Anaesthesiology

The Department of Anaesthesiology at CHI Crumlin provides anaesthesia and acute pain services for approx. 10 thousand children per year across a wide range of surgical specialities. The main theatre complex consists of 9 operating rooms, including Cardio-thoracic theatre, HCCL and Spinal Theatre. We also provide anaesthesia outside theatre in the radiology suite and remotely for children requiring radiation oncology.

The Department consists of 19 full-time equivalent Anaesthesia Consultants and 17 Anaesthesia Trainees, including 1x post-CST Anaesthesia Fellow and 1x Anaesthesia International Fellow. We work in close cooperation with our Colleagues in Intensive Care Medicine and our trainees have the opportunity to work in both theatre and PICU. This gives our trainees comprehensive training in both specialties- Paediatric Anaesthesia and Paediatric Intensive Care.

Our congenital cardiac surgery programme is an all-Ireland service with complex elective and emergency surgery carried out. This includes infants with single ventricle circulation, AVSD, TOF, TGA’s. We also run a national Cardiac VA ECLS service and a busy interventional cardiology programme. There are 500 cardiothoracic surgeries performed in Crumlin each year, with around 300 cardiopulmonary bypass cases. In the Hybrid Cath lab, approximately 700 cases per year are carried out, including diagnostic and interventional cardiac procedures as PDA stents in premature and extremely premature babies, RVOT stents, ASD and VSD device closures, and percutaneous pulmonary valve insertion. Approximately 30 cardiac hybrid cases per year are carried out in our Hybrid Cath lab.

Crumlin has a tertiary referral ENT for children and caters for approx. 800 ENT surgeries per annum. These include complex airway reconstructions and neonatal EXIT procedures in maternity hospitals which involve mobilisation of the CHI Crumlin team of which anaesthesia representation play a critical part of the team.

Anaesthesia works in collaboration with ENT in the management of difficult airway service for the country.

Crumlin has a comprehensive general surgical service, carrying out around 1700 surgeries per year and is the national congenital diaphragmatic hernia treatment centre seeing approx. 20 per annum. All complex critical neonatal surgeries such as trachea-oesophageal fistula, gastroschisis and laparotomies for suspected NEC in babies are seen and treated.

As well as the surgical specialties already mentioned, we provide anaesthesia for a broad range of other patients and surgical procedures. As outlined more broadly in the Anaesthesia report, we provide care for complex orthopaedic and congenital spinal patients, urology patients and oncology patients.

The Department incorporates pain medicine and peri-operative assessment subdivisions. With the support of clinical nurse specialists in pain management, we provide a 24-hour acute pain service.

In 2020, we looked after over 550 patients requiring PCA/NCA, over 400 patients with epidural catheters and other patients with peripherally inserted catheters (Paravertebral catheters, ESB catheters, Wound catheters).

Our department runs a 5-day pre-op assessment service which is consultant led and our team includes three clinical nurse specialists who work under supervision.

Specialist Anaesthesia Training

The department at CHI Crumlin is accredited by the College of Anaesthesiologists of Ireland (CAI) to provide training for specialist anaesthesiology trainees who each undertake a module in paediatric anaesthesiology and Intensive Care for a minimum of six months.

Fellowship in Paediatric Anaesthesiology at CHI at Crumlin

Our department has a comprehensive education and hands on training programme adapted and suitable for trainees interested in pursuing a special interest or full-time career in Paediatric Anaesthesia and Intensive care. This allows us to train future Anaesthesiologists with an interest in Paediatric Anaesthesia who can go on to support and develop the Paediatric programme regionally in line with the HSE Model of Care, (Hub and Spoke model). Our training programme offers anaesthesia modules for congenital cardiac surgery, ENT (with some airway surgery and difficulty airway training), Orthopaedics, General surgery, Dental, Maxillofacial and plastic surgery. There are many opportunities to learn regional anaesthesia for children and TIVA. There is also training in the recognition and stabilization of the critically ill child and an on -call commitment with some time spent in the Intensive care unit. These fellowships are recognised by COA and are advertised once a year by The College of Anaesthesiologists.

Paediatric Anaesthesiology Training Posts

CHI at Crumlin offers a few 6- 12-month positions posts in paediatric anaesthesia and PICU. Our start date for which is usually January and July. They are advertised in open competition.

Further information about these posts within the Department of Anaesthesia at CHI Crumlin can be found at https://chi.jobs and irishjobs.ie and are typically advertised 6-12 months in advance.

Learning opportunities

Our department runs very comprehensive teaching and training. The Anaesthesia and PICU Consultants give lecture on Tuesdays and Fridays. Interactive simulation sessions in small groups are running every Wednesday morning.

Introduction to ECMO half day is organised for trainees every 6 months and ultrasound guided regional anaesthesia and vascular access workshop runs usually once a year.

The department is also involved in organising specialist courses in paediatric resuscitation both on-campus and on external campuses

Trainees are actively encouraged to participate in departmental academic activities.

They can actively engage, either by leading a monthly journal club, organise and present during monthly Morbidity and Mortality meetings or present an interesting case of the month. There are several quality improvements project, audits or research projects running as well.

Trainees are also welcome to join the hospital ground rounds organised by paediatric teams once a week, usually on Fridays.