UCC Anaesthesiology Newsletter

22 Apr 2024

Welcome to the spring edition:

Dr Alina Patrache (Registrar), Dr Yasi Besharatian (SHO), Dr Oonagh Hickey (Consultant), Cork University Hospital:

Welcome to the Spring UCC Anaesthesiology Newsletter.

Spring has sprung and we hope that you are enjoying the warmer weather (between the occasional showers). We are especially enjoying the blast of colour brought by the cherry blossoms that are currently in bloom.

We would like to wish an Eid Mubarak to our colleagues and we hope that you had some well-earned time off to celebrate with your family and friends. 

We feature an interview with Ms Lavinia McCarthy, Anaesthetic CNM2 in CUH where she outlines her role. We also feature the CUH Theatre Staff Wellbeing Group “Cheers To Our Peers” initiative, as well as other team building activities including a highly competitive Go-Karting Grand Prix.

As always, academic, departmental, and social submissions are welcome from colleagues within and beyond the region. Please send submissions to: yesuccanews@gmail.com

 

Queens Medical Centre, Nottingham visit:

Dr Alan Horan, Consultant Anaesthesiologist, CUH:

On the 4th of March Dr’s Paudie Delaney, Murray Connolly (Consultants), Robert Craig (SpR) and I visited the Queens Medical Centre (QMC) in Nottingham to attend the Trauma Anaesthesia and Resuscitation Skills Course (TARSC) run by the Department of Anaesthesia, Nottingham University Hospitals NHS Trust. The target audience of this course is senior trainees in Anaesthesia or Intensive Care Medicine. TARSC is designed to complement other trauma courses such as ATLS/ETC and is tailored to the role of the anaesthetist caring for the acute major trauma patient.

QMC is the major trauma centre (MTC) for the East Midlands major trauma network in England and is the busiest MTC in the UK. I completed my fellowship training at QMC and have maintained close links with the department there. The purpose of our visit was to fact-find as we are currently developing a trauma resuscitation anaesthesia skills course bespoke to Irish practice.

Over the course of the day we attended lecturers on damage control resuscitation and the role of TEG in goal directed massive transfusion in major trauma care. The course allowed the participants to practise front of neck access, finger thoracostomy and subclavian CVC insertion on task trainers and to get tuition and advice from expert faculty. We also observed the role of medium fidelity simulation in preparing anaesthetists to work as part of a major trauma team. 

Our visit was very productive and it was great to forge links with the Department of Anaesthesia at QMC. Watch this space for the launch of the Trauma Resuscitation Anaesthesia course in Cork later this year!

Photo includes Dr Alan Horan, Dr Murray Connolly, Dr Paudie Delaney (Consultant Anaesthesiologists, CUH) and Dr Robert Craig (SpR CUH, CAI Simulation Fellow).

 

Interview with Ms Lavinia McCarthy, Anaesthetic CNM2, CUH

Hi Lavinia, thank you for agreeing to talk to us. Can you tell us a bit about your role?

I am the Anaesthetic CNM2 in the CUH. I have many roles, including being involved in day to day elective anaesthesia and emergency cases. I manage anaesthetic stock (which is very difficult at the moment due to ongoing supply and manufacturing issues), the trial of equipment and consumables, and I am also involved in tenders and liaising with company representatives regarding training and education. I am involved in standardisation and centralisation of anaesthetic equipment and information such as the anaesthetic drug trolleys, MH (Malignant Hyperthermia) trolleys, Anaphylaxis and Local Anaesthetic Toxicity kits, and QRH folders across the 13 theatres and outlying areas. I provide support for outlying areas which carry out GA cases such as the Cath Lab, Dental theatre, and Brachytherapy. I was involved in setting up for GA cases in the MRI Unit, as well as giving input into the Paediatric Theatres at the planning stage. I’ve been involved in the commencement of Cell Salvage cases in CUH and the training of staff to undertake this process. Education plays a huge part of my role and I work very closely with the Clinical Skills Facilitator in educating newly qualified staff as well as Adaptation Nurses from overseas. I also spend time working on the floor with staff to enhance their learning particularly for difficult airway cases and when using techniques or equipment not used on a regular basis. I particularly like being involved in paediatric cases as it draws on my previous knowledge and experience.

Please tell us about your career so far.

I qualified in 2003 Diploma in Nursing Studies and I continued on to complete the BSc in General Nursing in 2004. In 2006 I commenced my training in Children’s Nursing, qualifying in 2007. I immediately went into the Paediatric Theatre (T5) in Tallaght University Hospital and worked there until 2011, when I moved to Temple Street Children’s Hospital where I worked until 2014. In 2015 I commenced working in theatre in CUH, initially as a staff nurse in theatre 6, and I began my current post in early 2017. 

What initiatives are you currently working on?

