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In the dynamic and challenging world of healthcare, the decision to ‘act up’ as an intensive care unit (ICU) consultant is a significant step in a trainee doctor's career. 

It marks a pivotal moment where one transitions from the supportive cocoon of training to the forefront of decision-making, all while still enjoying the protective umbrella of being a trainee.

In this article, I share my personal experience to shed light on why I chose to act up, the intricate process involved, and the invaluable lessons learned during this transformative period.

Jono Brüün updates you on the College's approach to diversity, equity and inclusion.

As a medical student, someone once told me that helping patients stop smoking was the single best intervention available to us as doctors. I’ve never found a reference for that, but it stuck with me.

While I might not have the evidence for my claim, we do know that each year, smoking-related disease costs the NHS £2.6 billion and causes up to 76,000 deaths. The good news is that rates of smoking are decreasing each year, with the latest figure at 12.9%.

Aside from the general health benefits of quitting, several specific perioperative outcomes exist.

This article explores how to make the most of indirect supervision.

The 2021 curriculum was explicit about having ‘levels of supervision’ embedded within it. These are descriptors of the supervision level the anaesthetist in training (AiT) would require if they were to repeat the same Supervised Learning Event (SLE) immediately after. 

Dear Editor

Arterial cannulation is a frequent practice that comes with its own set of risks and complications. We would like to report an incident that occurred in an obstetric HDU involving bleeding from an arterial catheter that could have led to severe complications.

A radial arterial cannula was inserted due to development of postpartum haemorrhage, cardiovascular instability and the need for massive blood transfusion. While the patient was monitored in HDU, an emergency call went out alerting the team about an arterial bleed possibly due to the patient’s positioning. The midwife present in the room applied manual pressure to the bleeding site with gauze. The anaesthetist on call asked what happened while taking over the manual pressure and explained to the patient that the insertion site needed to be inspected.

Find out the latest appointments approved, and with sadness we record the deaths of some of our fellows. 

Dr Viola Mendonca and Dr Emma Smith look at the effectiveness of medical students in recognising cardiac arrest, initiating chest compressions, and delivering defibrillation.

The annual incidence of in-hospital cardiac arrest is 1 to 1.5 per 1,000 hospital admissions, and return of spontaneous circulation is achieved in 53% of those who are treated by a hospital’s resuscitation team.

The hospital resuscitation team must, at a minimum, be able to perform basic airway interventions, including the use of a supraglottic airway in adults, intravenous cannulation, intraosseous access, defibrillation, and drug administration. They also should be able to provide immediate post-resuscitation care. In some hospitals, the cardiac-arrest team may not include an anaesthetist, but advanced airway skills such as tracheal intubation should be accessible when needed.

Maintaining and improving the LLP

Since its launch in August 2018, the College has committed to improving the reliability, performance and general user experience of the Lifelong Learning Platform (LLP) for our members. With the inclusion of three new curricula and of ICM users in late 2021, it became apparent that the added level of complexity and the need to support more users required additional funding, so a sizeable new budget was approved by the College’s Finance and Resources Board in August 2022.

This additional funding has allowed us to resolve many historic issues, keep the infrastructure and related systems up to date, as well as making significant improvements where needed. We still have a great deal of work to do, but as you will see below, we have already achieved a lot over the last year and have a clear plan of where we are heading in the coming months.

Dear Editor

With the start of 2024 we will each have set our own resolutions and goals for the year ahead, both personally and professionally. But to achieve these we will be relying on our healthcare system to do the same. The NHS Long Term Plan delivers many promising messages, but there appears to be an ever mounting number of constraints and challenges to overcome, too.

It goes without saying that a swift resolution to the pay dispute is essential to prevent any further distress for both staff and patients. With waiting lists spiralling out of control, the pressure on us to work harder and longer is very real. We need to collaborate effectively with non-clinicians and service users alike to come up with realistic solutions to curb the demand and supply imbalance. In the meantime everybody needs to remain proactive in taking simple measures to improve our daily working conditions and ensure we feel valued.