Intensive care unit
We deliver world-class care to patients with life-threatening injuries and illnesses.
The ICU is located at 4G, Level 4 of the Royal Adelaide Hospital.
Reception phone
7074 3500
The RAH ICU is one of Australia's largest intensive care units. It delivers intensive care to patients with life-threatening injuries and illnesses and offers award-winning research, innovation, education, and training in critical care medicine.
What we do
The RAH ICU is a 48-bed unit that operates across 4 discreet pods.
We provide specialised intensive care clinical services, acting as a major trauma centre and the state-wide referral centre for the care of burns victims and spinal cord injuries.
We deliver post-surgery care for neurosurgery and cardiac surgery and provide mechanical support, including extracorporeal membrane oxygenation (ECMO).
As a university-affiliated quaternary referral centre, the RAH ICU seamlessly integrates research, innovation, and training with its clinical services, including:
- dedicated education and training areas
- hi-fidelity clinical simulation training in our simulation lab
- high-output research department with academic ties to the University of Adelaide
- translating our research and education into daily clinical practice to ensure we provide the best care possible to our ICU patients.
We translate our research and education into daily clinical practice to ensure we provide the best care possible to our ICU patients.
Where to find us
The ICU is at 4G, on Level 4 of the RAH. To find the ICU, go to Level 3 (ground floor), go to G lifts, go to Level 4 and follow the signs to the ICU.
Clinical services
The RAH ICU works with and delivers services in conjunction with other departments, including trauma, perioperative management and extra corporeal membrane oxygenation (ECMO).
ECMO is an advanced life support therapy for severe respiratory or cardiac failure. It is used when standard intensive care treatments are ineffective. ECMO involves circulating blood outside the body, oxygenating it with an artificial lung, and returning it to the patient.
This process provides oxygen to all organs, giving the heart or lungs a chance to rest and recover.
What we do
At The Royal Adelaide Hospital (RAH), our ECMO service offers venous (VV), venous-arterial (VA), and extracardiopulmonary resuscitation (ECPR) based on the patient's condition. This high-risk procedure requires skilled clinicians.
Our team provides on-site training with a structured education program.
Team
Michael Farquharson, Medical Lead
Email: Michael.Farquharson@sa.gov.au
Sophie Dohnt, Nursing Lead
Email: Sophie.dohnt@sa.gov.au
Ben Reddi, ECMO Research Lead
Email: Benjamin.Reddi@sa.gov.au
Resources
Monash University - ECMO Research
Video profile of RAH ICU ECMO team - SA Health Awards finalists 2022
The RAH ICU tracheostomy team is a multi-disciplinary service that supports the assessment and management of patients with a tracheostomy in-situ. The team includes senior medical and nursing staff from the ICU as well as the Ear, Nose and Throat surgery and Oral & Maxillofacial surgical teams.
The team is well supported by a multi-disciplinary group of senior allied health staff with expertise in physiotherapy and speech pathology. The team conducts a weekly review of in-patients and ad-hoc reviews to guide the process of weaning, decannulation and support of speech and swallow with an in-situ tracheostomy.
Contact
Gary Richards, ICU Nurse Unit Manager – Equipment
Email: Gary.Richards@sa.gov.au
The medical emergency response (MER) service provides timely critical care level response to acutely deteriorating inpatients, visitors and staff.
The MER team is physician led, with dedicated general medical trainees, intensive care based nurses, and supported by intensive care registrars, with a dedicated intensive care, and physician, based consultant support.
The service undertakes regular practical skills, multi-disciplinary simulation and case-based training, clinical review, quality and research activities, including higher degree candidates.
Contact
A/Prof Arthas Flabouris, Medical Lead
Email: Arthas.Flabouris@sa.gov.au
Lisa Thiele, Nursing lead
Email: Lisa.thiele@sa.gov.au
Quality improvement
The RAH ICU has a strong commitment to safety and high-quality patient-centred care.
