key: cord-0890060-8krdhou9
authors: Valand, P; Curran, TA; Chow, W; Howes, R; Lloyd, N; Williams, S; Steele, J
title: Upskilling the surgical workforce for vascular access provision during the Covid-19 Pandemic – The Salisbury Experience.
date: 2020-08-26
journal: J Plast Reconstr Aesthet Surg
DOI: 10.1016/j.bjps.2020.08.064
sha: a25aa90bbdc28926c376f94119a00012d631f00e
doc_id: 890060
cord_uid: 8krdhou9

A vascular access device is defined as a catheter inserted into veins allowing fluids and medicines to be delivered intravenously(1). The need for such devices in acutely unwell patients has remained steady throughout the COVID-19 pandemic. We describe here our experience of up-skilling the resident plastic surgery and maxillofacial surgical registrars to provide a vascular access service to reduce the workload on our intensive care colleagues. We hope that our practice and an ‘all hands on deck’ approach to the utilisation of baseline skills within the existing workforce will inform other departments to help ease the burden on critical care departments as we progress through the next stages of the COVID-19 pandemic.

A vascular access device is defined as a catheter inserted into veins allowing fluids and medicines to be delivered intravenously 1 . The need for such devices in acutely unwell patients has remained steady throughout the COVID-19 pandemic. We describe here our experience of up-skilling the resident plastic surgery and maxillofacial surgical registrars to provide a vascular access service to reduce the workload on our intensive care colleagues. We hope that our practice and an 'all hands on deck' approach to the utilisation of baseline skills within the existing workforce will inform other departments to help ease the burden on critical care departments as we progress through the next stages of the COVID-19 pandemic.

Keywords: Upskilling surgeons, COVID-19, Vascular Access, adaptable workforce In contrast to any other speciality, the COVID-19 pandemic has most severely impacted the anaesthetic and intensive care services in almost every hospital within the United Kingdom. Up until the 5 th of July 2020, 285,416 people tested positive for the virus and up to 44,220 deaths were recorded 2 . Within the surgical departments at Salisbury District Hospital (SDH), all non urgent and elective operating had ceased during the lockdown period. The junior surgical workforce had been redeployed to medical areas leaving the registrar body to staff a 24-hour rota but with profoundly reduced workload even with the provision of trauma services. This trend of redeployment of surgical staff was echoed across the United Kingdom. 3. In order to support and ease the burden of responsibility on our critical care colleagues, plastic surgery and maxillofacial registrars were identified as being 

Side-Restricted arm placement (e.g. axillary node clearance)?

Bleeding Risk-Anticoagulants or abnormal clotting? Not a contraindication but useful to know. 

Vascular access specialist teams for device insertion and prevention of failure

Internet Resource: Coronavirus cases in the UK: daily updated statistics

How to Establish an Effective Midline Program: A case study of 2 hospitals

Association of Anaesthetists of Great Britain and Ireland: Safe vascular access 2016

A new Formula-Based Measurement Guide for Optimal Positioning of Central Venous Catheters