Charing Cross

A large teaching hospital in Hammersmith, West London

Trainees rotate through teaching and district general hospitals in north west London, as well as some specialist hospitals in central London

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CXH Anaesthetic Department Induction

 

Introduction

Welcome to CXH anaesthetic department. This is a big friendly teaching hospital department providing services for several specialist areas including major head and neck surgery, neurosurgery and acute stroke services. There are many procedures you are unlikely to see anywhere else on your rotation. You will also be involved in providing critical care services and supporting the ICU so will be able to maintain and develop these skills.

The Daily Grind!

Lists are available on Cerner from around 1600hrs the day before but may be subject to change after this.

Patients for most elective operating will be admitted to the Elective Admissions lounge on 6W. It is best to arrive by 0730 at the latest. The first patient on the list should be sent for automatically at 0800hrs (but that is not always the case). Currently there are challenges with this process; missing notes and organisational difficulties are common. Do not be disheartened!

Major orthopaedic cases such as THRs may be admitted directly to main hospital wards, e.g. 7 South.

Angio. Suite - you may be attached to an interventional radiology list in the angio. suite.  This is located on the 1st floor in the imaging department.  Call 30777 the day before to find out what is listed. The department does not open until after 8am.

Who’s Who

Head of Specialty Anaesthesia at CXH – Dr Claire Hopkins

Departmental Office Manager/PA/Custodian (temporary Smartcards) - Ms Simona Eisvydyte. Please add her onto online study leave request as Leave approver/Rota Manager for Intrepid.

College tutors – Dr Nicky Stranix, Dr Ashwin Kalbag – They will authorise study leave – please add their email addresses to electronic study leave application via Intrepid.

Rotamaster – Dr Chris Whiten.

Trainee Rota Coordinator – Dr James Burrow. Please add him onto your online study leave request as Rota Manager/Leave approver for Intrepid.

In charge of fellows- Dr Dan Horner

Departmental Teaching – Dr Chris Whiten and Dr Dafydd Lloyd

 

Dr Tina Ainley: Breast and Vascular lists, Honorary Clinical Lecturer for Imperial College.

Dr Bruce Arrigoni: Mainly emergencies and orthopaedics.  Good person to ask for advice regarding preparation for Consultant interviews. Blood Transfusion Lead for the Trust.

Dr Stewart Berry: Neuroanaesthetist. Interventional radiology lists. 

Dr James Burrow: Neuro, Urology and Pre-Assessment.

Dr Derwin Christmas: Airway/ENT, General lists.

Dr Doris Doberenz: ITU Consultant. Occasional Urology and other lists.

Dr Nieves Dorronsoro: TIVA specialist - will use PKA pumps. Neuro, Plastics.

Dr Patrick Doyle: Neurology

Dr Claire Hopkins: Neuroanaesthetist. Clinical Lead.

Dr Dan Horner: Neuroanaesthetist, orthopaedic and ENT lists. Clinical Lead for Fellows programme.

 

Dr Stephen Humble: Pain and General lists.

Dr Ashwin Kalbag: College tutor. Orthopaedics. Neuroanaesthetist. Acute pain.

Dr Lena Ladas: Neuroanaesthetist.  Chronic pain.  Likes to use Airtraq and does scalp blocks before craniotomies. Uses TIVA.

Dr Dafydd Lloyd: Teaching Lead. Airway and General lists.

Dr Dejan Markovic: Neurology, Orthopaedics and breast lists.

Dr Cathal McCabe: Airway/ENT, Neuro, General.

Dr Roseanne Meacher: ITU Lead.  Does occasional urology lists.

Dr John Myatt: Plastics, head and neck lists, orthopaedics.  Does lower limb blocks.

Dr Vidhya Nagaratnam: Neuroanaesthetist

Dr Jim Poncia: Head and neck, urology and plastics lists.

Dr Mala Siva: Breast, Neuro, Head and neck, and Airway/ENT lists.

Dr Nicky Stranix: College tutor, acute pain, Airway/ENT, emergency lists.

Dr Drinka Uzeirbegovic: Orthopaedics, Bariatrics. Audit lead.

Dr Jason Wilson: Neuroanaesthetist, General lists, statistics guru.

