Managing Calls

Managing calls

Obstetric Anaesthetic Management

Epidurals

Refer to Obs Reg (0799) or Obs Consultant (9120).

Caesarian Sections

YOU MUST PHONE THE COORDINATOR (5010) to identify a theatre. Caesar theatre may be available.

ONET and Category A

These go in emergency caesar theatre or next available theatre.

Then call the obstetric consultant to ensure patient is seen on the ward/in transit (9120) to facilitate rapid transfer to theatre and glean vital information (MH history, difficult airway, allergies etc).

Check Anaesthetic Coordinator aware and assistant available (5065)

Category B

Find next available theatre to have gap depending on urgency:

  • Obstetric>gynae>general>plastics

If desperate and no place to go anaesthetic room 4 is possible or endoscopy.

  • Check if consultant in theatre happy to do Caesar – if theatre unmanned, use, obs cons, yourself, SR doubled up elsewhere, available.
  • You should ensure theatre is ready drugs: CMAC, BIS and await patients arrival.
  • If obs consultant is far away eg H1 go yourself to assess patient and get obs consultant or SR to prepare theatre.
  • If less urgent than Cat A or ONET send obs reg/SR to assess

Other Calls to the DA

Pain managment

Refer to pain reg (0400) or pain consultant (am only)

Medical Emergency Team (MET calls)

Assist pain reg or obs reg with difficult MET calls if required

Emergency Department

Hospital wide trauma calls/ airway emergencies. Familiarise yourself with ED resus bays, monitoring and its DI trolley. ED doctors will transfer patients to radiology/other hospitals. If coming to theatre liaise with ED doctor and either transport patient yourself (eg if tubed) or have them transport the patient while you prepare theatre.

Intensive Care

Airway emergencies or resus without senior attendance. ICU transports patients to CT themselves. Familiarise yourself with ICU monitoring/DI trolley.

Radiology

No current capacity for provision of GA or sedation in MRI – Pts need inter-hospital transfer. MET patients eg tubed after MET call bring monitor to patient (anaesthetic assistant to bring transport monitor).

Ward Calls

Deteriorating patients eg Mental health, surgical, medical patients requiring a scan – If intubation is required bring to theatre to prepare and induce in theatre, anaesthetic room 4 or recovery. CT is not set up well for induction and monitoring.

Surgery related calls

The general surgery registrar and orthopaedics registrar will call about list order changes/additions. Please either get them to call the appropriate consultant or pass on the message yourself. They should have decided this by 12pm.

Post anaesthesia related calls

If anaesthetist present and appropriate, arrange for them to assess patient. If not, assess yourself and liaise with HOD/clinical director if serious. Advise anaesthetist of complication if unaware. Arrange follow-up in clinic if necessary. Consider involvement of clinical governance risk officer: Elly Marrilier. Check if Risk Man has been completed. If patient at home get them to attend ED or clinic depending on urgency.

Other Hospitals

Due to us being a training site for GP anaesthetists sometimes we get calls from them when they are placed in other hospitals. Please give the best advice you can.

Patients

Some patients, particularly obstetric patients, may call as they have the direct DA number. If obstetric related, take their details and get the obstetric consultant to call them back. Other patients decide whether they need to attend ED or clinic for further assessment / follow up.