NUH is a leading national centre for TIVA and processed EEG (pEEG) in the UK, with more than 12500 cases performed using the technique across a range of daycase and specialist tertiary referral centre cases. The Trust has invested heavily in supporting TIVA, with over 200 TIVA pumps across the 60+ theatres. NUH is the biggest user of “BIS” pEEG monitoring in the UK, with over 80 monitors, as well as several NarcoTrend systems.
TIVA is performed in patients of all ages undergoing the full breadth of teaching hospital specialities including paediatrics.
NUH has consultants with national expertise in TIVA and pEEG who teach via the Association of Anaesthetists, SIVA and other local and national organisations.
Clinical:
The post holder will be expected to develop expertise delivering TIVA TCI to patients across the range of specialities performed in the Trust - including general and emergency anaesthesia, neuro, spines and paediatrics, there will be expert supervision and training to achieve this. In addition, the post holder will be encouraged to undertake solo lists with local and distant supervision where the use of TIVA will be supported and encouraged.
The use and interpretation of data from a range of pEEG devices will be developed and expertise in understanding the detailed use of these devices will be supported.
Teaching:
The post holder will be involved in teaching other anaesthetists locally and regionally in the use of TIVA TCI techniques; there may be opportunities to teach nationally via the annual NUH TIVA meeting and regular Association of Anaesthetists/SIVA meetings.
There will be opportunity to develop novel teaching materials for the introduction of the new Eleveld propofol TCI model - which NUH will be adopting in the near future - following a significant investment in additional new pumps.
The post holder is expected to be part of local faculty for teaching the use of pEEG, including interpretation of raw EEG, spectrograms and power spectrums; as well as appreciating the clinical utility of various systems.
Research:
The post holder will be expected to participate in current and future research projects (via the University of Nottingham) - current projects include optimising brain state prior to the delivery of ECT therapy, and the pre-operative evaluation of alpha power and relationship to the “vulnerable brain” phenotype and post operative delirium.
The post-holder will develop an appreciation of the literature surround the basic sciences underlying anaesthetic mechanisms of action, and the effect on the EEG, as well as an understanding of the basic pharmacokinetics of TIVA TCI.
Peri-operative brain health is an area of interest, and the post holder will be supported in creating audit, data capture and research projects in quantifying and improving care in this sphere.
Professional development:
The fellow will be encouraged to participate in audit and research projects related to TIVA TCI and pEEG both locally and nationally.
There will be opportunity to be involved in the evaluation of new and novel monitoring modalities (i.e. nociceptive monitoring, quantitative neuromuscular monitoring).
The fellow will be able to assist in in develop business plans for new equipment and continued expansion of TIVA TCI.
Collaboration with ICU and electrophysiology as part of audit and research will be encouraged.
Supervision:
The post will be supervised by Dr Barley and Dr Blanks (paediatric TIVA).