Objectives

Critical Care Consultant 1 (CCC1)

• During working hours, the ICU consultant will take the role of CCC1.
• Out of hours, the on call consultant will take the role of CCC1
• CCC1 will coordinate the critical care/anaesthetic team response

Action Card: Role Allocation for SJH Anaesthetic Consultants

Call out response overview:

• 36 SJH consultants on MIP Whats app call out
  • First 10 available should report immediately for allocation. Go to Anaesthetic Seminar Room, Theatre Corridor.
  • Further 10 should await more information, rest and plan to be available to cover the next shift/attned as necessary
  • Anticipate that 10 are on leave/unavailable
  • This allows for resilience in the system to be used as necessary
  • Consider wellbeing champion of numbers allow
• All anaesthetists to report ‘Theatre control team’ Anaesthetic Seminar Room, Theatre Corridor.
• Further anaesthetic staff will be allocated by CCC1 to support specific clinical areas: ED/Theatres and recovery including obstetrics/Red ICU/Green ICU: They should coordinate with the CCC area lead.
• Those rostered to be clinical within following 24 hours should state availability but not attend unless requested, to ensure resilience in ongoing shifts.

 

Role Allocations:

Critical Care Consultant (CCC) 1 = Overall coordinator with theatre control team:

 

Actions:

- Allocate critical care/anaesthetic consultant to hospital medical coordinator role (direct them to 2^nd floor office)

- Allocate a consultant lead to the following areas: Resus (CCC2); Red ICU  (CCC3); Theatre Corridor (CCC4); Green ICU (CCC5) as appropriate (first available within the hospital). These leads should coordinate with the Theatre Control Team (CCC1 bleep 3561) in Anaesthetic Seminar Room, Theatre Corridor.

- Allocate 1-2 further consultants to Resus/ Red ICU /Theatre Corridor/ Green as appropriate

- Allocate trainees to Resus/ Red ICU/Theatre Corridor/ Green ICU as appropriate

- Allocate appropriate consultants/trainees to prepare for/carry out transfers as necessary

- Identify those rostered to be on call/continue service over following 24 hours and protect them from immediate availability

- Work with theatre control team to identify appropriate roles for surgical trainees/consultants to support critical care staff

- Coordinate with Theatre coordinator, Recovery Lead, Surgical Lead, ED Lead, Critical Care Lead, BTS, Radiology

- Take roster of immediate attendance and prepare for next 24 hours. Consider shorter shifts if intense work load e.g. 8 hours

- Liase with hospital coordinator

- Document information coming and decisions made

Hospital Medical Coordinator: (See HMC action card)

• Coordinate hospital clinical activity at SJH and within NHSL

Critical Care Consultant 2: Resus critical care coordinator (See Critical Care Consultant 2 Action Card)

• Assist with ED intubations, stabilisation of patients, transfers to radiology/theatres/recovery/ICU
• Communicate with CCC1

 

Critical Care Consultant 3: Red ICU (See Critical Care Consultant 3 Action Card)

• Assess covid status of unit
• Take handover of patients present
• Identify stable/ward fit patients who could be discharged to Level 1 or transferred to Green ICU
• Coordinate activity within Red ICU (ground floor)
• Communicate with CCC1

 

Critical Care Consultant 4: Theatre corridor  (See Critical Care Consultant 4 Action Card)

• Coordinate theatre activity: facilitate safe and rapid cessation of ongoing surgery as appropriate
• Allocate appropriate anaesthetic cover to obstetric theatres
• Coordinate new admissions from ED into empty theatres with appropriate medical/nursing staff per patient
• Where possible, patients requiring resuscitation/stabilisation should go to theatres before transfer to Red ICU/other NHSL site
• Support nursing staff/ODPs
• Ensure that Belmonts/CVVH being primed
• If VIP involved, facilitate isolation of theatres 1 and 2 for VIP and security/administrative team. Allocate consultant to VIP area
• Communicate with CCC1

 

Critical Care Consultant 5: Green ICU (See Critical Care Consultant 5 Action Card)

• If in use, take handover of patients present
• Identify stable/ward fit patients who could be discharged to Level 1 or transferred out
• Coordinate activity around new admissions from medical wards/transfers from Red ICU
• Point of contact for in hospital Cardiac Arrest/medical emergencies from the wards.
• Communicate with CCC1

 

Anaesthetic/Critical Care Consultants: (See Anaesthetic Consultant Action Card)

• Report to CCC1 in Anaesthetic Seminar Room, Theatre Corridor for allocation to clinical area