Patient safety and quality care are top priorities in intensive care units (ICUs). Given the complexity and high acuity of ICU patients, clear systems and processes are essential to maintain patient-centred and safe care.
Utilising frameworks like the National Safety and Quality Health Service (NSQHS) Standards ensures consistent standards and facilitates quality improvement programs.
The RAH ICU is committed to implementing effective quality improvement programs. Key areas include patient safety, clinical effectiveness, patient-centred care, timeliness, and efficiency. Successful projects focus on delirium management, peer support for survivors, and end-of-life care.
In 2023, the ICU won the SA Health Award for Safety and Quality for a unit-wide project on arterial blood gas sampling practices.
RAH ICU offers various opportunities for engagement in safety and quality activities. These include leading or participating in projects, attending audit activities, like M&M and situational judgement reviews, and joining special interest groups.
The ICU also provides funded training positions affiliated with institutions like the Australian Council on Healthcare Standards. Special interest groups explore projects on critical care environmental impacts and end-of-life care, offering abundant opportunities for mentorship.
Information for patients, carers, families, and friends about the ICU. Find out how to prepare for a visit and where to get ongoing support.
About the ICU
Patients may require admission to the ICU for any number of reasons, including monitoring and treatment following:
- trauma or presentation to the Emergency Department
- complex surgery (planned or emergency)
- deterioration in hospital and requiring a high level of care or intervention.
The ICU is designed with a strong focus on natural light. It is situated next to landscaped gardens and courtyards, creating a healing environment for patients and their loved ones.
If you have any questions related to you, your care, or the care of a loved one, do not hesitate to contact your ICU clinical team. They are always on hand to support and assist you.
Visiting the ICU
Visiting a critically ill loved one in the ICU can be a confronting and sometimes distressing experience.
For many, the ICU is an unfamiliar environment, with numerous machines, alarms, hospital staff, and a high volume of medical information to absorb and understand.
We do our best to prepare visitors for their time in the ICU by talking to and updating families and friends as much as possible and answering questions they may have.
The ICU is a secure access clinical area, requiring one of our volunteers or clinical staff to escort you inside.
The ICU reception provides a comfortable waiting area until ICU clinical staff can update you or bring you to the bedside of your loved one.
The ICU is open to visitors daily at:
- 10 am - 1 pm
- 4 pm - 7 pm
We allow up to 2 visitors at the bedspace at any one time.
Ask to speak to our clinical staff if our visiting requirements are prohibitive.
Please note: flowers, plants and balloons are not permitted in the ICU.
We appreciate your understanding and that our visiting requirements may change at short notice under certain circumstances.
Resources
Being admitted to ICU can be a time of anxiety and uncertainty for both patients and families. During this often stressful time, we understand the value of privacy, compassion and attentive communication with all concerned.
We have 4 dedicated family meeting rooms that we can use when communicating with our patients’ loved ones, relaying information in a private and peaceful environment.
You can request to have a family meeting to discuss the progress of your loved one by speaking to one of our ICU nursing staff.
Since 2020, the RAH ICU, like all highly sensitive clinical spaces, has had to rapidly adapt to the challenges of the COVID pandemic.
Visiting and communication has changed as required and we have employed telehealth communications to facilitate conferences, family meetings and health updates for those unable to be in the ICU due to illness, location or other unforeseeable circumstances.
If you are unable to visit the ICU in person but would like to arrange a telehealth conference with treating staff, or with a an ICU patient, our staff can assist in setting up a video call.
The RAH ICU runs a dedicated, post-intensive care unit peer-support program called Survive and Thrive.
The program connects our ICU patients and families with others who have experienced the being in the ICU, so that they can share their collective knowledge and experience, and assist each other during the recovery process.
The program has a multi-disciplinary leadership group with physiotherapists, nurses, doctors, speech pathologists and other health professionals, as well as patient representatives to guide the aims and objectives of the program.
