Action Card: Role Allocation for SJH Anaesthetic Consultants

SJH Theatres and Anaesthetics
NHS Lothian

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 2nd 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