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Development of a dedicated ‘drive-through’ pathway for neonates with bilious vomiting: a prospective cohort study
  1. Catherine Dixon1,
  2. Harmit Ghattaura2,
  3. Susan Lloyd1,
  4. David Grant3,
  5. Eleri Adams1,
  6. Kokila Lakhoo2,4
  1. 1 Department of Neonatology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
  2. 2 Department of Paediatric Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
  3. 3 Department of Paediatric Radiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
  4. 4 Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
  1. Correspondence to Harmit Ghattaura, Department of Paediatric Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; ghattaura{at}doctors.org.uk

https://doi.org/10.1136/archdischild-2023-326415

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    We report the findings of our multidisciplinary, polyperspective, collaborative quality improvement project.

    Infants with bile-stained vomit require an upper gastrointestinal (GI) contrast and review by a paediatric surgeon to exclude a midgut volvulus due to malrotation. Surgical and radiological findings of this potentially fatal condition1 are shown in figure 1. At our institution, a patient referred from a local neonatal unit (LNU) with bilious vomiting would be reviewed by the Southampton Oxford Neonatal Transport team (SONeT). SONeT would stabilise the baby and transfer to a surgical cot in the John Radcliffe Newborn Care Unit (NNU) where tertiary services are located. The baby would be prepared for contrast study; accompanied by two porters, a registrar and nurse to the …

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    Footnotes

    • Contributors CD: idea for the article, design, implementation, data collection, data analysis, writing. HG (corresponding author): idea for the article, design, implementation, data analysis, writing. SL: idea for the article, design, implementation. DG: idea for the article, design, implementation. EA: design, implementation, supervision and senior author. KL: design, implementation, supervision and senior author.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer-reviewed.