intravenous drips and assisting doctors with examinations and medical procedures. Community-based nurses are also able to provide vital information to clients, their families and carer/s, much in the same way as district nurses, while emergencysupport may also be required in cases when a patient is suffering cardiac arrest or a stroke. This demonstrates the many hats a community nurse must don in their line of care.
So what is the difference between community and district nurses?
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