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Intensive Care Medicine and Anaesthetics

Dr David Perks

Dr Geoff Fisher

Kaye Sheppard

About Us

Anaesthetists are specialised doctors. Their work ranges from assessment and preparation for an operation, administration of the anaesthetic and pain relief, through to postoperative care in the recovery unit or the critical care unit. As well as anaesthetising patients for operations they have other specialist interests including obstetric anaesthesia, intensive care medicine and pain management.

Anaesthesia involves the administration of drugs to make the patient unable to feel pain. Different types of anaesthesia include:

• General anaesthesia - this involves the administration of drugs to induce a deep sleep

• Regional anaesthesia (epidural/spinal) - involves injecting drugs around the spine to numb the legs or abdomen

• Local anaesthesia - injecting drugs into the skin to numb a small area

• Sedation - this involves drugs that produce a light sleep but stops short of a general anaesthetic.

Most patients in the hospital, at some point of their stay, are cared for by an anesthetist.

People

The anaesthetic department office is located on the 1st floor, east wing opposite main operating theatres.

Staff in the department currently consists:

• 26 Consultants

• 1 Associate Specialist

• 4 Staff Grade doctors

• Trainee Anaesthetists from the Birmingham School of Anaesthesia

Clinical Services

Surgical Pre-assessment Unit

At the pre-assessment unit each patient requiring an operation is individually assessed in order that they are in optimal general health for anaesthesia and surgery. This will involve nursing or medical staff taking a detailed health enquiry followed by basic observations including blood pressure, temperature, height and weight. After this patients may require additional test e.g. blood tests, x rays or ECG (Electrocardiogram).

Pre-assessment units are located at Russells Hall and Guest hospitals.

Theatre Services

There are two theatre suites at Russells Hall Hospital comprising main theatres and day case. At Corbett Hospital a stand alone day case unit provides a service for minor orthopaedic and dental procedures.

We provide anaesthesia for a wide range of surgical specialities, including:

• General surgery

• Vascular surgery

• Orthopaedics and Trauma

• Gynaecology

• Urology

• Plastic surgery

• Ear Nose and Throat surgery

• Maxillofacial surgery

A trained anaesthetist will be present throughout the operation to monitor the level of anaesthetic and the body’s response to the anaesthetic drugs. The anaesthetist also ensures that the patient is given appropriate analgesia and anti-sickness treatment if needed. After completion of surgery, patients will spend a period of time in the recovery unit where a nurse will monitor recovery from the anaesthetic before returning to the ward.

Critical Care Unit

The Critical Care Unit has nine beds designed and equipped to manage and care for critically ill patients. The unit is run by eight consultant anaesthetists and one consultant physician who are specialists in the field of critical care.

Daily medical care on the unit is led by a consultant anaesthetist supported by a multi-disciplinary team including specialist nurses, physiotherapists, pharmacicts and dieticians.

There is a 24 hour outreach service whose role is to identify patients within the hospital who are becoming ill so that they can receive immediate treatment and admission to the Critical Care Unit if required. The Critical Care Unit is located on the 1st floor, east wing opposite main operating theatres.

Maternity

The maternity unit manages over 4000 deliveries per year and comprises 33 single delivery rooms and three-four bedded bays. There are two obstetric operating theatres and two high-dependency rooms for mothers developing severe complications during pregnancy or childbirth.

Anaesthetists provide a 24 hour service including a range of anaesthetic options for caesarean section, a 24 hour epidural service and joint management with the obstetricians of women with severe pregnancy complications.

Each week a consultant anaesthetist holds a clinic for mothers who require additional anaesthetic assessment prior to delivery.

The Maternity Unit is located on the 2nd floor at the end of east wing.

Acute Pain

The acute pain service reviews patients recovering from major surgery to ensure that pain is well controlled. This service currently comprises one consultant anaesthetist and two clinical nurse specialists who work through the week on wards across the hospital visiting patients and dealing with their needs.

Chronic Pain
The Chronic Pain Service provides a diverse and comprehensive range of treatments including physical therapies, injection therapies, behavioural pain management programmes and neuromodulation. The service is provided by four consultant anaesthetists and an associate specialist anaesthetist, three clinical nurse specialists, three physiotherapists, a psychologist and an occupational therapist. The service is recognized as the regional centre for inpatient pain management and a recent Dr Foster audit placed it in the top eight of all pain departments that met all criteria and as the only one that met waiting times.

Undergraduate Training

The Dudley Group of Hospitals is a teaching hospital of the University of Birmingham. Students are allocated to the department for five weeks for the Anaesthesia, Respiratory and Intensive Care Medicine Module. Time is divided between theatres, intensive care and respiratory medicine. Areas covered include:

Operating Theatre

• Airway and intravenous cannulation skills

• Basic understanding of techniques and drugs used in anaesthesia

• Intravenous infusion and drug administration

• Understanding of postoperative analgesia techniques

Critical Care Unit

• Systematic assessment of the acutely ill patient

• Physiological monitoring

• Rationale use of laboratory tests and investigations in the critically ill patient

Respiratory medicine clinics, bronchoscopy clinics and X-ray meetings

• Lung anatomy and physiology, lung function tests

• Lung cancer and obstructive/restrictive lung disease

• Assessment and Management of respiratory emergencies

Library
There are excellent library facilities with a dedicated team of six librarians and IT services including internet access.

There is a wide range of journals available including all the major anaesthesia and intensive care publications and a good selection of textbooks on anaesthesia, intensive care, pain management and topics for the FRCA exam.

An inter-library loan service between other libraries including the University of Birmingham is also available.

Meetings
There are regular tutorials and meetings in the department including:

• Weekly anaesthetic tutorial covering core topics

• Weekly intensive care tutorial journal club

• Monthly departmental audit meeting

• Monthly evening educational meeting

First floor, east wing, Russells Hall Hospital