To find out more, speak to one of the ICU clinical staff or contact the program team via email: health.rahsurviveandthrive@sa.gov.au
The RAH ICU is a multidisciplinary team featuring consultants, registrars, nurses, and allied health specialists from diverse cultural and professional backgrounds. The ICU welcomes and fosters trainees and specialists from all backgrounds, with a strong emphasis on education and training as well as research and innovation.
ICU medical team
The ICU medical team is made up of consultants, registrars, trainees and medical students.
Consultants in the ICU come from a variety of specialities including anaesthesia, general medicine and emergency medicine, who have subsequently trained in intensive care, as well as dedicated ICU fellows that work in the department.
ICU nursing team
The Royal Adelaide Hospital intensive care unit nursing team consists of over 450 qualified intensive care clinicians, providing collaborative nursing care within a multidisciplinary team.
Find out more about how the nursing teams work to deliver for the complex needs of patients in the ICU.
Allied health team
Intensive care dietitians work with medical, nursing, and other allied health professionals, to optimise nutrition care and help support patient recovery.
ICU dietitians are specially trained to provide individualised therapeutic diets, and oral and artificial nutrition support, with recommendations adapted to the patients’ clinical condition and medical therapy.
RAH ICU dietitians also have a key role in leading clinically focused nutrition research and have extended scope of practice to place post-pyloric feeding tubes at the bedside.
Senior intensive care dietitians
Associate Professor Lee-anne Chapple
Email: lee-anne.chapple@sa.gov.au
Lee-anne is a Senior ICU Dietitian at the RAH and leads the Nutrition Research Program within the ICU. She is also a Research Fellow at the University of Adelaide. She has a keen interest in understanding the impact of critical illness on nutrient utilisation, and the role of nutrition to improve patient recovery.
Elizabeth (Beth) Viner Smith
Email: Elizabeth.smith3@sa.gov.au
Beth is a Senior ICU Dietitian at the RAH and Research Fellow at the University of Adelaide. Her clinical and research interests focus on improving nutrition delivery and outcomes, particularly for patients with complex care needs and addressing current nutrition challenges faced in the ICU.
Physiotherapists are key members of the ICU team who routinely review ICU patients during their stay.
The supportive therapies delivered by physiotherapists have been shown to enhance patient rehabilitation and outcomes during and after critical illness.
Physiotherapist treatments may involve:
- listening to the chest and helping to clear the lungs
- maintaining a range of limb movements and mobility in bed with stretches
- strengthening exercises and helping with movement, such walking and transfer out of bed into a chair. This is important when patients are unwell to prevent deconditioning during critical illness.
RAH ICU senior physiotherapist team
Ms Simone Dafoe
Ms Anna Threadgold
Mr Rocky Callisto
The intensive care unit speech pathology service provides client-centred assessment and management of complex swallowing and communication difficulties in the critical care setting – caring for patients with multiple comorbidities and presenting aetiologies.
Speech pathologists work collaboratively as part of the multi-disciplinary team to provide timely and quality intervention, and in doing so contributes to optimising the patient journey. The goal is to achieve functional outcomes for patients in order to improve safety, independence and quality of life.
ICU speech pathologists have extended scope of practice training in Nasendoscopy and Videofluroscopy – providing instrumental assessment of swallowing and voice function.
As part of the ICU Tracheostomy Service, ICU speech pathologists contribute to multi-disciplinary decision-making around tracheostomy progression and provide specialist assessment and management of swallow and communication function.
The speech pathology team contribute to ICU research, education, and quality improvement initiatives, with tracheostomy management a key area of focus. As a member hospital of the Global Tracheostomy Collaborative, the Royal Adelaide ICU contributes tracheostomy outcome data, allowing international benchmarking.
