North Bristol NHS Trust Stage 3 Special interest in Burns anaesthesia Module
3 to 6 months placement in burns and plastics lists
Learning outcomes
- Provides safe perioperative anaesthetic care for a wide variety of complex plastics and burns cases independently
- Is capable of leading the delivery of care in this area of anaesthetic practice, to the benefit of both patients and the organisation
Southmead Hospital is one of 2 adult burns units in The Southwest Burns clinical network and accepts adult burns up to 40% Total Body Surface Area (TBSA), with burns greater than this referred to the Swansea Burns Centre. The paediatric burns centre is located at Bristol Royal Hospital for children.
There are 7 consultant burns surgeons who work at both Southmead hospital and the Bristol Royal Hospital for children.
The dedicated burns MDT and ward at Southmead hospital sees a wide variety of burns including electrical, chemical, inhalation, thermal with TBSA up to 40%, whilst the ICU has two dedicated rooms for burns.
The burns unit receives over 2000 referrals per year with around 300 admissions per year.
The ICU admits around 15 burn patients per year.
Burn injuries are multisystem and often require multiple intensive interventions over a considerable length of time. Whilst at Southmead, you will have the opportunity to work closely with the MDT, discuss the issues and find solutions together. There are multiple nuances to the anaesthetic and ICU care of the burns patient which you will observe and learn in order to deliver the best care for the burns patient.
During your burns placement:
There are 3 dedicated burns theatre lists per week but this is flexible, and on occasions more theatre time is required.
Theatre is very varied: from cleaning, debriding, change of dressings to grafting with artificial dermis or skin and complex skin release.
Weekly burns MDT – Monday afternoon
ICU care
Service improvement including developing and writing essential new guidelines
Examples of evidence
Experience and logbook:
- experience of a wide range of elective and emergency plastic surgery and burns procedures including those in children
- experience in the emergency management of major burns injuries.
Supervised Learning Events (SLEs) can be used to demonstrate:
- emergency assessment, resuscitation, and ongoing management of patients with major burn injury including airway management and organ support
- management of fluid resuscitation following major burn injury
- bronchoscopy assessment of inhalational lung injury
- perioperative management of patients undergoing major burns excision and grafting
- management of dressing changes including different analgesia and sedation techniques
- ICU management of patients with major burn injury requiring multi organ support
- perioperative management of patients undergoing free flap surgery
- perioperative management of patients undergoing reconstructive surgery
- management of major haemorrhage during major burns/plastics surgery including blood conservation techniques
- perioperative management of emergency plastic surgery cases including the use of regional techniques.
Personal Activities and Personal Reflections may include:
- national and international meetings related to plastic surgery and burns management
- attendance at regional education meetings
- presentation and discussion of cases at local, regional, and national network meetings
- burns specific resuscitation courses
- development of guidelines and policies for management of Burns
- leadership of QI projects related to plastic surgery and burns management
- leadership training
- simulation training.
Other evidence:
- satisfactory MSF.
Suggested supervision level
- 4 - should be able to manage independently with no supervisor involvement (although should inform consultant supervisor as appropriate to local protocols).
SIA lead:
Dr Skylar Paulich