Neuroanesthesia and critical care

Neuroanesthesia and critical care

Preop assessment service

All patients scheduled to have planned surgery at Salford Royal will undergo a preoperative assessment before having their operation.   Our preoperative assessment service is in the main out-patient department, and is staffed by 16 specially trained nurses, supported by consultant anaesthetists.   The purpose of the preoperative assessment is to ensure that the risks of surgery are kept as low as possible for all our patients.  Many people have medical conditions which may well be unrelated to the proposed surgery – for instance diabetes, anaemia or COPD.  It is well established that if medical conditions such as these are well controlled prior to surgery, the chances of complications following surgery can be reduced significantly.    

At the preoperative assessment we therefore take a detailed medical history and examination, and will discuss with patients  whether anything needs to be done to improve any medical conditions before surgery goes ahead.   We will also give  lots of information about what to expect when patients  come into hospital, and it is a great opportunity for them to ask questions.   For those taking regular medication, we will clarify what to do about taking these medicines in the run-up to surgery.   In certain circumstances if patients are having major surgery, or have very significant medical problems, we will also arrange for them to be seen by a consultant anaesthetist in our preop clinic.   This is so that a more detailed examination can take place, as well as further discussions about the risks and benefits of surgery.

So, a good preoperative assessment should reduce the stress of coming into hospital as patients are well informed about what to expect, and clear about what to do with their medicines.  Importantly, the chances of complications following surgery, or of  having the operation cancelled at short notice due to concerns about patients’ general health, are much reduced.   

The Neurosciences High Dependency unit (NHDU)

An 8 bedded area providing facilities to closely monitor neurosciences patients and offering some interventions that are not available on the wards.  
You may need care on here following a neurosciences emergency such as a stroke or spinal injury. You may be admitted here following neurosurgical or spinal surgery or prior to transfer to a ward area, if you have been admitted to the intensive care unit. 
We have a dedicated team of specialists to care for you during your stay on NHDU.
There is a Consultant Neuroanaesthetist covering the unit between 8am – 5pm daily.  They carry out a ward round reviewing daily assessments and care plans and are involved with the supervision and training of the junior medical staff.  They conduct an additional two ward rounds per day with the Consultant Neurosurgeon.
After 5pm there are resident senior anaesthesia and neurosurgery trainees available overnight, with support from the on call Consultant Anaesthetist and Neurosurgeon.
The nursing staff have specialist skills in the care of neurosciences patients and will be allocated to care for yourself and one other patient during your stay.
You are likely to meet allied health professional s who form the multidisciplinary team providing care on NHDU such as physiotherapy, pharmacy, dietetics, speech and language and occupational therapy.