Intensive Care Medicine

The Critical Care Department provides intensive care services to both BSUH adult hospitals, the Royal Sussex County Hospital in Brighton and the Princess Royal Hospital in Haywards Heath.

The Critical Care Unit at the PRH has 12 beds, the RSCH in Brighton has 31 beds, both caring for medical and surgical critically ill patients. In addition, the cardiac unit runs ten beds for patients requiring level 2 -3 care.

The department has the computerised medical records system, Metavision, and the front-end terminals allow access to PACS images, ICE, TOXBASE and multidisciplinary department guidelines.

Critical Care admits an unselected take of medical and surgical adult patients, in addition to booked elective post-surgical cases. The RSCH Intensive Care Unit admits around 2000 patients a year; 42% surgical and 58% medical special-

ties. The PRH Intensive Care Unit admits around 600 per year with 62% medical and 38% surgical admissions.

There are 18 consultants in critical care covering the units at all times. The junior critical care team consists of 22 junior doctors with varying parent specialties. These posts are mainly based at the RSCH; although, a portion of training is delivered at PRH.

Teaching

The training programme will be tailored to every trainee’s specific requirements and is significantly influenced by the trainee’s previous experience and placements. Specialty Trainees in year 3-4 usually focus on further developing their core competencies and extend their general ICM experience. ST5 to ST6 level training emphasises sub-specialty ICM including cardiothoracic, neurosciences and paediatric ICM, in addition to general ICM. ST7 trainees consolidated

INTENSIVE CARE MEDICINE

their ICM knowledge preparing to become consultants. A series of training courses are delivered in house, including the BASIC Course, ICM for Anaesthetists, Transfer course, ALERT course, FICE and FICM exam revision course. BSE training is specifically offered to the Echo ICM fellows. Trainees also have the opportunity of attending meetings with invited speakers in related fields, including Emergency Medicine, Medicine and Grand Rounds.

Trainees also have access to an extensive PowerPoint lecture presentation library, a reference library with ready access to bench books in the Consultant’s office, the Clinical Information System (CIS e-library), the European online modular teaching programme in ICM (PACT) and IRIS (an online e-learning resource). Local teaching is delivered in the daily, multidisciplinary ward rounds in the morning, lunchtime microbiology consultant led ward rounds, as well as at the evening ward rounds. Trainees are encouraged to participate in the monthly journal club, the morbidity and mortality meetings, as well as the clinical governance meetings. The department provides dedicated, bleep-free, weekly teaching on Tuesdays.

Research

The Intensive Care Research team has a good track record of conducting, presenting and publishing clinical research in ICM related topics. Projects include research into sepsis, acute respiratory distress syndrome (ARDS), shock, biochemical markers, optimisation and nutrition, as well as risk assessment in patients with traumatic brain injury. ICM staff are also involved in a significant number of audit and quality improvement projects. Trainees are expected to complete and present a project, collaborate in other audits and collect data for ICNARC during their time in critical care.