Episode 6: The ED/Critical Care Interface
Author: Eoghan Colgan @eoghan_colgan
Special Guest: Prof Kevin Rooney @kevindrooney
Professor Kevin Rooney
Consultant Anaesthetist & Professor of Care Improvement, University of the West of Scotland
Kevin Rooney was appointed as a consultant in Intensive Care and Anaesthesia at the Royal Alexandra Hospital in Paisley in July 2003. From February 2009 to January 2011, he was the Lead Clinician in Critical Care for Greater Glasgow & Clyde Health Board.
In January 2011, Kevin was made a Professor of Care Improvement at the Institute of Healthcare Policy and Practice within the University of the West of Scotland. He continues to practice in Intensive Care & Anaesthesia at the Royal Alexandra Hospital where he can pursue his interests of patient safety and healthcare quality improvement. Professor Rooney is a Clinical Lead for the Acute Adult Workstream of the Scottish Patient Safety Programme for Healthcare Improvement Scotland and led their breakthrough series collaborative on Sepsis, which resulted in a sustained relative risk reduction of 21% in sepsis mortality across Scotland.
Kevin is a Fellow for the Scottish Patient Safety Programme and a Founding Member of the Q initiative for the Health Foundation and the National Health Service. As critical care faculty for the Institute for Healthcare Improvement (IHI) he has taught quality improvement for IHI in the Hospitais da Universidade de Coimbra project (Portugal), “Patientsikkert Sygehus” (Danish Patient Safety Programme), the Improvement Science in Action Course for the National Guard Health Affairs in Saudi Arabia, the Best Care Always Programme for the Hamad Medical Corporation in Qatar and finally the Salus Vitae programme in Brazil.
Recent awards include Doctor of the Year Award in the Scottish Health Awards 2015, the Scottish Health Award 2014 for Innovation and a NHS Greater Glasgow & Clyde Chairman’s Gold Award for excellence in clinical practice in 2014.
Eoghan and Kevin discuss a range of EM and Critical Care topics, including sepsis, quality improvement, palliative care, leadership and making the workplace and enjoyable place for everyone!
Take Home Points
1. Early recognition and treatment is key
2. Recognise sepsis with NEWS score – if patient is scoring highly ask yourself – “could this be due to infection”
3. Early antibiotics
4. Fluid resuscitation guided by:
a. Vital Signs
b. Lactate Clearance
c. Assessment of adequacy of circulation
- Capillary refill
- Passive leg raise
- Echocardiography (if skills permit)
- What keeps me awake at night? or
- What are the department challenges?
These can be the starting points for a great QIP
Because we can do things doesn’t mean it is the right thing to do – consider what is necessary and valuable to the patient
Make work an enjoyable place to be – this will help with recruitment and retention of staff
Always try new things – you never know where it might lead!