Dr Chris Whiten: Regional, Plastics, vascular, Ortho, Urology. Teaching Lead.  Willing to help with Viva practice.

Dr Colleen Woo: Airway/ENT, General lists.

Dr Tom Dolphin, Dr Nick Gilfillan, Dr Sadie Syed, Dr Ian Bailes, Dr Boyne Bellew, Dr Shona Love  Dr Philippa Borra, Dr Ian Barker, Dr Gary Stocks, Dr Ivan Dillon. Dr Abigail Richardson are based at other sites but do cross cover.

Contact numbers on notice board in Anaesthetic coffee room.

 

Further Contacts

Paging:   Dial 456 then follow instructions

8844: Senior Registrar Anaesthetics

8189: ST3/4 Anaesthetics

8111: SHO Anaesthetics

7487: ICU SpR

1465: ODP On-Call

Useful extension numbers:

Anaesthetic coffee room      x30501

Anaesthetics Office              x17017

Theatre 8                              x30367    

Recovery                              x30310

Riverside:                             x38806

Milk:                                      x11352 (for coffee room!)

Operator 0

ICT x5555, option 2 for IT related issues

Surgery

Gen Surg SHO: 8811

Gen Surg SpR: 8800

ENT SHO: 8855

ENT SpR: Off site, via switch on mobile

Urol SHO: 9193

Urol SpR: Off site, via switch on mobile

Labs

Blood bank: x17112, BP 8160 Out of hours

Medicine

Med Spr: 8988

Med SHO: 8999

 

Training Opportunities

Units which can be completed at CXH:

Advanced

            Airway, Neuro, Pain

Higher

            General duties, ICM, neuro, airway and various optional units

Intermediate

            Pain, Neuro, Airway, General Duties,

Core

            All basic level of training units but without trauma, obs and paeds

Novice

            Initial assessment of competencies (IAOC)

 

Neurosurgery: Most of you will be placed at CXH primarily to sign off your intermediate or high neuro module. Ensure that you contact the rota coordinator early if you feel you are struggling to achieve the requisite number of lists.

ENT/Head and Neck: There are several interesting head and neck lists in the hospital and plenty of opportunity to work on your airway skills. Mr Sandhu performs laryngotracheal reconstructions which you may not see elsewhere. Both the anaesthetists and surgeons who work on these lists are friendly and approachable which makes it a great learning environment. There are numerous ENT clinics running in the hospital which might provide opportunity to practice nasendoscopy – approach one of the ENT team to attend.

Regional: Dr Boyne Bellew is an excellent regional anaesthetist and performs US guided blocks with an interest in teaching and organising courses.

 

Emergency Cases

 

  • NELA audit forms should be completed for all emergency laparotomy patients

 

 

 

Booking and Requesting Leave

The department actively try and facilitate leave where possible but the rota is tight and leave requests must be placed at least 6 weeks in advance.

There are four slots each day for annual/study leave for 8844/8189 trainees. There are two slots each day for 8111 trainees.

Submit an online study leave request form through Intrepid, accessed via the Source and searching for ‘Medical Education’: http://source/pgme_cpd/index.htm

Study Leave should formally be requested eight weeks in advance via Intrepid. Please also submit an online study leave request on CLW rota. We are generally quite flexible until the leave diary is closed prior to writing the weekly rota which is about three - four weeks before. This is a generous privilege which should not be abused and can be withdrawn.

Swaps should ideally be made before the rota is drafted, 3-4 weeks out as it creates extra work to move people around, but short notice swaps might be accommodated if there is no net change to the rota.

It is your responsibility to check that the online CLW rota is correct as this is always taken as the definitive rota.

ID Badges: This is on the ground floor, pathology block. If you arrive for your on-call in the evening and do not have your Security ID access card with you, a temporary one can be taken from the Security Office on the ground floor, near the main reception (from the side).

The department is in the process to have its own Security ID access cards for emergencies.

NHS Smartcard: Anaesthetics Office Manager Simona Eisvydyte is PIN unlocker and Custodian for the department. She can issue you with a temporary smartcard (with Doctor’s access) for a day (if you left yours at home) or while waiting for the appointment with the Smartcard Team to sort out your own smartcard.

