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

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. C-Level Corridor C-Level Theatres Stairs Patients

15. @iccueducation www.facebook.com/iccueducation www.iccueducation.org.uk

16. Password - Tippins45

17. ALL EDUCATIONAL OPPORTUNITIES ARE AVAILABLE TO EVERYONE, WHETHER YOU’RE DOING ICM OR NOT.

18. 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

19. 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

20. EVIDENCE BASED PRACTICE Via the website: http://www.iccueducation.org.uk/evidence-based-practice Monthly blog Please engage and leave a comment

21. 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

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

23. COACHING Contact Pete Hersey for more details. (Bit like mentoring but not)

24. ED If unsure take someone else

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

28. AIRWAYS AND ED

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

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

32. 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

33. OTHER BITS AND BOBS

34. OOH TRANSFERS Call ICCU Consultant first 1 st on – anaes cons will attend if anything is happening in obs/theatres. 2 nd on – anaes cons will attend ICCU res – ICCU cons will attend

35. 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)

36. SUNDERLAND-ISMS Scrict colloid avoidance HD rather than CVVF – RRT via renal Epidurals

37. FOR THOSE DOING AN ICM BLOCK

38. 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+

39. DAILY ROUTINE Handover 0800 until completed Allocate patients 0845 Team brief 0900 ward round 1100ish coffee and 5:15 Sort your patients 1400ish walk round Some time between 1700 and 1830 Consultant handover Handover 2000 until completed

40. WHO TO CALL FOR HELP OOH 1 st on for an extra pair of hands 2 nd 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 2 nd on can’t help with.  An extra pair of hands  If wondering whether to phone please do.

41. FINALLY

42. OTHER THINGS THAT HAVE TO BE MENTIONED Guidelines Sickness & Leave Incident reporting 2222

43. ANY QUESTIONS?