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Theatres, 
Critical Care and Anaesthesia services at Papworth Hospital

Theatres, critical care and anaesthesia services

The Theatres, Critical Care and Anaesthesia Directorate (TCCA) supports all surgical activity across the hospital and comprises the following departments:

   In addition, the TCCA covers the hospital's provision of ECMO

TCCA is managed by clinical director Dr Alain Vuylsteke and Directorate manager, Maggie Maxwell.

Theatres

There are five operating theatres with adjoining anaesthetic rooms on the first floor of the surgical unit. Each theatre is equipped to carry out the full range of cardiac, thoracic and transplant operations. Three theatres have facilities for remote viewing of operations, in the lecture theatre, by visiting surgeons or staff from other hospitals. There is a four bedded recovery area adjacent to the five theatres.

The theatre team consists of registered nurses, operating department practitioners, surgical care practitioners, healthcare assistants and ancillary staff. The qualified theatre staff are highly trained and all have a special interest in cardio-thoracic surgery.

Procedures undertaken include coronary artery bypass grafts, valve repair, valve replacement, heart and lung transplantation, mechanical cardiac assist device implantation and a wide variety of thoracic operations and endoscopic procedures.

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Critical Care

The 33 bed critical care area (CCA) comprises six cardiac recovery (CRU) beds dedicated to the care and treatment of patients for the first 24 hours following open heart surgery. The remaining 27 intensive care beds provide a flexible level of care for patients who require ongoing and more complex treatment and support. As a tertiary and national referral centre, the unit also admits patients needing mechanical support such as extra corpreal membrane oxygenation (ECMO), treatment for heart failure, and following transplant and pulmonary endarterectomy (PEA) surgery. In addition we treat patients with cardiothoracic emergencies eg aortic dissection and chest trauma.

A nursing team of more than 200 nurses, led by two matrons and 11 sisters / critical care practitioners (CCPs), provide continuous specialist nursing care.

Medical care is led by dedicated Consultant intensivists supported by a multidisciplinary team. This team includes referring and specialist consultants, specialist nurses, physiotherapists, pharmacists, dieticians and speech language therapists.

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Anaesthesia

The consultant anaesthetists are all specialists in providing anaesthesia for patients undergoing of cardiothoracic surgery.

The department accommodates a regular rotation of trainee anaesthetists of varying grades, from other hospitals in the region and is a renowned international centre for training in anaesthesia for cardiothoracic procedures.

Consultant anaesthetists with a specific interest in critical care (intensivist) lead the daily care of all patients admitted to the critical care area, working closely with all other specialists within the hospital.

The hospital resuscitation service is coordinated from the anaesthetic department. Another consultant runs a pain clinic.

An ongoing and broad range of active research programmes is also a common element of the department and a specific anaesthetic research unit runs various research studies. There is particular interest in research into the development of blood substitutes, the acute management of pulmonary hypertension, cardiac pharmacology and various outcome studies related to cardiac surgery.

The department has been a key player in the creation and development of national and international associations of doctors interested in the perioperative management of patients undergoing cardiothoracic surgery. Every other year, a national meeting involving all cardiothoracic anaesthetists from the United Kingdom is organised by the department and organised in one of the Cambridge colleges.

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Sterile Services

The Sterile Services Department is responsible for the disinfection of all re-usable medical devices for the operating theatres, wards and various other departments including critical care and radiology as well as external customers.

The department uses automated wash/disinfectors and utilises steam and gas plasma sterilisation techniques. Using a Health Edge Traceability System it tracks all instruments and related products throughout the decontamination/sterilisation process and to its subsequent use.

The department is the first in the area to have achieved both national and European accreditation for carrying out tasks of sterilisation and decontamination of re-usable medical devices. It is also accredited with BS ISO 9002:2000, BS ISO 13485: 2003 and Directive 93/42/EEC (sterilisation aspects only) for the disinfection, inspection, assembly, moist heat and gas plasma sterilisation of single instruments, instrument trays and procedure packs.

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Technical Support Services

The Technical Support Service Department is responsible for the maintenance of the majority of the medical equipment used at Papworth Hospital. Every piece of equipment, which the Trust owns, is registered on a database so that a full working history can be maintained on each item.

The department is staffed by a manager and technicians with expertise in electronic and mechanical engineering.

Technical Support Service is registered with ISO 9002.

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