Mark Borthwick

@markborthwick.bsky.social

Critical care pharmacist; what’s your poison….?

I get why people resign from positions of authority when organisation/leadership goes down the wrong path (yes, looking at the RFK vaccine nonsense) BUT Who do you think replaces the leavers? A similarly minded person, or someone more allied to those views? We give way, and so facilitate

#COVID5years Neuro ICU takes all general ICU work, other expanded/specialist units take covid patients PIPA in full flow Clinical trials mass produce propofol and atracurium syringes Nationally: Propofol supply begins to wobble Epoprostenol demand surges and detabilises supply

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#COVID5years A more robust near patient IV prep area is developed - Pharmacy Intravenous Preparation Area (*PIPA*) Staff trained in IV making and ANTT in a medical school facility Nurses, medical students, pharmacy technicians, pharmacists collaborate Critical care surges into cardiothoracics

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#COVID5years After the IV making service falls over, a new collaboration gets it on its feet again Outpatient areas are earmarked for an expanded service, shielding nurses and medical students are added to the initiative More critical care areas are converted to covid bays

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#COVID5years The near patient IV making service falls over: new staff supporting the weekend are not trained in time, the weekday staff are exhausted Clinical trials aseptics unit start production of prefilled syringes of propofol and atracurium Home haircuts begin

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#COVID5years Paediatric ICU empties and hands over the space to adult critical care to make ready for further influx The near patient IV medicines making area is pushed out of ICU as bays fill up with COVID, putting it in the “PPE only area” New spaces are eyed up to locate the service to

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#COVID5years Urgent planning for national medicines in critical care is underway Nightingale hospitals soak up infusion pump supplies (amongst other equipment and resources) “Making service” commences at OUH (this will morph into PIPA over time “Pharmacy Intravenous Prep Area”)

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#COVID5years Inside, urgent planning occurred Lightening nursing workload a key aim: -Simplify CD process -Prefilled syringes made in aseptics -Individual patient doses made nearby -COVID order sets simplify prescribing and administration timing Outside, it was beautiful

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