Following some very telling feedback a walk through of the process and problems of managing an arrest in Cath Labs the following has been suggested by our Leaders.
ODP's
Mrs Owens (theatre manager) has agreed that the ODA's will come down to to help our anaesthetic trainees. They will also come down if an 'anaesthetic team to cath. lab' call is put out. But this may not be possible when there is an emergency case ongoing in theatres.
In this situation, the junior registrars can get help from the SR's, who can either relieve the ODP to help with the cath lab arrest or themselves can help the junior registrar to manage the cath lab.
Depending on the situation, they can call the consultant on-call and the 2nd on ODP. I gather that it will take up to 45 minutes to get the 2nd on ODA's from home. Getting the help from labour ward ODAs in not an option obviously.
Anaesthetic Machine and Equipment check
The primary PCI's generally go in to Lab B and there is an anaesthetic machine , a trolley with drugs, airway , IV access and infusion equipment and a separate vascular access trolley.
THE ANAESTHETIC MACHINE WILL HAVE TO BE CHECKED AND THE CHECK LOGGED- ON EVERY SHIFT (I.E TWICE IN A TWENTY FOUR HOUR PERIOD). IT IS THE RESPONSIBILITY OF THE SHO ON THAT SHIFT TO DO.
We suggest to do this towards the end of night shift and day shift ( before handover).The ODA's on-call will come down with you and check and ensure that the trolleys are restocked and to change the circuits etc.
We have asked the cath. lab management to educate their staff not to tamper with the anaesthetic equipment ( Please identify and report this to the cath. lab charge nurse whenever this happens)
We will keep a spare anaesthetic machine ( to be stored in the alcove near lab.A) for use in cath. lab A or D , if these labs are being used for a primary PCI. There is no wall gas supply in the storage area, but the checks could be carried out with the cylinder gas supply.
Drugs - these should be in a bag in the fridge ready for use.
Syringe pumps - just ask lab
Portable monitor - and portable ventilators are currently kept in theatre storage cupboard. The lab can provide you with patient trolleys and oxygen cylinders.
Difficult airway trolley and Glidescope - is in the area outside staff room in the EP labs