Trainee Roles and Responsibilities On Call - QCCH

Team work and the team

The most important message is that the QCCH and HH bleep holders should work as a team. QCCH Bleep holders should NOT leave QCCH out of hours. HH Bleep holders may be a resource for urgent support until QCCH consultant arrival.

The following roles are guidelines and provided for clarity about first responders, so that we all know who MUST go to what.

  • If you are busy, and problems are developing then let your HH colleagues AND your consultant QCCH  know so that that they can cover your normal first responder bleep.
  • This is not set in stone and supporting each other to care for the patients who need our services is the key. We do not want a situation where one member of the team is run ragged and the others are in the coffee room….!

    • IF IN DOUBT DISCUSS with the QCCH consultant on call ASAP !!

    Calling for help.

    The QCCH consultants are happy to be called for advice at any time. In particular, we would expect to be informed in the following circumstances:

    •  Maternal death
    •  ITU referrals
    •  Ongoing major obstetric haemorrhage;
    •  Calling the anaesthetic registrar from Hammersmith site to provide extra cover
    •  or any political or potential medico-legal incident (including GA for pain under C/S)

    In addition, if workload on labour ward is excessive (e.g. patients waiting more than one hour for an epidural /many sick patients) please call us to discuss and we will attend on request.

    Whilst epidurals are not an emergency per se it must be very distressing to wait for longer than necessary. The ‘one hour rule’ for epidurals is a RCoA standard and we are proud of our adherence to this standard in the past. Remember to offer alternative analgesia to the patients if a delay is likely (eg all midwives can give im diamorphine) 

    Please make sure you know which consultant is covering during your shift; you can always ask the midwife co-ordinator to call us on your behalf if you are too busy. We can easily call back on theatre 1 phone or the phone at midwifery station. 

    Calling for help from Hammersmith ST3/4 - bleep 9007:

    Any anaesthetic or obstetric emergency where you need a second pair of hands.

    In a crashing emergency call 2222 through switchboard and state anaesthetic emergency on QCCH labour ward.

    Bleep 9404 (1 in 8)

    • Responsible for QCCH 
    • First on call for delivery suite, must carry bleep at all times
    • Wherever possible, attends multidisciplinary handovers at 08.00, 13.00, 17.00 & 20.00 hours
    • Close liaison with members of the obstetric and midwifery teams
    • Closely monitors status of any HDU patient
    • Out of hours, liaises directly with consultant on call

    Bleep 9007 (1 in 8)

    • CAN SUPPORT QCCH in emergency work
    • Carried by an anaesthetist in theatres (doubled up on a list) during normal working hours. After hours and at the weekend by the CICU SpR.
    • Handed to the CICU long day SpR around 6 at the end of the working day
    • Responsible for attending CICU ward rounds and clinical decision making and supporting the resident on the CICU, and expected to be rapidly available to the unit unless attending an urgent call.
    • Supports the SHO in theatres
    • First responder to the cath lab emergencies and PCI

    Bleep 9313 (1in 8)

    • QCCH SUPPORT only if previous experience in Obs anaesthesia
    • Takes all calls relating to emergency theatre work and should pre-assess patients in the first instance and organise the emergency theatre work load with the surgeons/theatre team
    • Attends all cardiac arrests anywhere in the hospital including cath lab
    • Assists in caring for ventilated patients in theatre