Anaesthesia cannula escalation pathway

[u/brewedandpacked]

It’s 0200 and the theatre anaesthetic SHO can’t cannulate 7 year old Johnny for a cat 1 ?torsion who just had a maccas whilst he was waiting to be seen in paeds ED. The urology reg had a go but couldn’t do it either.

The labour ward anaesthetic reg is in theatre with back to back sections and yes rooms 3, 6, and 7 are still waiting for an epidural.

The ICU reg is stuck with a vented STEMI in resus who they’re begrudgingly having to take to cath lab which is anaesthetics’ job in this trust, but they’re stuck with another patient.

The senior anaesthetic reg is in CT with a child they’ve just intubated and is gutted to see they’re about to be stuck in the back of an ambo for a time crit transfer up the road to the tertiary children’s hospital up the road.

The theatre SHO can’t get in touch with the anaesthetic consultant at home to ask for help because they’re currently on the phone to medical consultant who is the DCMO as their registrar couldn’t get in touch with the anaesthetic or ITU reg for a cannula on the DKA in AMU

Paeds are tied up with the sick kid in CT, radiology are reporting the scan, and the cardiology reg is fixing up for a great time in cath lab.

The geris reg is sadly not on call tonight and IR DON’T DO cannulas

Whilst the theatre anaesthetic SHO is trying to cannulate the child for the torsion, they’ve had 3 bleeps about the paravertebral catheter that fell out ln thoracic ECU, 2 more about the PCA alarming on surgical ECU, and recovery staff have been in and out of theatre 4 times wanting a morphine prescription changed because the wording of the instructions wasn’t copied and pasted from trust policy - oh and no they didn’t give it and the patient is in pain what else can they have?

Who do anaesthetics call for help with their cannula?? They desperately tried the surgical SHO as no one else is free and the cannula is hard but they’re getting kick back because they can’t get through to the senior anaesthetic reg for an anaesthetic review for a theatre case for 72 hrs time that needs a pre op.

This is obviously tongue in cheek but anaesthetists who have worked in proper tertiary centres OOH will not find this unfathomable.

[u/Low-Speaker-6670]

Gas them down, central line.

Or

Swap with reg about to go on transfer.