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Introduction Presentation ICCU, SRH

Introduction Presentation ICCU, SRH. ABOUT US. 18 Beds ≈ 1000 admissions/yr (≈ 50:50 L2:L3) Anaesthesia trainees - Advanced, higher, intermediate, basic. ACCS - Anaes, EM, AM Foundation programme F1&F2 Medicine - Respiratory, Acute ICM - Stage 1,2 &3. Dr Laura O’Connor

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Introduction Presentation ICCU, SRH

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  1. Introduction Presentation ICCU, SRH

  2. ABOUT US

  3. 18 Beds • ≈ 1000 admissions/yr (≈ 50:50 L2:L3) • Anaesthesia trainees - Advanced, higher, intermediate, basic. • ACCS - Anaes, EM, AM • Foundation programme F1&F2 • Medicine - Respiratory, Acute • ICM - Stage 1,2 &3

  4. Dr Laura O’Connor 53274 Dr Laura O’Connor 53274

  5. And… • 4 Consultant microbiologists • ~100 nurses • Ward Manager • 1.5 physio • 1 dietician • 1/2 pharmacist • Clinical nurse educators • Research nurse • SNOD • Outreach • Rehab team

  6. Outreach • Senior nurses • First hospital in NE to have 24/7/365 cover • See all discharges from critical care & referrals • Referrals triggered by NEWS or concerns • You are often their first point of call for often difficult ward decisions, which can be political rather than clinical……be supportive

  7. Unit Layout

  8. Interview Rooms (x2) C-Level Corridor Dave & Aly’s Office Lab, Storage Girl’s Changing Staff Room Boy’s Changing C-Level Theatres Reception Rooms 1-12b “Windy Cupboards” Rooms 17 - 18 Rooms 14-16 Outreach, Research, SNOD, Nurse Education

  9. C-Level Corridor C-Level Theatres

  10. C-Level Corridor C-Level Theatres

  11. C-Level Corridor C-Level Theatres

  12. C-Level Corridor C-Level Theatres

  13. Stairs Patients C-Level Corridor C-Level Theatres

  14. www.iccueducation.org.uk@iccueducation Password - Tippins45

  15. All educational opportunities are available to everyone, whether you’re doing icm or not.

  16. Simulation At least once during attachment Groups of ~3 Further training needs can be addressed with reasonable notice ‘Anaesthesia’ sessions by arrangement with Linda McGee or Keith Fordy

  17. Monthly Friday Mornings Last Friday of the month Open forum 0900 – 1100 Teaching 11-1200 If not doing ICM let Carolyn or Tony know if you want to attend

  18. Evidence based practice • Via the website: • http://www.iccueducation.org.uk/evidence-based-practice • Monthly blog • Please engage and leave a comment

  19. 5:15 • After the ward-round every day (imaging on a Monday) • Let someone in ICCU know if you want to attend, we’ll bleep you • 15 mins teaching and discussion

  20. Audit • If you want to do an audit in ICCU during your time in SRH let us know (Laura O’Connor is audit lead)

  21. ED If unsure take someone else

  22. Rebuild Paeds ED inc. resus Adult resus Adult ‘corridor’ ED Public Entrance ICCU Staff Entrance ICCU Visitors Entrance C-Level Theatres

  23. Airways and ed

  24. Difficult Airway Bag • Anaes / ICCU use only • LMA • Normal • Proseal • Intubating • OPAs • Selection of blades (inc straight & 3 and 4 McCoy) • Bougie • Stylets

  25. assistance • The ED nurses will assist (some re better than others). • There is no ‘floating ODP’ but overnight usually available. • Outreach will help if asked. • Do whatever you’re comfortable with.

  26. Cath Lab • B floor, end of cardiology ward (B21), not really • set up for intubation down there • If called then go as first responder, consider outreach • If in ED and patient going to cath lab contact ICCU cons immediately (24/7). Don’t delay by insertion of an A-line • If called to cath lab notify ICCU cons as soon as you get called • Same setup as for paeds calls

  27. Other bits and bobs

  28. Ooh Transfers • Call ICCU Consultant first • 1st on – anaes cons will attend if anything is happening in obs/theatres. • 2nd on – anaes cons will attend • ICCU res – ICCU cons will attend

  29. Handover • Deliberate Consultant absence. • Do not allow your colleague to leave until information has been adequately handed over. • For feedback about night shift speak to daytime cons after handover (we can’t give feedback if we don’t know what you’ve been up to)

  30. Sunderland-isms • Scrict colloid avoidance • HD rather than CVVF – RRT via renal • Epidurals

  31. For those doing an icm block

  32. Resident rota • Minimum 1 resident & 1 other • 1 other usually either F1 or F2 • F2 joins on call rota (weekend days and evenings) after approx 2 months • Overnight resident only • 1:5+

  33. Daily Routine • Handover 0800 until completed • Allocate patients • 0900 ward round • 1100 coffee and 5:15 • Sort your patients • Some time between 1700 and 1830 Consultant handover • Handover 2000 until completed • Medicus Instructions on Website

  34. Who to call for help OOH • 1st on for an extra pair of hands • 2nd on for help / advice (or an extra pair of hands) • Consultant unless told otherwise for: • All paediatric resuscitation • Cath lab • All admissions • All refusals except the obvious • Any queries or concerns that the 2nd on can’t help with. • An extra pair of hands • If wondering whether to phone please do.

  35. finally

  36. Other things that have to be mentioned • Guidelines • Sickness & Leave • Incident reporting • 2222

  37. Any Questions?

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