Work and wellbeing articles in Anaesthesia News | Association of Anaesthetists

Work and wellbeing articles in Anaesthesia News

Work and wellbeing articles in Anaesthesia News 



Healthcare worker safety and COVID-19

It had been apparent from the start of the pandemic that both patients and healthcare workers are at significant risk of acquiring COVID-19 in hospitals. In an early report from Wuhan more than 40% of infections were hospital-acquired, and three quarters of these cases were healthcare staff. This echoed the high rates of healthcare worker infections and deaths in the SARS and MERS epidemics.

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Exovent: an accelerated innovation journey in 2020

2020 was an exceptional year for the Exovent team. It has been an unusual year for everyone with a global pandemic disrupting life, while putting enormous strain on the NHS.

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Exovent: a new development from old technology

Few contemporary anaesthetists imagining negative pressure ventilation would picture a modern, lightweight, torso-only device, and fewer still would imagine it being described as “extremely pleasant” by a wide-awake subject who was able to eat, drink and talk freely during exhalation.

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A virtual mock OSCE

On the Your Letters page of Anaesthesia News April 2021: COVID-19 has had major impacts on medical training, including the cancellation of courses and examinations. The RCoA decided to deliver the latest round of the Primary OSCE and SOE via video-conferencing technology, a change that could be here to stay.

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Virtual block workshop – digital regional anaesthesia training during COVID-19

Regional anaesthesia has come to prominence during the COVID-19 pandemic, while teaching opportunities have decreased. We have therefore developed a weekly virtual regional anaesthesia teaching session lasting 20 minutes, with a live scanning demonstration and interaction with tutors to optimise learning.

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Patient safety in the COVID era; an update from the SALG-BIDMC Safety Scholars

The Safe Anaesthesia Liaison Group (SALG) offers scholarships at Boston’s Beth Israel Deaconess Medical Center (BIDMC) for trainees with an interest in patient safety.

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The COVID Novice

On the Your Letters page of Anaesthesia News February 2021: I have a confession; I am a senior anaesthetic trainee who has never cared for a COVID patient. By a peculiar twist of fate, I have ‘dodged’ working during the biggest healthcare crisis for 100 years.

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Improving motivation in Core Anaesthesia Trainees during the COVID-19 era

On the Anaesthesia News January Your letters page: In October 2020 I carried out a survey of 32 CT2/ CT2+ anaesthetics trainees across the North West, which revealed that trainees’ motivation towards ST3 applications had suffered significantly owing to the consequences of COVID-19. More than 90% reported feeling either somewhat or completely demotivated to apply.

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Unsuitable ventilators for Low & Middle-Income Countries

On the Anaesthesia news January Your letters page: In his recent article in Anaesthesia News (November page 20), Craig Thompson of Penlon states that ESO 2 ventilators are being offered as suitable for sale to ‘the World Bank, and countries of South America and Africa’.

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Providing care during the pandemic: the anaesthetists’ perspective

On 17 March, one of my first tasks as a newly appointed clinical psychologist to the Theatres and Anaesthetics Department at Leeds Teaching Hospitals was to attend a COVID-19 planning meeting.

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COVID-19 airway assessment: unmasked

On the Anaesthesia News December Your letters page: In this COVID-19 era, I would like to reinforce the importance of continuing to undertake a thorough airway assessment before commencing anaesthesia.

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How many times can one prone a patient with COVID-19 pneumonia?

On the Anaesthesia News December Your letters page: While tackling COVID-19, many of us are pushing treatment options to the extreme. These patients may develop respiratory failure similar to that seen in ARDS.

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Tea trolley model of training

On the Anaesthesia News December Your letters page: We would like to highlight how we have used our anaesthetic rooms, unused for clinical purposes during the COVID-19 pandemic, for training.

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Personal reflections: connection through COVID

We collectively watched the accelerating COVID-19 train closing in: powerless to influence its course, a terrifying run away. Ireland, hopelessly under-prepared for pandemic, announced the closure of schools, colleges, universities and childcare facilities on 12 March, the first in a series of societal and economic shutdowns.

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Coexistence, cooperation and collaboration in the coronavirus pandemic

Barema was founded in 1971 to represent companies that manufacture or supply anaesthetic and respiratory equipment in or to the UK, enabling the sector as a whole to work with the medical profession and other stakeholders, including the Association of Anaesthetists, RCoA and the Intensive Care Society; as such Barema have maintained a healthy interactive relationship with the Association for almost 50 years.

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Penlon and the ESO 2 Emergency Ventilator for COVID-19

At the start of the global pandemic, the international demand for ventilators rose almost instantly beyond the capability of the established suppliers to meet global needs.

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Diary of a SAS anaesthetist at the London Nightingale Hospital

Worrying news from overseas forewarned that hospital environments across the country would soon be changing, and our CEO requested volunteers for ICU redeployment. As a SAS doctor with plenty of recent ICU experience compared with some consultant colleagues, it seemed obvious to put myself forward.

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Extracorporeal membrane oxygenation for patients with COVID-19: a trainees’ perspective

On 5 February 2020, we began our placement on the Cardiothoracic Critical Care Unit at Wythenshawe Hospital, Manchester, one of only five adult extracorporeal membrane oxygenation (ECMO) centres in England. Most trainees will not be lucky enough to pass through such a centre in their careers, let alone during a global pandemic.

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Shielding and ‘wanting others to keep their distance’ – an online survey

In Anaesthesia News October Your Letters: As COVID-19 lockdown measures are eased, there is significant anxiety among some groups about decreasing adherence to social distancing.

