DOI: 10.1093/bjs/znad241.483 ISSN:

356 Registrar confidence levels managing paediatric surgical patients in a busy district general hospital

Jayan George, Charlie Leeman, Ahmad Hisham Wafai, Antonia Durham-Hall
  • Surgery



The abdominal pain pathway and appendicitis toolkit (APPAT) was developed to harmonise care across our region, reduce the negative appendicectomy rate, identify appendicitis accurately and increase the number of children undergoing a laparoscopic procedure.



Doctors were surveyed in January 2023. Two questions used Likert scales (1 to 5: not at all confident to very confident) in assessing paediatric patients. Three closed questions to assess the use of guidelines. Nine open questions to assess the network appendicitis tool. Data was initially inputted using Google Docs and analysed in Microsoft Excel.


7 registrars (7/13) completed the questionnaire.

The majority of registrars felt very confident (5) assessing paediatric patients aged 8-16.

Few registrars use any guidelines or pathways when assessing a patient with abdominal pain (1/7).

Most registrars do not use a scoring system to assess for appendicitis (4/7).

No registrars were able to accurately answer all aspects of the local network tool.

No registrar was able to answer the low, medium or high-risk score of the tool.


Registrars feel confident assessing paediatric patients. Most registrars do not use scoring systems to assess these patients. Awareness and accuracy of the specific parameters of APPAT were low. Further awareness and education may support the management of these patients.

More from our Archive