INTENSIVE CARE MEDICINE

The dedicated critical care units (CCU) at Ipswich and Colchester Hospitals provide care for critically ill medical and surgical patients. The departments also provide higher level post-operative care for high-risk elective patients. Both units have the facilities to offer level 2-3 support for up to 14 patients at a time.

Ipswich Hospital

The CCU team is made up of 9 consultants and a large team of approximately 30 trainees (anaesthetic core trainees, speciality trainees, ICM, ACCS, DREEM, IMT and FY1 doctors). There are also 2 ACCPs who are a consistent presence in the department. They provide support to trainees in terms of process and policy as well as education.

There is a large nursing team providing expert and specialist care such as haemofiltration, inotropes and care of intubated patients.

The CCU is a 14-bed level 2 (single organ support) and level 3 (multiple organ support) unit that has easily accessible extension area to cohort Covid-19 patients.

In addition, the team provides support to the paediatricians to stabilise unwell children prior to retrieval by regional transfer teams. They also provide mutual aid to other critical care units in the East of England.

Colchester Hospital

The CCU team is made up of 10 consultants and a large team of trainees including specialist registrars, core trainees, foundation doctors. Alongside this, there are critical care practitioners. The critical care unit is staffed daily by 7 junior doctors and 1 on-call consultant.

The CCU is a 14-bed level 2 and level 3 unit. A typical day on the critical care unit consists of a morning handover and ward round with plenty of training opportunities throughout the day. Both Ipswich and Colchester departments have the same computerized records system, Metavision. This allows for easy communication between the two hospitals. The front-end terminals allow easy access to images, ICE and TOXBASE and multidisciplinary department guidelines.

Intensive care medicine training requires trainees to become proficient in a wide range of procedures. Ipswich and Colchester sites offer plenty of opportunities and support to become competent in these procedures including central venous catheter insertion, arterial lines, intubation and extubation, and tracheostomy. Consultants are readily available to assist with these.

There are daily consultant-led ward rounds which enables regular bedside teaching and work-based assessments. Trainees are also expected to review patients independently and present their findings to consultants. As a result, trainees report they are able to achieve a large number of workbased assessments whilst working on the unit.

The consultants place an emphasis on good quality teaching. As a result, there is weekly departmental teaching which covers a wide range of topics including management of the acutely unwell patient, airway management and imaging techniques. In addition, trainees can volunteer to present in these teaching sessions.

Discussion about the most complex patients is held at the specialist multidisciplinary team meetings. Trainees are encouraged to attend these in order that they understand the complexities of decision making and ethical scenarios.

Research Opportunities

The CCU research team has an excellent track record of conducting, presenting and publishing clinical research in intensive care related topics. Colchester hospital participates in a number of important studies including the UK-ROX and SIGNET study.

Ipswich also has an active research programme mostly focused on the NIHR portfolio projects. They have a lead for research and are well supported by the Trust’s Research Nurses. They are keen for trainees to get involved in projects.