anesthesia 2011
TRANSCRIPT
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DEPARTMENT OF ANAESTHESIA AND
CRITICAL CARE
CENSUS 2011
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OT CENSUS
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Clinical Load
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GENERAL SURGERY (n=1551)
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Anaesthetic technique
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AIRWAY CONTROL
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STSG / flap Surgery 437
Exploratory laparotomy 402
Debridement / Fasciotomy 26
Amputation 88
Thoracic epidural (PAIN CONTROL) 57
Vascular repair / nerve repair 96
Tracheal injuries 18
Contracture release 25
Diagnostic Scopy 24
Bronchoscopy 11
Maxillofacial (ORIF) 89
Thoracotomy 33
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Comorbidities
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PATIENT DISPOSITION
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NEUROSURGERY (n=1220)
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Decompression craniotomy / severe head injury 528
EDH evacuation 158
Cranioplasty 97
Spine 326
Cervical Spine 170
Dorsolumbar spine 156
Brachial plexus injuries 71
Tracheostomies 47
VP Shunt 74
Others : Chronic SDH – Burr Hole 10
Infected bone flap removal 9
Miscellaneous (EVD Placement, Omaya Drain, Globe reconstruction, ICP bolt insertion 42
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Patient Disposition
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ORTHOPAEDICS (n=1402)
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Intraoperative Events
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Anaesthesia in Radiology
• MRI : 71• DSA: 23 • CT Scan: 152
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Periphery3178 peripheral calls and consultations•Paediatric IV cannulation•Central line insertion•Resuscitation•Acute pain services
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Trauma ICU (TC-2)
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0
100
200
300
400
500
600
2009 2010 2011
362
465
516
Admissions in ICU
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Admissions
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Age distribution
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Gender distribution
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Admission pattern
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•Referred from other hospital:152 (29.5%)
•Readmission : 38 (7.4%)
•Cardiac arrest prior admission to ICU: 23 (4.5%)
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Injury pattern
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Ventilation and ICU stayAverage ISS of admitted patients: 18.9 (9-75)
Average SOFA on admission: 4.25 (0-18)
S.lactate on admission: 2.63 (0.5-15mmol/L)
Average number of ICU stay days: 7.2 days
Average number of Ventilator days: 3.18 days
Incidence of VAP: 8.3/1000 ventilator days
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Ventilation and ICU stay
Average number of ICU stay days: 7.2 days
Average number of Ventilator days: 3.18 days
Incidence of VAP: 8.3/1000 ventilator days
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Nutrition
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Total number: 72 ( 13.8%) Referred from other centre:23(31.9%)
Mortality
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• Average ISS score in expired patients in ICU- 21.45
• Average value of Serum lactate in expired
patients in ICU - 5.09 mmol/L
• Average no of days of ICU stay of expired patient- 7.41 days
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Hemorrhagic shock with in few hours(< 24) of ICU stay: 20 patients
Average number of ventilator days in expired patients: 5.52 days
Average SOFA at admission in expired patients:
9.06
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PROCEDURES IN ICU
EPIDURAL INSERTION : 72
PERCUTANEOUS TRACHEOSTOMIES: 53
BRONCHOSCOPY: 107
CENTRAL VENOUS LINE: 135
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ACHIEVEMENTS
• Dedicated Pain team for postoperative pain relief
• Large number of trauma cases with difficult airway managed successfully
• Largest number of major surgeries (spine, pelvis, etc.) managed
• Publications: Twenty two
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• ICU Nurses educational programme• Decrease in mortality rate in ICU
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THANK YOU