Updated: Sunday October 13, 2013 MYT 9:49:54 AM
by datin dr v. sivasakthi, drs teoh sim chuah, ismail tan mohd ali tan, AND tai li ling
Admissions to the ICU after an elective surgery account for 10.3% of total ICU admissions, whereas patients admitted after an emergency surgery account for 24.6% of total ICU admissions.
This is the last in a series of articles to celebrate National Anaesthesia Day on Oct 16. Here, we talk about the intensive care unit.
OVER the past two weeks, we have been featuring articles that reveal the multifaceted responsibilities of an anaesthesiologist in caring for a patient’s life. We hope that reading these articles has been an enjoyable and informative experience.
Today, we will look into the function of an Intensive Care Unit (ICU) in follow-up care after surgery and management of critical medical illnesses not related to surgery.
The ICU team consists of a multidisciplinary team of experts, who are not exclusively doctors, but also nurses, physiotherapists, dieticians and pharmacists. They work under the leadership of an intensivist, who is a subspecialised anaesthesiologist/physician in Malaysia.
Postoperative admissions to the ICU can be elective (planned) or as a response to an emergency.
Planned admissions are for those with multiple medical conditions and patients who undergo major surgery and require close monitoring.
Emergency admissions may also include patients who have had unanticipated events occur during surgery.
Often, the very sick or high risk patients who require preoperative preparation and resuscitation prior to emergency surgery are brought to the ICU to be stabilised, so as to improve the outcome of anaesthesia and surgery.
Patients who are admitted for critical illnesses not related to surgery are also taken care of by the ICU team in a similar manner.
As pioneers in cardiopulmonary resuscitation, resuscitation of the very ill and crisis management are the anaesthesiologists’ forte.
A wide range of cases are treated in the ICU, spanning from life-threatening asthma and acute poisoning to severe head injury from road traffic accidents.
The aim of the ICU is not only to save a patient’s life, but also to improve quality of life.
Nutrition, physiotherapy and early mobilisation, together with constant motivation and psychological support, are all part of a holistic approach to superior care in the ICU.
Life as a patient in the ICU may be unpredictable, uncertain and dynamic, and therefore, requires the ICU team to make complex and quick medical judgments during critical patient care.
The thought of an admission to the ICU may be intimidating and frightening, but the intensive care team will try to make the ICU stay as reassuring and comforting as possible. Every effort is made to engage families, promote patient comfort and provide the highest level of care.
ICU beds are always in high demand. The ICU team adheres to the existing Admission and Discharge Policy, where one of the primary admission criterion is for patients with reversible and treatable illnesses.
The first ICU in Malaysia was established in 1968. Since then, these units have developed rapidly and are available in all tertiary care hospitals and selected secondary care hospitals in the Health Ministry.
According to the NHEWS Survey in 2010, ICUs were available in 127 hospitals in Malaysia, with 39% in public sector and 61% in the private sector.
There were 21 intensivists in Malaysia (0.075 per 100,000 population), which is much lower than the numbers in developed countries. For example, Australia has 1.65 intensivists per 100,000 population and the United States has 2.06 per 100,000 population.
According to the Malaysia Registry of Intensive Care, a total of 33,892 patients were admitted to the 49 government hospitals, which participate in the registry, in 2012, which is an increase of 13.8% compared to the previous year. These hospitals have a total of 589 beds.
Admissions to the ICU after an elective surgery account for 10.3% of total admissions, whereas patients admitted after an emergency surgery account for 24.6% of admissions.
National Anaesthesia Day
Interested to learn more about anaesthesia? We invite you to unveil an anaesthesiologist’s mask during this National Anaesthesia Day celebration on Oct 12.
This year, “Your LIFE... We CARE!!!” has been chosen as the main theme for the celebrations, and refers to our commitment to ensure that your life is in safe hands under our care.
> Datin Dr V. Sivasakthi is head of Anaesthesiology and Intensive Care Services, Malaysia, as well as head of the Department of Anaesthesiology and Intensive Care, Hospital Kuala Lumpur. Drs Teoh Sim Chuah, Ismail Tan Mohd Ali Tan and Tai Li Ling are with the Department of Anaesthesiology and Intensive Care, Hospital Kuala Lumpur. October 16th was observed as World Anaesthesia Day in 1996, 150 years after the specialty was founded, and it is now celebrated annually worldwide. The Malaysian Society of Anaesthesiologists and the Department of Anaesthesiology & Intensive Care, Hospital Kuala Lumpur, is launching National Anaesthesia Day to increase awareness about the role of anaesthesiologists and how they contribute towards patient care.
http://www.thestar.com.my/Lifestyle/Health/2013/10/13/Intensive-care-at-the-hospital.aspx