I am endeavouring to expand the group of nurses involved and trained in Cell Salvage. My CNM3 colleague and I are working to train Anaesthetic Nurses in CUH - currently in the CUH this is taking the form of bringing theatre recovery nurses into theatre to expand their role and utilise our resources more efficiently. In collaboration with my anaesthetic colleagues, we are hoping to introduce simulation training in theatre in the future. 

What departments and staff do you generally interact with?

I interact with the nursing staff and the anaesthetist’s in all theatres and outlying areas, as well as departments such as Pharmacy, Biomed, Haemovigilance, etc.

I act as liaison between the various departments, sharing relevant information and highlighting issues as necessary.

How does your role affect trainee anaesthetists?

I try to introduce myself to new trainees every January and July, giving an overview of my role and the standardisation which has been implemented in terms of trolleys, kits etc in each area. Hopefully I am able to offer support and help whether it’s looking for a piece of equipment or consumable or how to go about a task or finding out information. I also often link trainees to other departments if they are looking for information while pursuing their studies.

What is the one thing you wish that every anaesthetist knew/did/asked you?

As Dumbledore said to Harry Potter “Help will always be given at Hogwarts to those that ask for it”.  I like to think that this is true of me in theatre!

How do you unwind after dealing with us all day?

I love spending time with my family above all else, especially my husband and two kids. We have two ponies and three dogs so we spend a lot of time outdoors having fun!

 

The CAI Simulation Program at the ASSERT Centre, UCC:

The CAI Simulation Program aims to facilitate DIT’s in developing clinical and non-clinical skills in a safe and supportive environment. CAI simulation courses delivered at the ASSERT Centre, UCC, so far this year include SICC (Simulation in Intensive and Critical Care), AE (Anaesthesiology Emergencies) and COAST (Crisis in Obstetric Anaesthesiology Simulation Training - photo above).

As always, the Faculty Leads wish to thank the candidates, faculty and our partners at the CAI and the ASSERT Centre, UCC, for ensuring the success of these courses.

Anyone with an interest in joining the anaesthetic faculty at the ASSERT Centre, UCC, is invited to contact Dr Oonagh Hickey, Consultant Anaesthesiologist, CUH at yesuccanews@gmail.com.

 

The CUH Theatre Staff Wellbeing Group- the Cheers To Our Peers initiative:

Dr JR Sheehan, Consultant Anaesthesiologist, Cork University Hospital:

The CUH Theatre Staff Wellbeing Group was officially launched in January 2024. The group includes Ms Aisling Lehane, Ms Marie O’Donovan, Ms Aimee O’Donovan (CNM’s), Ms Sarah Dawn (Data Manager), and Mr Steve Baker (HCA). I’m representing the Department of Anaesthesia. A digital wellness noticeboard has been erected in the theatre corridor to keep team members informed about initiatives. 

The group's first initiative was “Cheers To Our Peers'' whereby theatre staff members can nominate colleagues for special recognition by writing a quick note and leaving it in the "Cheers To Our Peers" box found in the theatre staff tea room. The aim is to improve staff morale by acknowledging colleagues who go above and beyond. After a successful launch with acknowledgements flooding in for staff across the theatre department, we hope to keep the momentum going. Practising gratitude can lead to an improvement in overall wellbeing and outlook on life, so please take this opportunity to practise some gratitude to improve your own mental health, while also making someone else's day.

Of note, the CUH Theatre Marchathon Leaderboard has been announced. This is an initiative run by the National Transport Authority each March and teams are encouraged to register their steps each day. First place went to “Scrambled Legs”, followed by “The Insain Bolts”, “The Theatre Legends”, “The Rota Marchers” and “The A Team”.

Time Out Thursday is a weekly 3 minute mindfulness meditation conducted at 8am in Theatre 8. On the 18th April this was facilitated by Ms Aisling Lehane (CNM 3) (photo). Team members practised focusing on the moment and the breath, while wishing wellbeing to our patients and to our colleagues.

 

 

The Coffee and a Gas Program, CUH:

The Coffee and a Gas Program is a wellness initiative promoted by the Association of Anaesthetists and the College of Anaesthesiologists in Ireland. It provides an opportunity for members of departments to meet in an informal setting and is particularly important for a large department such as ours working across multiple campuses.

On January 18th, the CUH Department held their first Coffee and a Gas of the year, with a second such gathering on April 16th. Cupcakes and fruit were provided by Hannah’s Kitchen and funded by the CAI Tutors Fund.

 

Farewell Pizza Party, CUH:

The CUH Department of Anaesthesia gathered at Tom Barry’s on the 24th of January for pizza to bid farewell to Dr Florian Hamm, Dr Ahmed Shehata (Consultant Anaesthetists) and Dr Fanni Lukacs (PNB Fellow). The pizza was funded by the CAI Tutors Fund.

