Anaesthesia , Intensive care and Critical care

Intensive care is the medical speciality that supports patients whose lives are in immediate danger.

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Overview

Intensive care requires a team

Intensive care is a particular medical speciality where the role of each professional is important and in which there are common values. In an ICU, the work has to be extremely structured and the intervention of the different professionals has to be coordinated. It is a multidisciplinary activity, which brings together numerous specialities – doctors, nurses, carers, physiotherapists – who all play an essential role in maintaining the physical condition and early stages of rehabilitation of the patients.

THE TEAM…

Intensive care doctors, nurses, carers, physiotherapists, pharmacists, dieticians, occupational therapists, all make up the team, working in close collaboration to offer the best care and treatment adapted to each and every patient. All the members of an ICU demonstrate the same devotion and empathy towards the patients and their families.

Diagnosis

A. Cardiac System

Acute myocardial infarction with complications
Cardiogenic shock
Complex arrhythmias requiring close monitoring and intervention
Acute congestive heart failure with respiratory failure and/or requiring hemodynamic support
Hypertensive emergencies
Unstable angina, particularly with dysrhythmias, hemodynamic instability, or persistent chest pain
S/P cardiac arrest
Cardiac tamponade or constriction with hemodynamic instability
Dissecting aortic aneurysms
pain
Complete heart block

B. Pulmonary System

Acute respiratory failure requiring ventilator support
Pulmonary emboli with hemodynamic instability
Patients in an intermediate care unit who are demonstrating respiratory deterioration
Massive hemoptysis
Respiratory failure with imminent intubation
Need for nursing/respiratory care not available in lesser care areas such as wards or
intermediate care unit

C. Neurologic Disorders

Acute stroke with altered mental status
Coma: metabolic, toxic, or anoxic
Intracranial hemorrhage with potential for herniation
Acute subarachnoid hemorrhage
Meningitis with altered mental status or respiratory compromise
Central nervous system or neuromuscular disorders with deteriorating neurologic
or pulmonary function
Status epilepticus
Vasospasm
Severe head injured patients
Brain dead or potentially brain dead patients who are being aggressively managed while determining organ donation status

D. Endocrine

Thyroid storm or myxedema coma with hemodynamic instability
Hyperosmolar state with coma and/or hemodynamic instability
Other endocrine problems such as adrenal crises with hemodynamic instability
Severe hypercalcemia with altered mental status, requiring hemodynamic monitoring
Hypo or hypernatremia with seizures, altered mental status
Hypo or hypermagnesemia with hemodynamic compromise or dysrhythmias
Hypo or hyperkalemia with dysrhythmias or muscular weakness
Hypophosphatemia with muscular weakness
Diabetic ketoacidosis complicated by hemodynamic instability, altered mental status, respiratory insufficiency, or severe acidosis

E. Gastrointestinal Disorders

Fulminant hepatic failure
Severe pancreatitis
Esophageal perforation with or without mediastinitis
Life threatening gastrointestinal bleeding including hypotension, angina, continued bleeding, or with comorbid conditions

F. Haematology

Severe coagulopathy and/or bleeding diathesis
Severe anemia resulting in haemodynamic and/or respiratory compromise
Severe complications of sickle cell crisis
Haematological malignancies with multi-organ failure

G. Obstetric

Medical conditions complicating pregnancy
Severe pregnancy induced hypertension/eclampsia
Obstetric hemorrhage
Amniotic fluid embolism

H. Surgical

Post-operative patients requiring hemodynamic monitoring/ventilator support
or extensive nursing care

I. Drug Ingestion and Drug Overdose

Hemodynamically unstable drug ingestion
Drug ingestion with significantly altered mental status with inadequate airway protection
Seizures following drug ingestion

J. Miscellaneous

Septic shock with hemodynamic instability
Hemodynamic monitoring
Clinical conditions requiring ICU level nursing care
Environmental injuries (lightning, near drowning, hypo/hyperthermia)
New/experimental therapies with potential for complications

K. Vital Signs

Pulse < 40 or > 150 beats/minute
Systolic arterial pressure < 80 mm Hg or 20 mm Hg below the patient's usual pressure
Mean arterial pressure < 60 mm Hg
Diastolic arterial pressure > 120 mm Hg
Respiratory rate > 35 breaths/minute

