The development of a nurse-led preoperative anaesthesia screening tool by Delphi consensus.

Background: Low- and middle-income countries have a critical shortage of specialist anaesthetists. Most patients arriving for surgery are of low perioperative risk. Without immediate access to preoperative specialist care, an appropriate interim strategy may be to ensure that only high-risk patients are seen preoperatively by a specialist.

An unusual case of frost bite autoamputation of toes.

Background: We report a case of a 15 year old young female who suffered autoamputation of left mid foot and four digits of right foot following repeated application of snow to relieve the pain in her frost bitten feet.

Case Presentation: The sociodemographic background, cause, resulting injury and subsequent management are discussed.

Conclusion: Such injuries are relatively rare but awareness of the risk of this type of injury is important.