Speech pathology team
Senior Speech Pathologist
Anne Gatley
Email: anne.gatley@sa.gov.au
Senior Speech Pathologist
Lee Pryor
Email: lee.pryor@sa.gov.au
Administration team
ICU secretary
Contact the ICU secretary to make appointments with ICU team members
Kelsie Nuer
Email: Kelsie.Nuer@sa.gov.au
Phone: 7074 1741
Medical rostering officer
Kristina Gabell
Email: Kristina.Gabell@sa.gov.au
Phone: 7074 1738
Nursing rostering
Contact Nurse managers for rostering queries
Stella Macdonald
Email: stella.macdonald@sa.gov.au
Mark Paltridge
Email: mark.paltridge@sa.gov.au
Phone: 0428 934 454
The Royal Adelaide Hospital intensive care unit is one of the major education and training providers for intensive care medicine in Australia and New Zealand. Our expert clinicians and educators deliver a comprehensive accredited training program to doctors and nurses seeking advanced training in critical care.
Training in the ICU
The RAH ICU is accredited by the College of Intensive Care Medicine as a General/C24 training institution.
We are one of only two major tertiary/quaternary centres in South Australia accredited to provide:
- foundation training
- general/ core ICU training
- subspecialty training in neurosurgical ICU
- cardiac ICU and trauma care, and
- Fellowships (Transition year training).
We also routinely have rotational trainees and visiting international medical graduate trainees and specialists, who come to our unit to further develop their ICU experience and credentials.
See all current vacancies at the RAH, including the ICU.
Medical training
The ICU offers the following Fellowships (transition year training) positions:
Specialist ICU Education Fellowships
The ICU Education Fellowship coordinates the medical education training program and produces the RAH ICU Medical Education Report. The roles also facilitates attainment of post-graduate qualifications in clinical education and has ties to the ANZCEN Clinician Educator Incubator
Cardiac ICU Fellowships
The Cardiac ICU Fellowship interfaces with a robust echocardiography program that can help progress DDU and other echocardiography qualifications. They are also routinely involved in a dedicated echocardiography training course (coming soon) and an extra-corporeal membrane oxygenation (ECMO) training course (coming soon) that are coordinated by the department.
The Cardiac Fellow is also regularly involved with practical ultrasound and echocardiography skills training sessions that are conducted at the bedside in the ICU, as well as monthly echocardiography review meetings.
There are 6-10 Senior registrars in the trainee group who have a pivotal role in the effective running of the ICU.
Greater clinical autonomy and longitudinal responsibility of patient care allows our trainees to be charged with complex clinical tasks, lead roles in teaching, and the supervision of less experienced trainees.
All trainees are encouraged to have non-clinical interests, however Senior registrars are given opportunities to cultivate a discrete non-clinical portfolio, with many opportunities supported directly by members of the consultant group.
Some Senior registrar positions may also be allocated as Fellows (Transition Year), with education, cardiac and other specialty interest portfolios that can be negotiated, depending on the trainee.
Appointment to any of the Senior registrar positions is competitive and requires consideration of prior experience, clinical acumen and demonstration of leadership potential.
We believe that the combination of autonomy, higher level clinical tasks and support with non-clinical role development, provides our trainees with exceptional training opportunities that prepares them well to become well-rounded senior clinicians and consultants.
The designation of Senior registrar within the ICU may be independent of the CICM regulation definitions of a “Senior Registrar rotation”. Term accreditation can be discussed with Supervisors of Training prior to commencement to ensure that vocational training requirements are met.
The RAH ICU welcomes registrars and residents from a variety of levels and specialist training pathways, providing a robust training program that accounts for the breadth of specialists and experience levels of clinicians in the unit.
We have dedicated sessions for core ICU topics, evidence-based medicine (Journal Club), radiology tutorials, audit/quality improvement and review, and inter-disciplinary in-situ simulation training covering general ICU and ECMO scenarios.
Registrars and residents seeking ICU rotations are encouraged to discuss their training pathway with their supervisors of training and Medical Workforce.
Contact the ICU secretary to get access to our education program and weekly education newsletter.
Undergraduate and post-graduate medical students are frequently posted in the ICU and participate in the ICU education program, while also having a dedicated critical care training program schedule coordinated by an ICU consultant.
