Annex A > Chapter 13 - Pre-operative Care > Pre-operative management of care > Further assessment by other specialties
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Further assessment by other specialties
41 Dr Stephen Pryn, consultant anaesthetist at the UBHT, told the Inquiry about the involvement of anaesthetists in pre-operative care:
`I always visited the patient on the afternoon or evening prior to surgery. I attempted to coincide my visit with the child's parents or guardians, although this was not always possible. I did not see it as my role, nor did I have the experience, to reassess the patient's cardiac condition with a view to determining whether the proposed operation was still indicated, nor whether this was the optimum time for the surgical intervention ... during the visit I assessed the general medical fitness of the patient, reviewed the medication being taken, and assessed any specific anaesthetic problems. I developed an anaesthetic care plan in my mind and explained to the parents the basics of my plan for pre-operative starvation, pre-medication, anaesthetic induction, invasive monitoring and intensive care.' [48]
`As an anaesthetist, I respected the experience and authority of the surgeons. If I saw a child pre-operatively and I thought that the child was not optimally fit for anaesthesia and surgery because, for example, of a chest infection, I would go and discuss the case with the consultant surgeon concerned. Having expressed concerns that I had, I appreciated that the surgeon had to balance the risks of delaying surgery with the risk of proceeding, and that the final decision had to be made by him.' [49]
43 Mr Eamonn Nicholson, clinical perfusionist, told the Inquiry:
`Perfusionists generally were not involved pre-operatively, save to visit the wards pre-operatively to review the patient's history from the records and to identify anything unusual which might affect the choice of equipment for perfusion ... the pre-operative assessment and preparation did not involve perfusionists at the relevant time, but this has changed since Mr Pawade [consultant paediatric surgeon] came.' [50]
44 Mrs Mona Herborn, Sister in Cardiac Theatres at the BRI, explained that: `Theatre staff had no input into pre-operative assessment of patients.' [51]
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Footnotes
[48] WIT 0341 0016 Dr Pryn
[49] WIT 0341 0010 Dr Pryn
[50] WIT 0489 0053 Mr Nicholson
[51] WIT 0255 0031 Mrs Herborn