Senior Registrar

Designation: Senior Registrar – Critical Care Services
Department: Critical Care Medicine 
Reporting To: Consultant / Head – Critical Care Services

Key Responsibilities

1. Clinical Management

• Assess, stabilize and manage critically ill patients admitted to ICU/HDU and other critical care areas.
• Conduct comprehensive clinical assessment, formulate differential diagnoses and initiate appropriate management.
• Participate in daily ICU rounds with the Consultant/Intensivist and implement agreed treatment plans.
• Monitor haemodynamic, respiratory, neurological, renal and metabolic status of critically ill patients.
• Manage patients requiring mechanical ventilation, non-invasive ventilation and other organ-support therapies.
• Recognize and promptly manage deterioration, sepsis, shock, respiratory failure, acute kidney injury and other life-threatening conditions.
• Review patients referred from the Emergency Department, wards, OT/recovery and other clinical departments.
• Assist in ICU admission, triage, transfer and discharge decisions in coordination with the Consultant.
• Provide appropriate handover of patients during shift changes and transfers.

2. Emergency & Resuscitation

• Respond promptly to Code Blue, cardiac arrest and other medical emergencies.
• Participate in advanced life support and resuscitation according to hospital protocols.
• Assess and stabilize deteriorating patients outside the ICU in coordination with the treating team and Intensivist.
• Escalate complex or unstable cases to the Consultant without delay.

3. Procedures

Perform or assist with critical care procedures within demonstrated competency and hospital authorization, including:

• Endotracheal intubation and airway management.
• Central venous catheterization.
• Arterial line insertion.
• Ultrasound-guided vascular access.
• Pleural procedures/chest drain insertion where credentialed.
• Lumbar puncture and other bedside procedures where appropriate.
• Assistance with tracheostomy, bronchoscopy and other advanced procedures.
• Bedside point-of-care ultrasound/ECHO as per training and credentialing.

All invasive procedures must follow consent, infection-control, documentation and patient-safety requirements.

4. Patient & Family Communication

• Communicate the patient's clinical condition, treatment plan and progress to patients and relatives appropriately.
• Support Consultants in discussions regarding prognosis, treatment limitations and end-of-life care.
• Maintain confidentiality and demonstrate empathy and professionalism in all patient interactions.
• Facilitate communication between families and the treating Consultant/primary clinical team.

5. Supervision & Team Coordination

• Supervise Junior Residents, Registrars and other medical personnel working in the ICU.
• Guide junior doctors in clinical assessment, documentation and procedures.
• Coordinate closely with ICU nurses, respiratory therapists, technicians, pharmacists and other members of the multidisciplinary team.
• Liaise with specialty consultants and referring teams for coordinated patient management.
• Ensure appropriate escalation of clinical concerns to the Consultant/Intensivist.

6. Documentation & Patient Safety

• Ensure accurate and timely completion of admission notes, progress notes, treatment orders, procedure notes, transfer notes and discharge summaries.
• Maintain accurate ICU charts, medication records, investigation results and clinical handovers.
• Ensure compliance with hospital policies, clinical protocols, infection-control standards and patient-safety practices.
• Report adverse events, medication errors, near misses and other incidents to the appropriate authority.
• Participate in clinical audits, morbidity and mortality reviews and quality-improvement initiatives.

7. Teaching & Training

• Participate in teaching of Junior Residents, interns, nurses and other ICU personnel.
• Conduct bedside teaching, case discussions, presentations and journal reviews as assigned.
• Participate in simulation training, mock drills, resuscitation training and departmental academic activities.
• Support orientation and competency development of junior ICU staff.

8. Quality, Research & Continuous Improvement

• Participate in departmental audits and quality-improvement projects.
• Support implementation of evidence-based Critical Care protocols and clinical pathways.
• Participate in research, data collection, clinical studies and publications where applicable.
• Contribute to infection-control, antimicrobial-stewardship and patient-safety initiatives.
• Keep updated with current critical care guidelines and practices.

Key Performance Indicators (KPIs)

• Quality and timeliness of ICU patient assessment and management.
• Compliance with ICU protocols and patient-safety standards.
• Timely response to emergencies and clinical deterioration.
• Accuracy and completeness of clinical documentation.
• Appropriate use of ICU resources and investigations.
• Compliance with infection-control and medication-safety practices.
• Effective multidisciplinary communication and handover.
• Participation in teaching, audits, quality improvement and research.
• Patient/family communication and professional conduct.