Preparing for COVID-19: rapid redeployment workshops for Senior Doctors.

This article was migrated. The article was marked as recommended. Background Restructuring secondary care provision for COVID-19 raised the possibility of redeployment of senior physicians. Increasing specialization meant that redeployment of non-acute or non-medical consultants to support the medical take was a source of anxiety. Objective We delivered focused refresher training for senior doctors. This study hoped to determine usefulness, feasibility and acceptability of delivering training in this new fashion. Methods Candidates undertook a half-day course of high-fidelity simulation, resuscitation, recognizing COVID-19, oxygen therapy, basic procedures, IT training, and PPE. The sessions were delivered by clinicians from across the medical and nursing hierarchy, with social distancing maintained throughout. All candidates were given an anonymous post-course evaluation. Results We received 307/360 evaluation forms. 98.7% of candidates agreed (31.1%) or strongly agreed (67.5%) that the course was beneficial. Candidates commented that they felt more confident, and less anxious, about redeployment to manage COVID-19 patients. Discussion The employment of Clinical Fellows in Medical Education without ties to service provision allowed them to focus on high volume, high quality training. The resultant redundancy in staffing proved useful in covering faculty sickness but also ensuring smooth running of the course. Freeing up the education team allowed simultaneous planning and adaptation of the sessions upskill 4 th and 5 th year medical students. Our simple course model with nimble staffing solutions could be reused in any future major incident. Conclusions Our experience demonstrates clear benefit in a cohort of juniors with educational interest. Lean working provides adaptability and resilience when training must be delivered rapidly.

Outcomes in patients with acute kidney injury reviewed by Critical Care Outreach: What is the role of the National Early Warning Score?

INTRODUCTION: This study investigated outcomes in critically unwell acute kidney injury patients and the role of the National Early Warning Score and other factors in identifying patients who experience negative outcomes. METHODS: Retrospective cohort study investigating 64 patients seen by Critical Care Outreach between November 2014 and February 2015. Mortality at one year was analysed using multivariate regression; all other statistical tests were non-parametric. RESULTS: Forty-four per cent of patients required escalation to higher level care, 56% failed to survive beyond one year and 30% of those who did survive had a deterioration in renal function. Previous acute kidney injury significantly predicted mortality but the National Early Warning Score did not. A subgroup of patients developed Stage 3 acute kidney injury before a rise in National Early Warning Score. CONCLUSIONS: Acute kidney injury in the Critical Care Outreach patient population is associated with high morbidity and mortality. Previous acute kidney injury and acute kidney injury stage may be superior to the National Early Warning Score at identifying patients in need of Critical Care Outreach review.