ANNUAL REVIEW 2004 - St Vincent's University Hospital

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Emergencies A total of 2,339 emergencies were carried out in SVUH and 1,298 of these were performed outside the normal working day. In 2004, 45 liver transplants were carried out in SVUH. Outstanding / Significant Achievements Congratulations to the following individuals who obtained their exams in 2004. Dr Brian Alyward Fellowship Dr Michelle Roets Primary Dr Mary White Primary A revised series of resident merit awards is to be introduced at the end of 2005. Two former transplant/research fellows, Dr. D.M. Honan (2001-2) and Dr. C.L. McCaul (1999-2000), were appointed to consultant posts in 2004. Dr. J.G. Laffey, a previous fellow (2001-2), received the 2004 JMS Anaesthesia award for research conducted while based at SVUH. Dr. John Boylan was appointed as honorary lecturer in clinical physiology at the Department of Physiology, UCD. Significant Publications / Academic Activity Peer-Reviewed Publications J.G. Laffey, D. Honan, N. Hopkins, J-M. Hyvelin, J.F. Boylan, P. McLoughlin. Hypercapnic acidosis attenuates endotoxin-induced acute lung injury. American Journal of Respiratory & Critical Care Medicine 2004: 169: 46-56. (This article was the subject of an accompanying editorial - Erik R. Swenson: Therapeutic hypercapnic acidosis: pushing the envelope. American Journal of Respiratory & Critical Care Medicine 2004; 169: 8-9.) Academic Activity Labour Analgesia – What’s New? College of Anaesthetists Obstetric Anaesthesia Study Day - December 2004 Anaesthesia for Liver Disease Final Fellowship Course, College of Anaesthetists - January 2004 Influence of the introduction of guidelines for the prescribing of medications pre-operatively I. Brady, I. Browne, J. Boylan College of Anaesthetists Annual Scientific Meeting, Dublin - May 2004 Current practice patterns in teaching hospitals for the discontinuation of OCP/HRT prior to surgery F. Naughton, I. Browne,T. Owens College of Anaesthetists Annual Scientific Meeting, Dublin - May 2004 Pre-operative herbal medicine uses and the anaesthetist’s opinion K.Tan, D. Harmon, I. Browne College of Anaesthetists Annual Scientific Meeting, Dublin - May 2004 Resuscitation Training/ Developments In 2004, education and training was provided to 1,046 staff members in the form of in-service, lectures, ward-based training and formal workshops and courses. 687 of the staff were nurses, 177 were doctors, 60 were paramedical staff, 68 were non-clinical staff and the remainder were students. 87 staff trained as ACLS Providers. 471 staff trained as Basic Life Support Providers. An Intern Orientation Programme was presented for the second time and included Adult Heartsaver AED training. This is one of the pre-requisites for ACLS training. Other courses include Basic Rhythm Recognition workshop, Cardiac Arrest Management workshop. Numerous lectures and in-service were presented on a variety of topics associated with resuscitation. Ward-based training proved most popular and it is hoped to increase the number of sessions provided in 2005. In addition: • SVUH renewed its status as a training site with the Irish Heart Foundation. • A database of those trained was maintained. • A database of cardiac arrests was maintained. Departmental Review 103
Department of Anaesthesia, Intensive Care and Pain Medicine • Obsolete defibrillators continue to be replaced. • Contents of the cardiac arrest trolleys were reviewed and significant improvements made relating to equipment and drugs. • A new cardiac arrest trolley content check list was piloted and introduced to the wards. • Additional Laerdal pocket masks were placed in strategic locations around the hospital. • SVUH collaborated with St Michael’s Hospital to provide both ACLS and BLS Instructor training. • Training equipment was purchased through the ACLS Account. • Resuscitation guidelines have been reviewed and are being updated. • Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) draft guidelines are in the final stages of review. • Cardiac arrest trolleys and defibrillators were assessed for the tender for the new building. • A Resuscitation web page has been developed by the IT Department. • Ongoing risk assessment and ‘trouble shooting’ takes place. Cardiac Arrests In 2004, 283 cardiac arrest calls were received by switch. Of these calls, 111 were to the Emergency Department. From these 283 cardiac arrest calls, 94 audit forms were received. The breakdown of the cardiac arrest calls detailed on the audit forms was as follows: - • Asystole (59 cases) • Pulseless Electrical Activity (18 cases) • Ventricular Fibrillation / Pulseless Ventricular Tachycardia (13 cases) Risk Management Dr Richard Assaf has been appointed for an initial period as Clinical Risk Facilitator. He is involved in liasing with the Medical Board and Hospital Management on Clinical Risk Management issues, and teaching the NCDH staff. His role also includes reviewing all adverse drug reactions submitted to the Ethics Committee. Vascular Access Director Dr Alan McShane Consultant Dr Neil McDonald 2004 was another busy year for the Vascular Access Service, with procedure numbers increasing to 421, an increase of 59 cases. Despite the huge numbers being processed, there has been little progress in the provision of dedicated theatre sessions for the service. This is far from satisfactory from a patient and doctor point of view. It can lead to anxiety, unnecessary fasting, interference with drug administration and sometimes cancellation of cases. The service needs a dedicated slot each day to continue to provide consultant delivered care. On a positive note, an ultrasound device was purchased in 2004 to aid line placement. This should make the procedures safer and will greatly aid in the teaching of the technique. At the request of the College of Anaesthetists, Dr McShane organised a Vascular Access workshop. This was well attended and proved to be very popular. Dr Neil McDonald was part of the faculty. A study was also undertaken to evaluate the safest and most useful methods of identifying correct venous line placement. This should be published in 2005. South East Dublin Department of Anaesthesia (SEDDA) Report Co-ordinator Dr Alan McShane The South East Dublin Department of Anaesthesia was delighted to welcome the appointment of two new consultant colleagues, who will work between St. Vincent's University Hospital and the National Maternity Hospital. Dr Ingrid Browne took up her post in November 2004 and Dr Ola-Petter Rosaeg is due to commence in April 2005. A new consultant locum position was also filled by Dr Gabrielle Iohom, working between St. Vincent's University Hospital and St. Michael's Hospital Annexe. This appointment has greatly aided and increased the throughput of elective surgical patients from St. Vincent's University Hospital. The popular rotation of anaesthesia trainees has continued between the constituent hospitals. Attendance at the organised teaching sessions has improved. Looking to the future of SEDDA, serious effort is to be expanded on rationalising the multiple night duty rosters. The busy areas will have to be better staffed and in light of recent proposals, the less busy locations will probably be best closed at night. Finally, I would like to thank Dr Edward Gallagher for his professionalism and collegiality over the years. I wish him many happy years of retirement. 104 St Vincent’s Healthcare Group
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ANNUAL REVIEW 2004 - St Vincent's University Hospital

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