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Resurgence in use of the facemask hook ring during COVID-19 – just like the good old days

In Anaesthesia News October Your Letters: There has been extensive correspondence in Anaesthesia News calling for the discontinuation of plastic hook rings provoked by Rattenberry and Shinde’s article.

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Anaesthesia Digested – October

Outcomes from intensive care in patients with COVID-19: a systematic review and meta-analysis of observational studies; Demand-capacity modelling and COVID-19 disease: identifying themes for future NHS planning; Kicking on while it’s still kicking off - getting surgery and anaesthesia restarted after COVID-19

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An appeal for redesign of ICU ventilators with CO2 absorbers to reduce oxygen usage during a COVID-19 surge

COVID-19 has raised unprecedented issues in the provision of healthcare. Therapy for COVID-19 respiratory disease encompasses various methods of oxygen delivery, with some using flow rates in excess of 100 l.min-1. Hospitals’ capacity to deliver a consistent oxygen supply has been a major concern, and in certain hospitals supply would have been exceeded without significant changes to the infrastructure.

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Novice training during COVID-19: challenges and considerations

In the August issue of Anaesthesia News, Dr Lim highlighted the impact of COVID-19 on novice anaesthetists. With a second wave predicted, we should again anticipate disruption for our novice trainees and be prepared to adapt our approach in order to maximise their experience. Here are some of the main challenges faced by new novices, with some potential solutions.

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Mitigating the impact of COVID-19 on training

During the pandemic, elective surgery postponement, emergency rotas and the formation of intubation/ proning teams proved challenging for all members of our department, but in particular for trainees.

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A new platform for the journal club: using the opportunity to expand debate

In March 2020 we received notification that all upcoming Health Education England meetings would be postponed until further notice because of the coronavirus pandemic. Our department’s education team removed the usual protected teaching time, and focused instead on ensuring our workforce were suitably upskilled to care for the anticipated influx of patients with COVID-19.

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Supporting the shielded - results from a national survey of shielding doctors

In spring, NHS staff responded to the looming COVID-19 pandemic with an impressive level of strategic planning. However, a small and unknown number of these doctors were issued with stark instructions from the government to shield themselves from the crisis. Facing an unexpected disruption to careers and training, shielding doctors found themselves confined to their homes. This disconnection from the frontline created significant practical and psychological challenges.

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A valuable lifeline during ICU lockdown

"Early on in the crisis, our department had the foresight to purchase 30 iPhones to enhance communication between ‘yellow’ and ‘green’ zones. When they hit the floor, my colleagues were quick to introduce new uses, of which the best was video-calling relatives."

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Selection process for trainees during COVID-19: a chance to assess what is important?

This includes a response from the Association's Trainee Committee

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COVID-19: hoodwinked? The view from the other side of the mask

"As the hospital Trust serving the region at the centre of the UK’s cluster of COVID-19 cases, it is fair to say that the management of these patients has generated a great deal of discussion within our anaesthetic department."

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Preparation for SARS-CoV-2 pandemic in South Wales: practical steps

On 28 February 2020, the first case of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) originating from Wuhan, China was diagnosed in Wales. The patient contracted the infection during his visit to Lombardy, where the outbreak in Northern Italy started to get a foothold. At this stage, the official Welsh strategy was containment and preparation for a potential outbreak, in line with the rest of the UK. 

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A suggestion for safe lung deflation during one-lung ventilation in COVID-19 suspect or positive patients

Institution of one-lung ventilation using a double lumen tube (DLT) or bronchial blocker in a COVID-19 suspect or positive patient might increase the risk of staff exposure to a high viral load, through shedding into the theatre atmosphere. ACTACC-UK recommends that it is vital to occlude access to the non-ventilated lung. However, the lung needs to be deflated before occluding the tube, and advice on how to do this safely is lacking.

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Personal protective equipment, Public Health England and COVID-19: ‘Montgomery in reverse’? 

Concerns around personal protective equipment (PPE) availability are headline news. The Health Secretary’s comment that ‘some staff may be mis-using’ PPE received sharp rebuke from the Royal College of Nursing. Public Health England (PHE) has struggled to offer consistent guidance on which type of PPE to use, and this in turn has led to some of the Royal Colleges issuing their own variant guidance. All this reflects difficulties in understanding some of the core issues. 

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Evidence from the Cochrane Anaesthesia Review Group for anaesthesia and critical care during the COVID-19 pandemic

The COVID 19 outbreak has posed many challenges for anaesthesia and critical care. Apart from the clinical burden, one of the biggest problems is getting hold of accurate information. There are many infuriating social media experiences of information from untrusted, and occasionally unnamed, sources being shared widely. Even though these might not be enough to persuade us clinicians to change our current practice, they can create anxiety about how we manage our patients. To combat this, Cochrane has put together some resources that bring together the best evidence-based practice. 

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ICU surge capacity in a busy London district general hospital during the COVID-19 pandemic

Northwick Park Hospital in North West London has been one of the hospitals hit hardest by the COVID-19 pandemic in the UK. Having one of the busiest emergency departments in London, and a tertiary infectious diseases service, we were designated as an additional high consequence infectious disease ICU. During the transitional phase, we became one of the busiest hospitals in the UK with COVID-19 ICU admissions, reaching this at an earlier stage than others and with a greater mismatch between baseline-funded ICU beds and surge capacity beds, requiring a proportionately much greater and more rapid expansion. We write to offer some insights from the frontline about our management of hospital surge capacity.

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Maximise your day while shielding

The current international pandemic is an unprecedented situation for our generation. It has changed our lives drastically in both personal and professional spheres. Who would have thought that working from home could be so hard?

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