Car Park Permit: Go to the front desk/main reception on the ground floor and show your ID access card and car registration number.  The permit costs £10 per day or monthly payment of £66.67 for 30 days.  If you want the payment to be taken monthly from your salary, please email staffcarparking@imperial.nhs.uk

You will get a ticket if you do not show your permit.  Code for the car park is 4321.

It is not sure if your CXH parking permit can be used at other Imperial sites, thus please email Security directly at securityadmin@imperial.nhs.uk  to enquire if you need to at some point. The email must be sent from your Imperial email address.

Locum shifts: Time to time the department is looking to cover on-call gaps or sickness absence. If you are interested in locum shifts, please speak to Simona, so she can add you to the locum distribution list. If you want to do the locum shifts after leaving the Imperial Trust, please contact Doctor’s Bank imperial.locums.admin@nhs.net 1 month before you leave to start a registration.

Code to department: CX1986

Codes to on-call rooms: Doctors’ Mess on 3rd floor South Wing (directly above the main canteen): Room 7 CX3579, Room 9: CXZ048

 

Appendices

Major Orthopaedic ER Protocol

Airway emergency algorithms – www.tracheostomy.org

Cerner - On the desktops or in the start menu of the PCs attached to the anaesthetic machines is a link called ‘Cerner in Theatres’. The URL is http://170.71.159.29/Citrix/NotimeoutSSOWeb/ (this link will not log you out of Powerchart so you don’t have to keep logging in).

 

Consultants who are able to sign off module completions:

Neuro Module                                   Airway / ENT

Dr Stewart Berry                              Dr Mala Siva

D Nieves Dorronsoro                       Dr Nicola Stranix

Dr Jason Wilson                               Dr Jim Poncia

Dr Ashwin Kalbag                             Dr John Myatt

Dr Vidhya Nagaratnam                          

Pain Module                                    Orthopaedic         

 

Dr Lena Ladas                                 Dr Bruce Arrigoni

Dr Stephen Humble                         Dr Chris Whiten

Dr Ashwin Kalbag                            Dr Drinka Uzeirbegovic

Dr Nicola Stranix                              Dr Dejan Markovic

Dr Suneet NayeeTop of Form

Bottom of Form

                              Dr Daniel Horner

 

General module - any consultant who is an educational supervisor should be able to sign off.

The Hospital

Charing Cross is a large acute general hospital. It is part of the Imperial College NHS Healthcare Trust and one of Imperial College School of Medicine’s teaching hospitals.  It contains The Kennedy Institute of Rheumatology, West London Neurosciences centre and Maggie’s cancer centre.  It is a tertiary referral centre for complex surgery, plastic reconstruction and neurosurgery; as well as for head, neck and urological cancers.

As part of Imperial Healthcare trust it is a centre for Healthcare research namely in rheumatology and cancer research.

The Anaesthetic Department

The anaesthetic service is delivered by consultants, senior clinical fellows and senior trainees under direct supervision.  Anaesthesia is provided for patients undergoing General surgical procedures, specialist ENT and Airway surgery, Urological (including gender reassignment and cancer) surgery, Plastics, Neurosurgical and Orthopaedic surgeries.  Charing Cross Hospital is now the main site for Imperials’ chronic pain service with interventional procedures and clinics taking place.

As a trainee there is the opportunity to gain exposure to all of these surgical specialities as well as gaining experience in Regional techniques and anaesthesia for radiological procedures. The on call service is provided by a senior and junior registrar with support from consultants. Theatre, ED and ICU referrals are covered by this team on a 24/7 basis.  Fellowships are available.

Weekly half day teaching is provided as well as monthly morbidity and mortality meetings. There is also an active Audit programme lead by Drinka Uzeirbegovic that everyone is encouraged to take part in. 

 

Audit Lead: Dr Drinka Uzeirbegovic

Charing Cross

Fulham Palace Road, Hammersmith, London W6 8RF
Dept 020 3311 7017 Fax 020 8846 7585 Switch 020 3311 1234
Department Website
College Tutors Nicola Stranix, Ashwin Kalbag
Department Admin Simona Eisvydyte
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