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Aims/Background Symptomatic abdominal aortic aneurysms carry significant mortality risk. This is supplemented by the Royal College of Emergency Medicine guidelines which suggest imaging for patients 50 years of age or older presenting with unexplained abdominal, flank, or back pain. This study aimed to evaluate the prevalence and mortality rates of patients with symptomatic abdominal aortic aneurysms in a high-risk population and to assess scanning rates in the accident and emergency department. Methods Retrospective analysis of patients presenting to the accident and emergency department at a district general hospital over 6 months was performed. Patients 50 years of age or older presenting with abdominal, flank, or back pain were included. Collected data points included; whether or not a scan was performed in the emergency department, the modality of imaging, whether an abdominal aortic aneurysm was identified on the scan, the age of patients with an abdominal aortic aneurysms identified on the scan, size of the identified abdominal aortic aneurysms, primary diagnosis at the time of review in the emergency department, and all-cause mortality rates. Results 361 patients were identified to have an indicated scan, of which only 122 (33.8%) had a scan in the emergency department. In the syndromic group, the prevalence and 30-day mortality of patients with an abdominal aortic aneurysm were 5.5% and 1.1% respectively. Only 12 out of 20 patients with an abdominal aortic aneurysm were identified in the emergency department. Conclusion The criteria outlined by the Royal College of Emergency Medicine does well at identifying patients with abdominal aortic aneurysms when followed. However, this study reveals that scanning rates in the emergency department are low. The encouragement of scanning and improved ultrasound skills among emergency medicine clinicians can reduce missed diagnoses. Additionally, we recommend further studies to assess the mortality rates of emergent abdominal aortic aneurysm presentations. [ABSTRACT FROM AUTHOR]

Aims/Background: Feedback from foundation trainees in Blackpool highlighted low levels of confidence with the prospect of surgical on-call shifts. Key areas of concern were assessing and managing the acute surgical patient, identifying which patients need an operation and having the technical skills to proficiently assist in theatre. This lack of confidence prevents trainees engaging in what should be an educational and rewarding rotation. Methods: The authors designed and facilitated a day of workshops, addressing these key educational needs. Bespoke to the trust's services, lectures were delivered by core surgical trainees on the assessment and management of acute surgical patients in general surgery, urology and trauma and orthopaedics. For the development of technical skills, an afternoon of surgical skills workshops covered suturing, knot tying, laparoscopic principles and theatre etiquette. Small groups of foundation trainees rotated through each workshop, delivered by surgical registrars (ST3+), to ensure high fidelity training. Results: Pre- and post-course questionnaires assessed the efficacy of teaching. Out of a total of 72 foundation trainees, 55 attended the teaching day, of which 45 (81.8%) completed pre- and post-course surveys using a six-point modified Likert scale. Rates for satisfactory confidence levels while on-call improved from 66 to 100% of participants after the course. Suturing skills satisfaction rose from 37.5 to 100%, among other impact markers. Discussion: All trainees that attended the course displayed a marked improvement. This course is now being incorporated into foundation teaching programmes at a regional level and has scope to be expanded nationally. [ABSTRACT FROM AUTHOR]