Emergency General Surgery Procedures Protocol Template

1. Initial Assessment and Triage

Priority Classification

• Level 1: Immediate surgical intervention (≤1 hour)
• Level 2: Urgent surgery (≤6 hours)
• Level 3: Semi-urgent surgery (≤24 hours)

Common Level 1 Emergencies

• Perforated viscus with septic shock
• Massive gastrointestinal hemorrhage
• Necrotizing soft tissue infections
• Acute mesenteric ischemia
• Traumatic abdominal injuries with hemodynamic instability

2. Pre-operative Protocol

Essential Steps

1. Rapid clinical assessment
2. Critical laboratory studies
   • CBC, CMP, Coagulation profile
   • Type and cross-match
   • Arterial blood gases
3. Immediate imaging (as appropriate)
   • FAST scan for trauma
   • CT with contrast if patient stable

Team Activation

• Primary surgeon notification
• Anesthesia team alert
• OR team mobilization
• Blood bank notification

3. Operating Room Preparation

Standard Emergency Cart Contents

• Emergency surgical instruments
• Vascular clamps and retractors
• Staplers and energy devices
• Emergency medications

Room Setup Requirements

• Rapid sequence intubation equipment
• Warming devices
• Cell saver (if indicated)
• Emergency blood products

4. Post-operative Care

Immediate Post-op Monitoring

• Vital signs q15min for 2 hours
• Fluid balance monitoring
• Pain management protocol
• Early warning score assessment

Documentation Requirements

• Operative notes within 24 hours
• Post-op orders
• Critical care pathway if applicable
• Handoff documentation

5. Quality Metrics

Time Benchmarks

• Door to OR time
• Team activation response time
• Post-op complication rate
• Length of stay

Monthly Review Process

• Case review meetings
• Protocol compliance audit
• Outcome assessment
• Process improvement initiatives