L. Laboratory Values

Serum sodium < 110 mEq/L or > 170 mEq/L
Serum potassium < 2.0 mEq/L or > 7.0 mEq/L
PaO2 < 50 mm Hg
pH < 7.1 or > 7.7
Serum glucose > 800 mg/dl
Serum calcium > 15 mg/dl
Toxic level of drug or other chemical substance in a hemodynamically or neurologicallycompromised patient

M. Radiography/Ultrasonography/Tomography

Ruptured viscera, bladder, liver, esophageal varices or uterus with hemodynamic instability.
Dissecting aortic aneurysm.
Cerebral vascular hemorrhage, contusion or subarachnoid hemorrhage with altered mental status or focal neurological signs

N. Physical Findings (acute onset)

Unequal pupils in an unconscious patient
Burns covering > 10% BSA
Anuria
Airway obstruction
Coma
Continuous seizures
Cyanosis
Cardiac tamponade

FAQ

What do you do to give anesthesia ?

Depending upon the needs of operation to be done, general ( full) or regional ( in the area to be operated) anesthesia can be given.

Why is pre-anaesthetic check (PAC) required? Do you give the patient a trial of anesthesia during PAC ?

Anaesthesia is highly specialized procedure which entails three main activities.

To produce & later on reverse the anesthesia.
To avoid & treat any threats to patient’s well being ( including his life) during & sometime after anaesthesia.
To control/treat associated medical diseases (like hypertension, angina, asthma, drug allergies, fits, diabetes, loss of blood etc.) during the anesthesia & for sometime after anesthesia. Anesthesia can thus be a complex combination of many medical activities being done at the same time. It is very important to know before hand, the patient’s general medical condition before an operation is done. It is important to know the risks to the patients health (&life) that can threaten him during and after the operation. These knowledge’s are acquired by anesthesiologist by doing examination & testing of the patient. Before he is actually anesthetized. PAC is a detailed medical, surgical, laboratory & radiological evaluation of patient’s condition. No trial of anesthesia is given during the PAC.

What is the intensive care unit?

The intensive care unit (ICU) is a special part of the hospital that provides care to patients with severe, life-threatening injuries or illnesses. ICUs have higher nurse-to-patient ratios than other parts of the hospital. They also can provide specialized treatments, such as life support.

What is sepsis?

Sepsis is an infection that results in organ damage. When patients develop an infection, their bodies release chemicals to fight off the infection, but sometimes these chemicals can also damage vital organs, such as kidneys and lungs. When organs are damaged as a result of infection, this is known as sepsis. Any infection can lead to sepsis, but most commonly sepsis results from pneumonia, an abdominal infection (appendicitis or gall bladder infection), or a skin infection (for example, a cut that gets infected).

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Services We Offer:

– State of the art well equipped ICU
– Central pipeline oxygen and vacuum with bed head panels
– Invasive and non invasive ventilators (BIPPAP, CPAP)and High Flow Oxygen Therapy Equipment
– Patient Monitors for constant monitoring of potentially life-threatening conditions.
– Portable Ultrasound for invasive procedures
– Infusion pumps for continuous and controlled infusion of medication
-Huntleigh mattresses for prevention of bed sores
-Support services for appropriate support of failing organ systems including bed side dialysis
-Quality protocols for prevention of infection
-Dedicated staff for the management of patients with life-threatening illnesses, sepsis,injuries and complications.

OUR OPERATIONAL EXCELLENCE / HOSPITAL FACILITIES & SERVICES

– 20 + Medical Specialities Under One Roof

– 24×7 Emergency & Ambulance Services
– 24×7 Pharmacy & Lab Services
– Highly Qualified and Experience Rich Super Specialists.
– World Class Modular Infrastructure
– Latest Medical Equipment & Technology
– Highest Patient Satisfaction Rate.

0172-5088883

OUR OPERATIONAL EXCELLENCE / HOSPITAL FACILITIES & SERVICES

– 20 + Medical Specialities Under One Roof

– 24×7 Emergency & Ambulance Services
– 24×7 Pharmacy & Lab Services
– Highly Qualified and Experience Rich Super Specialists.
– World Class Modular Infrastructure
– Latest Medical Equipment & Technology
– Highest Patient Satisfaction Rate.

+91 9464343434