Seminal paper presentations
From 2024, we are providing up to date links to all seminal paper presentations for all ICU staff on Google Drive.
Nursing training
Nursing Education in the RAH ICU offers progressive, contemporary learning opportunities for the development of all levels of nursing staff. The team is located within the ICU, developing a close understanding of the development needs of individual nursing staff.
The Nurse Education Team consists of two Nurse Educators (RN3) and four Clinical Nurse Educators (CNE RN2 job share).
Induction into working within the RAH ICU for new nursing staff is developed and delivered by the Nurse Educators.
New nursing staff to RAH participate in Central Adelaide Local Health Network (CALHN) orientation and this is followed by a two-week ICU induction period.
The ICU induction consists of a dedicated ICU induction day, supernumerary patient care shifts, specific education sessions, workshops and supported clinical learning at the patient bedside.
The induction also introduces current patient data and workforce structure, addressing the National Safety & Quality Health Service Standards, fundamentals of care and foundations of intensive care nursing, ensuring new staff have the knowledge and skill set to be work ready.
Professional development pathways are designed to provide a structure for staff development.
Read more about the pathways in place for the nursing team:
Transition to Professional Practice Program Pathway
Each year we welcome a large cohort of graduate registered nurses in their first year of nursing undertaking the Transition to Professional Practice Program. They have a six-month placement in ICU with supported education and training
Registered Nurse Professional Development Pathway
This pathway is designed with learning activities which support developing clinical practice and preparedness for postgraduate specialisation studies
Critical Care Registered Nurse Pathway
The Critical Care Registered Nurse pathway supports postgraduate qualified registered nurses with development to extend their clinical and professional practice, leading into advanced roles such as Access Nurse (Team Leader) and Medical Emergency Response Team member.
In-service education program
The in-service education program is delivered Monday to Friday, during nursing double staff time.
There are several sessions each day addressing the learning needs of the whole team, junior and senior staff. The format includes traditional lecture style, case presentations, skills stations, and clinical deterioration simulation scenarios.
Professional Development Programs
There are many professional development programs for staff in ICU and Central Education.
Programs delivered by the nursing and multidisciplinary team include renal dialysis, ECMO and Cardiac ALS.
For more information, contact nurse educators:
Natalie Vinzcer
Email: natalie.vinzcer@sa.gov.au
Gigy Cherian
Email: gigy.cherian@sa.gov.au
At RAH ICU we partner with all three South Australian universities - The University of Adelaide, Flinders University and the University of South Australia - for postgraduate studies in critical care/intensive care nursing.
Currently, over 60% of RAH ICU nursing staff have postgraduate nursing qualifications in critical care nursing.
Completion of postgraduate critical care nursing studies leads to high acuity patient allocation and development into advanced nursing roles within ICU.
Undergraduate student placements
RAH ICU facilitates many pre-registration final year nursing student placements each year. The students are supported by a local ICU experienced clinical facilitator.
ICU placement provision
RAH ICU nursing education facilitates placements for registered nurses from a variety of metropolitan and regional health service organisations and international nurses, seeking intensive care unit exposure.
Courses
There are several courses conducted in South Australia that support intensive care skills training and contribute to continuing professional development. Numerous members of staff at the Royal Adelaide Hospital ICU serve in faculty positions including as convenors, course directors and instructors.
Most courses are reliant on cross-campus support across health networks and training sites. The collaborative delivery of courses is a key strength, ensuring attendees are exposed to a wide range of instructors with broad and extensive experience.
The courses listed are open to attendees across the State and Nationally, with increasingly high demand.
Richard Strickland - course co-ordinator
Nick Edwards - Course director
Mike Davies - course convenor
Kenneth Lee - course convenor
Contact for information and to register for this course.
Email: Kenneth.Lee@sa.gov.au
Michael Farquharson - Course director
Course information coming soon.
