CRITICAL CARE UNIT

Information about postgraduate doctors placements within the Critical Care Unit at Medway NHS Foundation Trust.

Welcome

We have a busy 25 bedded critical care department, admitting around 1800 patients/ year, comprising a separate 9 bedded ICU, 10 bedded surgical HDU and 6 bedded medical HDU.

Being one of the busiest critical care units in the region, the department provides postgraduate doctors with opportunities to gain experience in a diverse case mix of critically ill medical patients alongside a large number of elective and emergency post-surgical patients The case mix for the level 3 admissions is approximately 90%-10% emergency: elective split and approximately 70:30 medical: surgical split.

The hospital houses the local vascular and ENT services and therefore we receive the casemix associated with these specialties.

Ventilators (Draeger Infinity C500) with advanced modes including APRV are in use in the unit. Citrate anticoagulation (Nikkiso Aquarius) is first line for CVVH and we use Edward’s EV 1000 and PiCCO for cardiac output monitoring. There is an active interventional radiology department and we take advantage of this service to deliver unique modalities of therapy (e.g. catheter directed/ ultrasound assisted thrombolysis for intermediate risk pulmonary embolism).

The emergency department is the busiest in the region and treats wide ranging acute illnesses. Respiratory medicine department has a comprehensive range of services (TB, lung cancer including interventions like EBUS/ Thoracoscopy, pleural service, busy sleep and domiciliary NIV service) and works in close collaboration with critical care. There is a 24/7 on-call GI bleed rota in place and 24/7 on-call service is also in place for cardiology and major surgical specialties (ENT, orthopaedics, vascular, urology).

There is a well-established Post-ICU clinic with physiotherapists and a counsellor embedded within the team.

Image by Jair Lázaro
 

About training in the Critical Care Unit

 

More information from the professional and statutory body for the specialty of intensive care medicine.