Senior Adult Intensive Care Medicine Fellow with an interest in ECMO

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PRINCIPAL ELEMENTS OF THE POST WILL BE:

1.    Day to day care of Adult intensive care patients

You will become a key member of a highly skilled multidisciplinary team (including ECMO consultants, intensivists, AICU nurses, ECMO specialist nurses, perfusionists, cardiothoracic surgeons and anaesthetists, pharmacists, physiotherapists, dieticians, radiologists and radiographers) providing advanced respiratory and cardiovascular critical care support including ECMO (both veno-venous for respiratory support and veno-arterial for cardio/cardiorespiratory support) and inhaled nitric oxide in adult patients. Within the role there is opportunity to become competent in a number of invasive procedures including ECMO cannulation and decannulation, percutaneous tracheostomy, bronchoscopy, central line insertion for drug delivery, renal replacement therapy and invasive monitoring and chest drain insertion.

 2.    Transport of patients

You will be part of our established transport team, and you will gain experience in transport of critically ill patients by road and by air (when possible). You will liaise with referring hospitals regarding retrieval and repatriation of patients. This will include both short trips within UHL and the local network and transport of patients to and from hospitals anywhere in the United Kingdom. The transport of patients with Severe Acute Respiratory Failure will be achieved by conventional means, with the possible addition of inhaled Nitric Oxide and in prone position. The most unstable patients and those in whom their current treatment cannot be replicated in the ambulance/aircraft will be transported on mobile ECMO. Initially all transfers of patients referred with Severe Acute Respiratory Failure (SARF), whether conventional or mobile ECMO retrievals will be undertaken under the supervision of an ECMO consultant. During the post you will be expected to gain experience and confidence with independent transfers of critical care patients with increasingly complex needs. Fellows will aim to undertake independent conventional retrievals of SARF patients and intra-hospital transfer of ECMO patients by the end of the attachment.

 3.    Training in ECMO

You will be expected to undertake our ECMO specialist training programme and we guarantee a place on our popular ECMO specialist course. You will attend daily ECMO ward rounds with the resident ECMO consultant, ECMO co-ordinator and specialists. There will be an opportunity to participate and deliver ECMO simulation for clinicians, ECMO specialists and nursing staff utilising the ECMO simulator.

 4.    Audit, research and teaching

There is an active programme of audit and research, and you will be expected to participate in data collection and analysis - the post holder will undertake a supervised project in the field of ECMO. There are opportunities to present data at local, national and international meetings. The post holder will be responsible in the organization and delivery of a local journal club to the trainees on the unit, present ECMO cases of interset during the ECMO MDTs and participate in the ECMO Fellow teaching programme.  

5. Assessment

Each Fellow will be assigned an educational supervisor and will have an initial meeting to discuss educational goals and set a personal development plan for the attachment. Thereafter meetings will be held every 3 months. ECMO specialist training involves attending the theoretical and simulation based course, 40 hours of preceptorship and a written exam. Fellows will be expected to keep a reflective log of all transfers undertaken. ICM Workplace based assessments will be completed to demonstrate practical skills (DOPS and mini-CEX) and each Fellow will be expected to complete adequate breadth and quality of assessments during the post, to allow ECMO trainers to make valid judgements of the doctor’s performance across all areas of the ECMO curriculum. For those trainees in recognised ICM training posts who wish to undertake the ECMO module as part of their specialist skills year (SSY), assessment will be as above plus documentation of assistance at 10 ECMO cannulations and decannulations and 10 inter- and intra-hospital ECMO transfers and completion of an audit or service improvement project with national publication (in accordance with the FICM SSY ECMO curriculum)

 6.    On-call duties

On-call commitments are split - 50% providing cover for the unit (resident, 1 in 7) and 50% for ECMO and Severe Respiratory Failure work (supernumerary and non-resident, 1 in 8) with defined rest periods. All daytime on-call duties will include support to the resident on-call staff.