More Pizza!

A second gathering was organised by the CUH Department of Anaesthesia at The Franciscan Well in February to celebrate various academic successes. The pizza was funded by the CAI Tutors Fund.

 

CUH Anaesthesia Grand Prix - Race Report:

Dr Andrew Maxwell (SpR), CUH:

Fifteen competitors submitted entries for the 2024 CUH Anaesthesia Grand Prix, which took place on the 14th of March at the Adventure Park at Kartworld circuit near Watergrasshill.

Drivers competed for the traditional silverware and, more importantly, bragging rights. A number of other special awards were also to be handed out at the discretion of the chief race steward, based on notable driver performances throughout the race.

The weather on the night made for difficult conditions with a very slippery wet track, although a break in the rain was forecast for the race itself. However, as the group was made up entirely of anaesthesiologists who are trained to always plan for the worst, it should come as no surprise that everyone wanted a Plan B safety net and opted for the rain suits anyway.

Looking like a group of Navy Seals preparing for a perilous night mission, the drivers were ready to take to the track.

A five-minute practice session took place before the race where the drivers could get a feel for the Karts and, in many cases, the gravel traps. After the drivers had had the chance to acclimatise to the slippery conditions and slick tyres, they returned to the pits where the starting order for the grid was randomly decided by the computer at race control.

The race was to get underway with a rolling start following the safety car, driven by one of the race marshals. The race would be 35 minutes in duration, with the winner being the driver to complete the most laps in that time. Drivers were reminded that it’s difficult to win the race in the very first corner, but very easy to lose it.

After the safety car pulled into the pits, an excited and closely packed group of drivers fired over the start/finish line to start the race. As the drivers remembered the advice given in the pits, the initial racing was close but very well controlled as the drivers exercised a very commendable level of restraint and focused on the long game. But rather predictably, things quickly went a bit like the famous “corkscrew” corner at Laguna Seca: steeply downhill.

Like protons before they are exposed to the magnetic field of an MRI machine, the drivers seemed to be spinning constantly and pointing in all different directions. The race quickly became about who could simply stay on the circuit the longest. After all: to finish first, you first must finish.

The race was packed with action and yellow flag incidents, but nearly everyone made it through unscathed. As the chequered flag fell and the drivers completed their lap of honour (or shame), they returned to the pits eager to find out the race results. Drivers took the opportunity to debrief the many on-track battles during the race, or to pray for forgiveness.

Race Classification after 36 Laps:

In 1st place, Dr Sershin Moodley (Reg) with a very impressive drive to the top step of the podium.

Dr Usama Rehman (Reg) took 2nd, and Dr Matthew Day (Consultant) 3rd.

Special awards (in the form of creme eggs) were also handed out in defined categories, although some were accepted with more grace than others (and one was downright refused!).

1. Most interesting technique: Dr Usama Rehman (Reg). Usama seemed to only use about 50% of the available throttle for the entire race, but combined this with taking the shortest (as opposed to the fastest) line by hugging the inside of the circuit the whole way around. This method paid off very well in the wet conditions and earned him 2 nd place.
2. Most ruthless competitor: Dr Cathal Lee (SHO). A healthy aggression and determination in both attack and defence. Unfortunately, this didn’t achieve him any particular success, but was admirable nonetheless.

1. Biggest liability: Dr Yasi Besharatian (SHO). This award was created in advance of the session, and so was always going to be awarded to somebody. Unfortunately, that person was Yasi. The drivers are reminded that awards may have been earned based on a single witnessed event (such as cutting across the race steward in a dangerous fashion) and not the entire race performance, but also that the race steward’s decision was final and that there was no right to appeal.
2. Best reaction time: Dr Matthew Day (Consultant). A stunning, reflexive avoidance of a collision when another driver spun on the exit of turn 2 with almost no time for Matthew to react, and very little room to manoeuvre on either side. The move was executed with no sign of losing control himself. Over the course of the race distance this sharpness surely contributed to his podium finish.

1. Participation award: Dr Chris Yen Cho Lo (SHO). A valiant effort from Chris who, despite feeling unwell, soldiered on before being forced to retire 2 laps early.

A huge thank you to everyone who took part, and also to the CAI for the generous contribution towards the event courtesy of the Tutor Fund.

Editor’s Note: Dr Andrew Maxwell not only organised this event but generously withdrew himself from the awards, despite achieving first position!

 

Guy's and St Thomas’ Hospital Advanced Airway Course 2024:

Dr Natalie Lenggenhager, SHO, CUH: 

A fabulous crew from Cork ventured all the way across the pond to attend Guy’s and St Thomas’ hospital Advanced Airway course. It was a wonderful experience for all. While there were many opportunities to discover new gadgets for the management of difficult airways, potentially the most important take home message was the attention and respect to marginal gains that can be achieved by even the most novice doctors of the airway. Consistency in safety checks, respect to foundational airway positions, height of the bed and adequate preoxygenation will take you a long way even in the most daunting of situations.

