DEPARTMENT OF ANAESTHESIA AND

CRITICAL CARE

CENSUS 2011

OT CENSUS

Clinical Load

GENERAL SURGERY (n=1551)

Anaesthetic technique

AIRWAY CONTROL

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

Comorbidities

PATIENT DISPOSITION

NEUROSURGERY (n=1220)

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

Patient Disposition

ORTHOPAEDICS (n=1402)

Intraoperative Events

Anaesthesia in Radiology

• MRI : 71• DSA: 23 • CT Scan: 152

Periphery3178 peripheral calls and consultations•Paediatric IV cannulation•Central line insertion•Resuscitation•Acute pain services

Trauma ICU (TC-2)

0

100

200

300

400

500

600

2009 2010 2011

362

465

516

Admissions in ICU

Admissions

Age distribution

Gender distribution

Admission pattern

•Referred from other hospital:152 (29.5%)

•Readmission : 38 (7.4%)

•Cardiac arrest prior admission to ICU: 23 (4.5%)

Injury pattern

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

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

Nutrition

Total number: 72 ( 13.8%) Referred from other centre:23(31.9%)

Mortality

• 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

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

PROCEDURES IN ICU

EPIDURAL INSERTION : 72

PERCUTANEOUS TRACHEOSTOMIES: 53

BRONCHOSCOPY: 107

CENTRAL VENOUS LINE: 135

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

• ICU Nurses educational programme• Decrease in mortality rate in ICU

THANK YOU