Anaesthesia for Vascular Surgery

Contact

Dr Richard Dodwell (richard.dodwell@nhs.net) Dr Mike McGovern (michael.mcgovern@liverpoolft.nhs.uk)

Location
Countess of ChesterLUHFT (Aintree)
SIA Group

2

Countess of Chester Hospital

Contact: Dr Richard Dodwell (richard.dodwell@nhs.net)

Module Details: The Countess of Chester Hospital is the South of the Mersey Arterial (SMART) Centre covering Wirral, Warrington and the Chester area. Stage 3 trainees will principally be attached to our two vascular theatres, where high-risk patients receive perioperative care for a wide range of complex major procedures, including open and endovascular aortic surgery, carotid endarterectomy and peripheral revascularisation. There is ample opportunity to practice regional anaesthesia, with trainees being encouraged to experience carotid surgery both asleep and awake, gain exposure to peripheral nerve block strategies for lower limb surgery and participate in our growing nerve catheter service. Trainees will experience multidisciplinary working, accompanying consultants at MDT meetings, responding to formal anaesthetic referrals for risk evaluation and optimising comorbidities through the vascular preoperative assessment clinic. We work closely with our Stage 3 trainees and collaborate with our colleagues around the region to offer a comprehensive training experience.

LUHFT (Aintree)

Contact: Dr Mike McGovern (michael.mcgovern@liverpoolft.nhs.uk)

Module Details: We offer an in-depth programme that encompasses complex open and endovascular AAA surgeries, carotid endarterectomies and peripheral vascular work. The patient load is often high risk with significant co-morbidities, requiring invasive monitoring with the potential for catastrophic blood loss. We rotate trainees through extensive pre-operative work including clinics and MDTs. There is the option for joining the vascular team on a morning ward round to provide anaesthetic expertise. The great thing about this module is that the vascular team get to know you well during the 6 months and you become part of the team. They are very supportive of our role in educating the next generation of vascular anaesthetists. Recent QI projects include topics such as frailty, anaemic management, service reorganisation (out-of-hours endovascular repair of ruptured aneurysms), simulation and pre-habilitation. The focus is on producing a trainee who is confident in patient selection for high risk procedures, is able to anaesthetise ASA 4 patients safely and can manage a patient who has lost most of their circulatory volume.

Trainee Feedback: Good exposure to vascular cases, emphasis put on vascular lists. Available QI projects and lots of Consultant support. On call is covering emergency theatre, so good experience for Consultancy. Lots of practice supervising core trainees and stepping up to Consultant C1 role. Attendance at Consultant meetings and MDT. Increasing solo work as rotation progressed.