Clinical Emergencies 

• DO NOT PANIC. Even if you do not know what to do. 
• Approach the patient in an ABC manner. Give 100% oxygen, call for senior assistance and establish IV access. 
• ICU Middle grade bleep 1005 
• Anaesthetic Senior registrar bleep 4598 
• On-call consultant via switchboard. You must never worry about contacting a consultant in an emergency situation. 

Fire Alarms 

If you discover a fire dial 4444 or break the nearest break glass point. You should familiarise yourself with emergency exits, alarm points and fire extinguishers in the unit. 

Fire alarms are tested at midday on Tuesdays if the alarm rings at any other time it should be assumed that it is a real fire. 

A continuous alarm means that the fire is in the immediate area. If you are not on the unit you should return to the unit (if it is safe to do so) to assist the nursing staff. The senior nurse on duty will obtain information regarding the location of the fire. If the unit needs to be evacuated this is done in a ‘horizontal fashion’. If it is safe to do so we relocate the ICU patients to theatre recovery. We may need to move patients rapidly. Every bed space in ICU has an orange ‘Fire box’ on the bottom of the ventilator stack. This contains an oxygen cylinder and ambu-bag for hand ventilation of the patient during emergency transfer. 

Major Incidents 

If a major incident is declared ICU is informed as part of the hospital cascade. You will be informed by the senior nurse or on-call consultant. You should report to the senior nurse and assist with identifying any patients who are suitable for step down of care to HDU or ward. You should complete discharge documentation asap for these patients and ensure the rest of the patients are as stable as possible. Patients who do not require tertiary services can also be identified for transfer to other units however it is unlikely that there will be sufficient ambulances for immediate transfer of these patients during a major incident. 

There may be a significant delay before any patients reach critical care however you should remain on the unit and not be tempted to go ‘help elsewhere’ – it is likely that the hospital bleep system will be overloaded and you may not be able to be contacted when you are needed. If you are required elsewhere you will be asked to attend by the Consultant.