Assessment of the emergency surgical patient

In 2011 the Royal College of Surgeons of England and the Department of Health published a report on the perioperative care of the higher risk general surgical patient. In the same year a National Confidential Enquiry into Patient Outcome and Death report looked into the process of care for patients undergoing surgery and highlighted areas which could be improved. Both bodies have highlighted steps needed to ensure that the risk of further deterioration in high-risk patients is matched with urgency of diagnostic testing, seniority of clinician in decision-making, timing of surgery and crucially, appropriate clinical location for postoperative care. Assessment of the emergency surgical patient should be performed and repeated throughout the patient pathway. Timely gathering of relevant information and simultaneous optimization of the patient for anaesthesia and surgery are required. A formal risk assessment score should be used to guide perioperative management, inform the patient and improve outcomes.