Royal Victoria Hospital, Belfast Health and Social Care Trust

• The Royal Victoria Hospital Regional Intensive Care Unit (RICU) has capacity for 30 critical care patients.
• The unit manages elective and emergency cases from a range of specialities, including tertiary services for Northern Ireland, such as vascular and thoracic surgery, cardiology, major trauma including spinal surgery, neurosciences including acute stroke, and major burns.
• We have a relatively low elective admission rate, supported by the anaesthesia delivered Post Anaesthesia Care Unit (PACU) service.

• The Royal Hospital is regional major trauma centre and receives trauma cases via ambulance and HEMS. Other admitting specialities to RICU include infectious diseases, endocrinology, acute medicine, urology, gynaecology and obstetrics.

• Specialities not primarily on the Royal site but on other sites in the Belfast Trust include: nephrology, oncology, haematology and organ transplantation. RICU is also a major contributor to the national organ donation and transplantation network with excellent results in the national Potential Donor Audit.

• There is no split site working within this Unit

RICU is one of the most research active units in the UK, with opportunities for trainees to participate up to and including PhD level.  Those with a research interest should contact d.f.mcauley@qub.ac.uk, particularly if considering a PhD project

Our main research interest is ARDS, from basic science to clinical trials, although the research programme includes sepsis, cardiac arrest, traumatic brain injury and organ donation. Our research active consultants are Prof Danny McAuley, Dr James McNamee, Dr Chris Nutt, Dr Peter McGuigan, Dr Michael McGinlay and Dr Jon Silversides. Ongoing research projects include MARCH, REMAP-CAP, SOS, SIGNET and GuARDS. Currently consultants in RICU supervise clinicians who are undertaking PhD research projects related to critical care.

Prof Rob MacSweeney is the founder of Critical Care Reviews, an open access educational website providing the world’s largest structured collection of critical care papers. He curates the associated weekly newsletter, containing links to the most relevant critical care publications in the preceding seven days. He has also established the internationally renowned Critical Care Reviews meeting annually in Belfast, which with the support and collaboration of the ANZICS clinical trials group will be replicated in Melbourne in 2024.

12 ICU Consultants, expanding to 16 in 2025.

There are 25 consultants providing critical care in RICU, accompanied by 2 SAS colleagues. Areas of interest among the senior medical staff include critical care transfer, PHEM, echo, education and simulation, neurocritical care, rehab and patient safety. We have one FFICM examiner and 5 EDIC examiners among the consultant body.

On a daily basis there are four Consultants covering the main clinical areas, with an additional Consultant available for the NI Specialist Transfer and Retrieval Service. Two of these Consultants maintain clinical continuity of care over the week. A Consultant is then on call from home out of hours, supported by a second on call consultant as needed.

We have 14 Clinical Fellows, and 16 rotational training doctors working in the department, which allows 4 tiers of resident medical staff out of hours. We have a ‘first on’ 1:8 rota of Foundation, IMT and ACCS doctors in training and a ‘second on’ 1:8 rota of Anaesthesia and ICM doctors in training.

We have 2 ACCPs with a further number of ACCPs in training.  There is team of pharmacist, dieticians, physiotherapists and a 24 hour critical care outreach service.

• Training in point of care ultrasound 
• Opportunity to attend theatre for airway experience 
• Exposure to paediatric emergencies Trauma from 14 years
• Interhospital transfers 
• Opportunity to attend a Cardiac Catheterisation lab 

Other: Tertiary centre neurocritical care, In situ simulation training and dedicated simulation bedspace, Trainee Representative for Organ Donation Role, Weekly Follow up Clinic

Please contact Dr Mottram (Faculty Tutor) if you have specific questions on training

The Royal Victoria Hospital Regional Intensive Care Unit provides opportunities to gain competencies from the Foundation Programme right through to Stage 3 Intensive Care Medicine training. We offer a number of Fellowships including Senior Clinical Fellow, Trainee Lead for Organ Donation, a Transfer Fellowship and soon an Education Fellowship. Trainees can obtain focused intensive care echo (FUSIC) accreditation in our unit under the leadership of Dr Chris Nutt & Graham McCracken.  Senior ICM trainees are offered additional leadership experience in rota and junior trainee management. Transfer experience can be obtained with the NI Safe Transfer and Retrieval (NISTaR) service.

We have an in situ simulation bed space where trainees can participate in, or indeed design and deliver their own simulation scenarios. Our NISTaR education lead also delivers simulation based education across the region and there is opportunity to attend and support the delivery of these.

The varied tertiary casemix includes trauma, neurosciences, thoracic surgery, hepatology, upper and lower GI surgery, infectious diseases. We have a twenty-four hour cardiac catheterisation labs on site for emergency percutaneous coronary interventions. There is a very clinically active interventional radiology department and a dynamic interventional neuro-radiology department, which facilitates provision of acute thrombectomy in appropriate stroke cases. The Royal is recognised nationally for being one of the leading thrombectomy sites in the UK. There is a separate cardiac ICU, neonatal ICU and paediatric ICU on the Royal Group of Hospitals site.

We are highly effective in relation to organ donation, with 100% approach to families of potential donors. The Regional lead for Organ donation in Northern Ireland also works in the unit. This activity provides important multidisciplinary and high level communication experience for ICM trainees.

Doctors in training may attend the weekly multidisciplinary ICU follow up clinic.

• Tuesday:          Morning teaching
• Wednesday:   Morning teaching
• Thursday:         Journal Club
• Friday:             Clinical fellow delivered teaching

Introduction to Practical skills course – all trainees new to critical care

NISTAR educational programme – for critical care transfer

Annual Regional ICM seminar in September for all ICM doctors in training

Simulation training: Dedicated in situ Sim Bedspace with monthly simulation sessions, Multidisciplinary SCREAM course, ICM trainee specific simulation sessions biannually.

Daily unit multidisciplinary safety briefs

Daily pod huddle & safety brief

Weekly patient safety & governance meeting incorporating M&M

Weekly consultant business meeting

Monthly rolling governance meetings incorporating anaesthesia and other specialty teams.

Quarterly NIStaR governance meetings

Three month blocks of education focus on a specific area of safety

Use of a departmental app for patient safety information, guidelines & updates

• Access to on call rest facilities
• Access to resident & SAS doctors’ office
• Four staff rest rooms
• Four staff changing rooms with locker access
• Staff wellbeing room
• Peer support group & pilot staff support psychologist
• Some parking spaces allocated to NIMDTA doctors in training
• Seminar room for education delivery
• In situ simulation bed space