SUPERVISION & ESCALATION

See also the section on Indirectly Supervised Lists on the Modules, Training and EDT page

Daytime

9030 consultant or “mentor” consultant on CLWrota are your first ports of call.

In a clinical emergency, bleep 2222 and declare "anaesthetic emergency" followed by your location. This will alert a bleep group comprising senior anaesthetists and anaesthetic assistants.

Theatres are equipped with a red emergency bell which can be pulled, but be mindful of two things:

1. The 9030 bleepholder will not necessarily hear the alarm (e.g. if they are in the anaesthetic department)

2. In Interventional Radiology this alarm only sounds within the IR area, so limited help may arrive!

Out-of-hours

1st on-call consultant:

Via 9030 whilst on site
Via switch or phone directly

It is the 1st on-call consultant’s responsibility to call in the 2nd on consultant +/- any other resources

Trainee Supervision

If working alone, it is important that a supervising consultant is documented on the chart:

Out-of-hours: 1st on-call consultant.
Daytime: 9030 consultant or “mentor” consultant on CLW (usually adjacent theatre).
You should record name and supervision (direct/local/indirect) and if (and what) advice given
Emergency laparotomies with a P POSSUM >5%, require a consultant to be informed.
Emergency laparotomies with a P POSSUM >10% require a consultant to be present unless by agreement with the relevant, responsible consultant
Anyone you think might die on the table or immediately post op, or anyone you are not happy about, should be discussed with the consultant as a bare minimum

We formally review consultant supervision on a regular basis and would appreciate all those involved to record their experiences to allow us to be as objective as possible.

You are expected to ask for help whenever you need it (or even if you just think you might….) - but equally we are very happy for you to "stretch your wings" a little without prior agreement if you feel up to it.

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