Revisiting the Great Ormond Street Hospital protocol for ward decannulation of children with tracheostomy.

Introduction: Tracheostomy decannulation is an important and final step in managing patients once the underlying issue requiring a tracheostomy resolves. However, no consensus exists on the optimal method to decannulate a paediatric patient. We revisit the Great Ormond Street Hospital (GOSH) tracheostomy decannulation protocol, a 5-day process involving downsizing the tracheostomy tube, capping, and observation, to evaluate its effectiveness and assess if changes to the protocol are required.

Omental infarction mimicking acute appendicitis with negative radiological findings.

A male in his 30s presented to the emergency department with a 1-day history of supra-umbilical pain migrating to the right iliac fossa. On examination, his abdomen was soft but tender with localised guarding in the right iliac fossa and a positive Rovsing's sign. The patient was admitted under a presumptive diagnosis of acute appendicitis.