Built in 2004, Royal Aberdeen Children’s Hospital (RACH) is an 85 bed tertiary paediatric hospital providing high quality care for children up to the age of 16 years from the north-east of Scotland and the Orkney and Shetland Islands. Wider clinical networks exist enabling children from other parts of Scotland to receive their specialist care at RACH.
A team of six consultant paediatric anaesthetists lead the delivery of paediatric anaesthesia care to neonates, infants and children attending RACH for surgery or other procedures requiring general anaesthesia.
Our theatre caseload equates to 5000 cases per year and includes at least 40 neonates each year.
Anaesthesia is frequently provided for children with multiple complex co-morbidities. Volatile anaesthesia and total intravenous anaesthesia techniques are both practiced.
Theatres and Recovery
RACH has three modern spacious and well lit operating theatres, one of which is retained for unscheduled work. A dedicated dental theatre is co-located within the children’s theatre suite.
Both first and second stage recovery of patients takes place within dedicated post-anaesthetic care areas of the theatre suite.
RACH covers a wide range of elective and unscheduled paediatric surgical specialities including neonatal surgery, general surgery (major GI, urology and thoracic cases), major orthopaedic surgery, ENT, ophthalmology, plastic, maxillofacial and dental surgery. There is a variable neurosurgical caseload that is accommodated within the unscheduled theatre activity.
Anaesthetic support is frequently required for insertion of long term venous access lines.
Theatre sessions exist to cover medical paediatric specialities in particular oncology, gastroenterology and respiratory medicine. RACH is the regional oncology centre for the north of Scotland.
There are many opportunities to deliver continuous epidural analgesia for major general surgery or orthopaedic cases. Postoperatively these patients are cared for in the High Dependency Unit.
Caudal epidural analgesia and ultrasound guided regional anaesthesia techniques are also frequently practiced in RACH.
Within theatre we have comprehensive equipment available to manage the paediatric difficult airway.
This includes a C-MAC videolaryngoscope, with a comprehensive range of paediatric blades and paediatric fibrescopes.
Anaesthesia Support for Scans
There is one MRI GA session each week which takes place in the MRI suite at Aberdeen Royal Infirmary.
We have access to an MR conditional IV infusion pump to enable delivery of TIVA to our patients in the MR environment.
Anaesthesia support is also provided for CT and nuclear medicine scans. A link bridge connects Aberdeen Royal Infirmary with RACH to enable easy access to the MRI, CT and Nuclear Medicine suites.
Neonatal Intensive Care Unit
The level 4 Neonatal Intensive Care Unit is currently located within Aberdeen Maternity Hospital.
The Baird Family Hospital, due to be opened in 2023, will include a brand new Neonatal Intensive Care Unit, with a direct link bridge connection to RACH.
Paediatric Pain Service
The paediatric pain service provides both acute and chronic pain support to hospital inpatients and outpatients.
This service is provided by the ARCHIE Foundation specialist nursing team, along with the involvement of Dr Graham Wilson, Consultant Paediatric Anaesthetist.
Paediatric Critical Care
Paediatric anaesthetists work as part of a multidisciplinary team in the resuscitation and stabilisation of critically ill children.
The eight bedded High Dependency Unit has the capacity to provide level 3 intensive care for short periods.
All patients requiring longer term level 3 intensive care are retrieved to the paediatric intensive care units in Glasgow or Edinburgh via the ScotSTAR retrieval service.
Paediatric Major Trauma Centre
RACH is one of three designated Paediatric Major Trauma Centres in Scotland. It is part of the collaborative North of Scotland Major Trauma Network, spanning five health boards.
Teaching and Training
High quality training in paediatric anaesthesia is provided to speciality trainees in core, intermediate, higher and advanced training blocks. The paediatric anaesthesia team also supports teaching of other healthcare professionals.
Regular continuing medical education meetings take place both within RACH and the wider anaesthetic department.
Aberdeen runs two APLS courses each year.
Multidisciplinary paediatric simulation sessions are organised regularly by our paediatric surgical colleagues, Miss Melanie Clarke and Mrs Gillian Winter.
The paediatric anaesthesia team at RACH has a well-established commitment to research and maintains good links with the University of Aberdeen. Current research includes “SNAKES” and “MAGIC” randomised controlled trials. Our department is highly supportive of Paediatric Anaesthesia Trainee Research Network (PATRN) projects.
Quality improvement is one of our top priorities. We continually strive to improve the quality of the perioperative care that we deliver.
Current areas of focus include pre-operative assessment, pre-operative preparation of the child, facilities for day case surgery and postoperative nausea and vomiting. An active RACH Quality Improvement Group exists to support hospital projects.
Safety is another top priority. WHO Surgical Safety Checklists are firmly embedded into our daily theatre practice.
Reporting and learning from critical incidents is actively encouraged. Morbidity and mortality meetings take place regularly within RACH and the wider anaesthetic department.
RACH takes an active role in the Scottish Patient Safety Program and participates in the Maternity and Children Quality Improvement Collaborative (MCQIC).
We are incredibly lucky to work as part of a well-motivated theatre team with a proven track record of efficiency and a “can-do” attitude. Good communication and relations exist between the children’s theatre team, anaesthesia and other specialities. The consultant paediatric anaesthetists work closely together and are highly supportive all team members, as well as to each other.
Watch this short video to see our amazing children’s theatre team in action.
If you are interested in working with us in the future, or would just like to visit and see what we do, please get in touch using the details on the contact page.