Cardiothoracic, Cardiology and Respiratory (CTR)

Who are we?

We are the directorate of Cardiothoracic, Cardiology and Respiratory and we provide several key services across the Royal Infirmary of Edinburgh.

We are a regional centre for Cardiothoracic surgery taking patients from the east of Scotland right up to the Highlands and Islands. We are also the National Centre for Surgical Trans Aortic Valve Implantation (TAVI).   We look after patients from all over Scotland requiring heart and lung surgery including aorta surgeries as well as patients after trauma to the chest- admitted from A+E or the major trauma centre. Other operations include diagnostic lung surgery and chest deformity surgery.  We take all ages of patients from 16 years old up to 90 years +.

We offer a Cardiology service to the south east of Scotland providing access to primary percutaneous coronary angioplasty, percutaneous valve implementation and implantation of various pacemakers and defibrillators.

Cardiothoracic (Ward 102/ Ward 111 ITU/ Ward 112 HDU)

Cardiothoracic Surgery comprises of a 9 bedded ITU, 8 bedded HDU & 36 pre / post operative ward beds. Video-assisted Thoracic Surgery was pioneered in the unit and minimally invasive and other innovative Cardiac Surgical techniques have been introduced.

Ward 102 is a very busy surgical ward and can cardiac monitor up to 20 patients as well as level 1 patients. Clinical skills include, ECG monitoring, cardiac pacing, chest drain insertion and management, pain management, wound management, palliative care, psychological care, cardiac rehab.  We work very closely with ward 111(ITU), 112 (HDU) to ensure the patient pathway runs smoothly and we can offer rotation to these areas. This is a very interesting and rewarding speciality to work within.

Cardiology (Ward 103 and CCU, Cardiac Cath Lab and Medical Daycase)

The Edinburgh Heart Centre is a 46-bed department comprising of an acute ward of 36 beds and a Coronary Care Unit of 10 beds.

RIE Cardiac Cath lab is also part of the Edinburgh Heart Centre and consists of a multi-disciplinary team of highly skilled medical staff, nursing staff, clinical physiologists, and radiographers.  Our purpose is to provide high quality specialised care to patients who require interventional cardiology procedures.

Medical Day Case (MDC) is a nurse led day procedure ward providing care for patients who attend for planned procedures and investigations. Most of our patients come from cardiology, however, other specialties that we see in MDC include respiratory, gastroenterology, vascular and haematology.

Respiratory

Ward 204 is a 46 bedded ward, making this the largest ward in the Royal Infirmary of Edinburgh. We provide care for patients with complex respiratory issues including level one patients receiving ward-based Non-Invasive Ventilation and High-Flow Nasal Oxygen.

Advanced Practice Teams 

Within CTR there are a number of specialist nursing teams which include nurse practitioners, advanced nurse practitioners, clinical nurse specialists and surgical care practitioners. The areas supported by the specialist teams are heart failure, rapid access chest pain, acute and chronic respiratory disease, cardiothoracic surgery and lung cancer pathways. The roles include specialist service provision for in-patients, out-patients, operation theatres and in the communities covered by NHS Lothian.

Newly qualified nurses may find it useful spending time in these services as part of a rotation programme within the associated specialty. It will give them a better understanding of the entire patient pathway. It is also an opportunity to see different models of nursing progression and career options.

Department of Sleep Medicine

The Department of Sleep Medicine (DSM) is also part of the CTR directorate and is one of the largest centres in the country specialising in Sleep Medicine.  The DSM was established over 30 years ago and supports over 20,000 patients who are treated with continuous positive airway pressure (CPAP) or Bi-level (Non-Invasive Ventilation) therapy, as well as caring for patients with Narcolepsy and Parasomnias. 

Home Ventilation Service

The Home Ventilation Service is another specialised area that sits within CTR.  It was established in 1997 to provide care and treatment for patients with chronic neuromuscular respiratory problems.  We also provide advice for patients who continue to need invasive ventilation following critical illness, as well as patients with complex health needs and respiratory failure. This service covers the Southeast of Scotland and has a 24/7 on-call service.