Paediatric Anaesthesia

Experience

Training in Paediatric Anaesthesia is provided in the John Radcliffe Hospital West Wing. During the module, trainees can expect to be involved in providing anaesthesia for children of all ages, including neonates, for a variety of surgical and diagnostic procedures both in theatres and in remote sites.

At the end of your Fellowship, you should have achieved your core clinical learning outcomes including the following.

1. Appropriate level of confidence in providing anaesthesia to children across different age groups and for a wide variety of paediatric procedures
2. Ability to resuscitate and stabilise sick children appropriate to your level of training prior to transfer to a specialist centre.
3. Decision-making and organisational skills required to safely manage paediatric surgical / procedural cases and lists.
4. Ability to communicate compassionately and effectively with children and young people, their carers and other members of the multidisciplinary team.
5. Experience in teaching less experienced colleagues of all grades.

Consultant Trainers

Training in Paediatric Anaesthesia is principally provided by the Consultants in the Paediatric Group, but also by other Consultants with a paediatric interest.

Oxford Children's Hospital

Oxford Children's Hospital (also known as 'Children's Hospital Oxford', or 'CHOX') shares an atrium with the John Radcliffe Hospital West Wing.

Level 1

• Children's Day Care Ward
• Tom's Ward - general surgical and orthopaedics
• Robin's Ward - specialist surgery and TDA

Level 0

• Melanie's Ward - adolescents
• Kamran's Ward - haematology and oncology
• Bellhouse-Drayson Ward - medical

Level LG1

• Radiology
• Community Paediatrics
• Paediatric Outpatients

For more information visit:

Oxford Children's Hospital

John Radcliffe Hospital

Level 1 main hospital building

• Paediatric Critical Care (PCC, PICU and PHDU) are next to the main Emergency Department.
• Paediatric Theatres

Level 0 main hospital building

Paediatric patients are treated regularly on mixed specialist surgical lists:

• Craniofacial, cleft and plastics
• ENT
• Ophthalmology

Emergencies

There is a significant emergency out-of-hours workload for all West Wing surgical services. Oxford is the regional centre for Neonatal Surgery and Paediatric Neurosurgery in addition to all local paediatric emergencies that can occur across the various surgical specialties.

Training in Paediatric Anaesthesia requires exposure to an adequate number of cases and practical procedures, as well as careful pre-operative assessment, which includes establishing a rapport with both the child and the parents / carers.

Consultant Trainers may on occasion move trainees to more valuable teaching lists to ensure opportunities to achieve the required case-mix and experience.

In addition to clinical experience, trainees will also have the opportunity to undertake quality improvement projects and take part in the journal club.

What should Fellows achieve

Advanced training in Paediatric Anaesthesia should be delivered in a designated specialist centre undertaking a wide variety of complex elective and emergency paediatric procedures, with the necessary associated paediatric critical care facilities.

This unit is designed for those trainees who wish to be paediatric leads in the DGH environment (six months) and those trainees who wish to specialise as paediatric anaesthetists in a tertiary centre (12 months).

By the end of the Fellowship, the Fellow should be able to demonstrate competency in practising anaesthesia post-CCT with a special interest in paediatric anaesthesia as a consultant with specific responsibility for paediatric anaesthesia.

This implies the following.

• Delivery of safe and effective perioperative / peri-procedural anaesthetic care to a wide-range of paediatric surgery / procedures including those with complex co-existing disease.
• Mastery in the management of such cases, and the critically ill child when needed, and in doing so demonstrating the necessary multidisciplinary leadership, communication and teamworking skills necessary to ensure the care delivered benefits both the patient and the organisation.
• Maturity in understanding the importance of using the time allocated to paediatric clinical sessions effectively, optimising throughput whilst not compromising patient safety.
• Effective and compassionate communication with children and young people, parents and carers throughout the surgical episode, and also within the multidisciplinary paediatric team.
• Ability to guide the choice of audit cycles in developing practice within this subspecialty area, and understand the legality of consent in children and young people, in relation to research, restraint and procedures.
• Familiarity with recent developments in perioperative anaesthetic care to this area of practice, to evaluate these developments and to advise colleagues of useful changes in practice.
• Knowledge of the drivers for the provision of paediatric services in the DGH [National Service Frameworks etc.].

For the Paediatric Specialist in a tertiary centre, in addition to the above, the following.

• Ability to practise post-CCT anaesthesia as a Consultant Paediatric Anaesthetist in a specialist paediatric hospital or tertiary referral centre: the delivery of safe and effective perioperative anaesthetic care to a wide range of complex paediatric surgical cases, including the very premature sick neonate and those children with complex co-existing disease. (The precise skill mix required will depend upon the nature of the post and may or may not include patients undergoing cardiothoracic or neurosurgery).
• Knowledge of the drivers for the provision of paediatric services in the tertiary centre.

Further information

Protocols and guidelines

Protocols, guidelines and 'room tips' are available on the OUH SharePoint intranet, and there are books and journals in the paediatric section of the Nuffield Department of Anaesthetics. Please feel free to use them.

Recommended reading

Paediatric & Neonatal Anaesthesia: Anaesthesia in a Nutshell
Ann Black MB BS DRCOG FRCA and Angus McEwan MBchB FRCA

An excellent book and essential reading for all trainees - comprehensive without being too long.

Oxford Handbook of Anaesthesia: Section on Paediatric Anaesthesia

Comprehensive and very well written

Literature

This journal is a source of review articles on various aspects of Paediatric Anaesthesia.

BJA Pediatric Anaesthesia Anaesthesia

Links

Association of Paediatric Anaesthetists of Great Britain and Ireland

Interested trainees should consider joining our sub-specialty association.

Welcome to APAGBI - Association of Paediatric Anaesthetists

In addition to the RCA e-learning website, the websites of the following organisations contain important guidelines and recommendations:

Association of Anaesthetists

Virtual patients and hot topics

Virtual patients are interactive cases that have been developed by members of the Education and Training Committee to support members in gaining or refreshing the knowledge base required for revalidation against the Level 2 CPD matrix (continuing professional development matrix).

'Hot topics' provides an interactive poll and discussions around topical and controversial areas of Paediatric Anaesthesia.

Contact us

Dr Sumit Das

Head of Paediatric Anaesthesia Fellowship Programme

Email: sumit.das@ouh.nhs.uk