Staffing:
There are usually two registrars present on labour ward from Monday – Friday
On some days, there are two consultants (covering LW and elective list) and two ODPs (9406)
Long day reg (bleep carrier): duty anaesthetist on LW (bleep 9404)
2nd on reg: elective sections (carries bleep 9012)
Consultant: carries bleep 9605
In reality, the workload is shared and we just do whatever work is available!
The red book:
Inset a patient label and details for every anaesthetic procedure performed (GA and RA)
This book is used for follow up and audit purpose
Also useful for patients who have had issues and have returned in subsequent pregnancies.
Elective section pre assessment:
Around 1:30pm: will receive bleep from Edith Dare ward to pre assess patients for elective section the next day – pre assess, give pre-meds (provided by EDW staff)
Take completed anaesthetic charts back to LW and file in red clipboard
Flag up any issues to the duty anaesthetists for the day after is possible
Follow ups:
Take the Red book and review all patients on the postnatal wards
Review NHS and private patients (note patients on Stanley Clayton ward can still be NHS patients but have paid for a private room)
Once follow up outcome inputted on the redbook, information then needs also be inputted onto CRS (template available – search for ‘regional anaesthesia’)
Handover:
8am: Anaesthetic handover and MDT handover in LW office
(In the weekend, anaesthetics handover at 08:00 and 20:00, MDT handover at 08:30 and 20:30)
1pm: MDT handover in LW office (this is due to obstetric team changeover)
5pm: MDT handover in LW office (again, due to obstetric team changeover)
8pm: anaesthetic handover
8:30pm MDT handover in LW office
Elective sections:
Patients arrive on LW at 7am
They would have had premeds at home
They are taken to allocated bed in recovery to ‘get ready’
Start time depends on ODP, obstetricians and midwifery availability
Check group and save (Note on Monday: check the expiry date of group and save as bloods taken on Friday will only be valid for 72 hours)
Once section done, they return to same space in recovery: if HDU bed required (e.g. MOH, sepsis, invasive monitoring), patient can go straight to HDU from theatre to be recovered, providing HDU team is aware
Patients can also be recovered in side room (on high risk side) with one to one HDU midwife (e.g. infection control, IUD or expected poor neonatal outcome)
Equipment available in LW
Ultrasound machine
Anaesthetic machine: no piped N2O, cylinder needs to be turned on at the back of the machine
Cell salvage
Airtraq available in both theatres –Glidescope can be borrowed from main theatres