Our trip was of course completed with a lively evening out on the town of London and musicals had to be seen. An overall excellent experience and team bonding experience!

Photo includes: Dr Siobhan Murphy (SHO), Dr Natalie Lenggenhager (SHO), Dr Anne Coakley (Registrar), and Dr AnnLin Bejoy Philip (Consultant) from the CUH.

 

Successful summit of Mount Aconcagua:

We congratulate Dr Kevin McSweeney, SpR, on successfully reaching the summit of Aconcagua, the tallest mountain in the Americas. Ascent took 13 days and no oxygen was required. We wish Dr McSweeney safe travels as he continues his tour of South America before he returns to Ireland.

 

Visit from an old friend:

Dr Rory O’Brien, retired Consultant Anaesthesiologist, paid a visit to the Department of Anaesthesia, CUH. He shared anecdotes from his time as a Consultant and on the development of the speciality in Cork. 

Included in photo: Dr Robert Craig (SpR), Dr Rory O’Brien, Dr Alan Horan (Consultant) and Dr Michael O’Sullivan (SpR). 

 

Dr Ivanna McMahon, Miss Ireland:

We congratulate Dr Ivanna McMahon who was crowned Miss Ireland in 2022 and who competed in the Miss World 2024 finals which took place in New Delhi in March.

Dr McMahon is from Barefield, Co. Clare, and studied medicine at University College Cork, graduating in 2020. She completed her medical internship at Cork University Hospital and surgical rotation at University Hospital Tralee. She entered the Southwest GP Training Scheme and also works as a part time model. She has also volunteered in Zambia. She is a fluent Irish speaker and talented musician, playing many instruments including the harp, drums, harmonica, fiddle, bodhrán and tin whistle. She started playing the harp at the age of 13 and has played with the National Irish Harp Orchestra and has toured Germany and Austria. 

Dr McMahon took the title of Miss Ireland at the Miss Ireland Diamond ball, performing Cosmic Love by Florence and the Machine on the electric Harp. Her performance on the harp at the Miss World finals secured her a top 10 placement for talent, ensuring her a spot to perform at the Miss World ball. Dr McMahon was also placed as a finalist in the public speaking challenge. 

Dr McMahon promotes a number of Irish charities, including the Irish Heart Foundation, Pieta, COPD Ireland, The RNLI and The Julian Benson Cystic Fibrosis Foundation. She has also addressed the difficulties experienced by dyslexics at a briefing for Oireachtas members on behalf of the Dyslexia Association of Ireland (DAI).

We wish Dr McMahon continued success in her career and in her other activities.

 

The Stone Corridor, UCC:

The College of Ireland Act was passed in 1845, facilitating the founding of Queen’s Colleges at Belfast, Limerick and Cork in honour of Queen Victoria. Work began on the Main Quadrangle (“The Quad”) of Queen’s College Cork (now University College Cork) in 1847 and it was opened in 1849. It was built from locally quarried limestone laid down millions of years ago when much of Ireland was covered by a warm tropical sea. The appropriately named Stone Corridor within the North Wing of The Quad contains many archeological treasures.

 

The carved stone with the cupmarks was found in Castletownshend, Co. Cork and the carvings are thought to be about 4,000 years old. Their meaning is unknown. The stone slab with the carved cross comes from an early Christian site in Reask, Co. Kerry and the inscriptions are thought to date from 700-900 AD.

 

A number of the stones have deep lines carved in them- these are Ogham inscriptions, of which 400 examples have been found in Ireland and Britain. These are thought to date from 400-700 AD, and examination of ancient manuscripts has allowed us to decipher the Ogham alphabet. These stone carvings are read from the bottom up and usually refer to personal names. They may serve as territorial boundary markers or memorials. The stone in the centre of the photo was found in a souterraine (underground tunnel) in Garranes, Co. Cork, and part of the inscription is thought to be the tribal name “Cailtrige.”

The Stone Corridor is easily accessible when the university is open to the public. It’s worth noting that generations of students have avoided walking directly across The Quad as this is meant to bring bad fortune in upcoming exams. More recent superstitions suggest that stepping on the crest at the end of the Stone Corridor under the archway will result in a pregnancy within the year but rubbing George Boole’s nose is meant to bring good luck in exams which is probably why it is starting to look distinctly shiny.

 

Editors:

Dr Alina Petrache, Registrar; Dr Yasi Besharatian, SHO; Dr Oonagh Hickey, Consultant Cork University Hospital

yesuccanews@gmail.com