Welcome to obstetric anaesthesia!

Some of you will have had experience of the subspecialty at other hospitals, some of you will have little or no experience in this field. We hope that we will be able to provide you with valuable learning opportunities during your time at St John’s, whatever stage you are at.

Our obstetric unit currently has approx. 2800 deliveries per year, and we have a daily Caesarean section list, as well as an epidural service. We have an Obstetric anaesthesia handbook. Please read this!

If you already have experience of obstetrics and have done more than one year of anaesthetic training, you should read it before your first night on call. If you are new to anaesthesia (less than one year of experience) then you will not be expected to carry out unsupervised anaesthesia for obstetric patients. However, those who have done between 6 and 12 months of anaesthesia should be starting to do (supervised) obstetric anaesthesia.

The Obstetric Anaesthesia handbook is on this app under Local Guidelines, SOP & Contacts tab.

There are paper copies of the obstetric anaesthesia handbook in the seminar room, in the labour ward theatre and recovery room. Electronic copies are available by emailing yvonne.mallon@nhslothian.scot.nhs.uk. If you would like your own hard copy, also ask Yvonne, our secretary. 

If you are rostered for Labour ward on call then you should collect the 3948 bleep from the trainee who has been on overnight at 08.00 and get a brief handover. You should then go to the daily labour ward meeting which takes place at 08.30 in the office in labour ward. Deliveries from the previous 24 hours are discussed, as well as current labour ward patients, gynae patients and any outliers. The anaesthetic consultant, who is on for labour ward, will also attend this meeting.

We usually run our epidural patients on infusions of 0.1% bupivacaine with 2mcg/ml fentanyl. Some of our midwives have been trained to give epidural top-ups. We are about to switch to a new PIB regime so watch this space!

Dr Jeffrey supervises the Initial Assessment of Competencies in Obstetric Anaesthesia. As part of the OAA, Association & RCOA recommendations, there is now a requirement for trainees to undertake approximately 20 supervised Obstetric Anaesthesia sessions, completing the mandatory simulation component in the new curriculum and signing off the IACOC prior to undertaking Obstetric Anaesthesia without direct supervision.

Once you are up and running you can attend a PROMPT course (Practical Obstetric Multi Professional Training) which encompasses non technical skills as well.

Although we try to accommodate individual needs, as Trainees, it is YOUR responsibility to ensure that YOU are getting adequate exposure to Obstetric Anaesthesia by informing Dr Caesar of your requirements.

There is a new monitoring system for Intrapartum care in Lothian: K2 Guardian. This will be standard across St.John’s and SCRH outwith COVID times. It requires that you are registered and trained in its use, as well as enrolled via fingerprint for you to input data. If you are new to this system, please ask for access on the Shared drive section of the IT Access Form. Then speak to Claire Caesar, Anaesthetic Consultant, for training and enrolment.

Dr Claire Caesar, Obstetric Anaesthesia Updated June 2021