Amy Sanguesa - course convenor
Contact for information and to register for SAILS sessions.
Email: Amy.Sanguesa@sa.gov.au
The RAH ICU is renowned nationally for its leadership in ICU research, which includes supporting new investigators and spearheading international trials.
Projects cover a wide range, from trainee-led initiatives to multidisciplinary collaborations, with engagement in translational research and support for higher degree programs.
We have strong academic ties with institutions like the University of Adelaide and NHMRC Centre of Research Excellence in Translating Nutritional Science to Good Health.
Our research and innovation efforts are focused on three main types of projects:
- Locally Initiated Projects: Led by our team, including trainees, with a focus on diverse topics within intensive care medicine
- Multi-centre Studies: Collaborations with the Australian and New Zealand Intensive Care Society Clinical Trials Group (ANZICS CTG) on large-scale research initiatives
- Pharmaceutical Company Sponsored Research: Partnering with industry for specialised investigations.
- Stress hyperglycaemia
- Neurocritical care
- Nutrition and metabolism
- Trauma and bleeding
Current trials endorsed by ANZICS CTG:
- BONANZA
- EPO-TRAUMA
- MEGA-ROX
- TARGET PROTEIN
Our dedicated research team includes research nurses, scientists, and clinician academics:
Head of Research and Innovation – Associate Professor Mark Plummer MBBS, PhD, FCICM
Mark is an academic intensivist and current NHMRC Emerging Leader fellow. His research interests include neurocritical care, sepsis, glycaemic control and clinical trials. He is on the ANZICS-CTG management committee and the steering committee for several ANZICS-CTG sponsored multi-centre trials. He has received over $11 million in Category One funding from the MRFF, NHMRC Ideas Grant and Investigator Grant Schemes.
He is enthusiastic about sharing his passion for critical care research and is experienced in supervising PhD and Higher Degree candidates.
Further research and innovation teams members include:
- Sarah Doherty – Research Nurse Unit Manager
- Kathleen Glasby – Research Nurse Unit Manager
- Lisa Hinds
- Justine Rivett
- Nerissa Brown
- Mahni Foster
- Imogen Asser
- Hope Smith
- Matthew Summers
- Lee-anne Chapple
- Beth Viner-Smith
- Timothy Webber
- Aniket Nadkarni
PhD completions
Dr Tejaswini Murthy
2022, University of Adelaide
Recent funding
MRFF EMCR
Lankadeva Y, Plummer MP et al. MEGA-dose aSCORbatE for Sepsis (MEGASCORES): An interdisciplinary research program to transform management of sepsis in intensive care units. Value $4,897,652
Diabetes Australia General Grant
Umapathysivam M, De Sousa S, Plummer MP, Jones K, Horowitz M, Gloyn A. Do carriers of type 2 diabetes risk alleles in PAM have accelerated gastric emptying? Value $57,000
NMRHC Ideas Grant
Young R, Topry D, Nenke M. AI Meyer E, Plummer MP, Ahamed M. Harnessing a native corticosteroid-binding globulin to treat life-threatening septic shock. Value $1,235,443
NHMRC Investigator Grant (EL1)
Plummer MP. Sickly sweet: managing high blood glucose during and after critical illness. Value $447,128
MRFF Cardiovacsular Health Grant
Burrell A, McQuilten Z, Nair P, Marasco S, Serpa Neto A, Shekar K, Fraser J, Kasza J, Nichol A, Hodgson C, Higgins A, Dennis M, Stub D, Combes A, O’Sullivan J, Pellegrino V, Fan E, Gattas D, Kaye D, Litton E, Plummer MP, Young M, Brown A. Precision ECMO in cardiogenic shock: PRECISE study. Value $997,500
Diabetes Australia General Grant
Horowitz M, Chapman MJ, Plummer MP, Jones KL, Deane AM, Rayner C.
Management of critical illness-induced (‘stress’) hyperglyacemia with native glucagon-like peptide-1 (GLP-1).
Value $60,000