Postoperative electrolyte management: Current practice patterns of surgeons and residents

Area of Science:

• Medical Education
• Surgical Practice
• Patient Management

Background:

• Postoperative electrolyte imbalances are common and management is often based on tradition rather than evidence.
• There is a need to assess current practices in managing postoperative electrolytes among surgical trainees and attending physicians.

Purpose of the Study:

• To evaluate the current practice patterns of postoperative electrolyte management among surgeons and residents.
• To identify areas for improvement in the education and management of electrolyte imbalances in surgical patients.

Main Methods:

• An online survey was administered to attending surgeons and residents at the University of Toronto.
• The survey included questions on workload, decision-making in clinical scenarios, and perceived needs for improvement.

Main Results:

• A 67% response rate (156/232) was achieved, with junior residents predominantly managing electrolytes, often with senior resident supervision.
• Many residents lacked awareness of attending surgeon involvement and formal training in electrolyte replacement, yet reported high confidence.
• Discrepancies were noted between resident and attending surgeon approaches in hypothetical scenarios, with a protocol favored for improvement.

Conclusions:

• Electrolyte management is a significant part of surgical workload, with residents often lacking formal training but feeling competent.
• Resident practices in electrolyte management are variable and may not align with evidence-based recommendations.
• A structured framework is needed to enhance knowledge, training, and reduce interventions for optimal postoperative electrolyte management.