O059 Introduction of the SHOUT protocol in the early post-operative period following carotid surgery

Abstract

Abstract Introduction The SHOUT protocol acts as a tool for assessing risk to the airway following anterior neck surgery. While this tool is commonly used in other specialities, we have introduced the protocol for regular use in the post-operative period in carotid surgery. Methods The SHOUT protocol was included in the operative notes of all patients undergoing carotid intervention, allowing all members of the post-operative team to be aware of major warning signs. A Retrospective review of all patients undergoing carotid artery intervention between November 2018 and June 2022 was completed. Results A total of 216 patients underwent carotid artery intervention, 100 had intervention before the application of the SHOUT protocol (Group A), all having endarterectomies. 116 patients were treated after the introduction of the protocol (Group B), consisting of 112 endarterectomies and 4 stents. In Group A, 9 patients (9%) required reimaging for urgent neurological symptoms, and 2 (22%) of them had new stroke findings and were managed medically. 3 patients underwent urgent surgical re-intervention; 2 returned to theatre without imaging due to significant hematoma. In Group B, 11 patients (9.4%) required reimaging, 3 (27.2%) had new stroke findings and were managed medically, while only one patient (0.8%) needed surgical re-intervention for haematoma evacuation. Conclusion The SHOUT protocol is a simple tool that aids all members of the post-operative team in the early recognition of potential time-sensitive complications. Early recognition allows for more time to formulate and execute the appropriate management plan.