The Medical/ Surgical ICU is equipped with latest and state of art machines and equipment to give full tertiary care support to all patients. The list of equipment is exhaustive and includes the following types and makes-

• Ventilators- Dragger Evita2 Dura, Evita4 and Savina, Siemens 300, 300A, 900C, 900 E and Servo I, Puritan Bennett B 7200 AE, Dragger transport ventilator Oxylog 3000

• BIPAP devices- Respironics STD 30 and BIPAP S, Sullivan VPAP II

• Defibrillators- BPL, Wipro GE Cardioserve

• Patient Monitors- Wipro GE Dash 4000, Wipro GE Solar 8000 M, Marquette 3000, Marquette 1000, L&T Stellar

• Central monitoring stations- Wipro GE Sync Master

• Pulse oximeters- Novamatrix, Simed, Nellcor Puritan Bennett 190, 195

• Radiology equipment- X-ray machine-Siemens Multimobil, Transcranial Doppler-Multi Dop P, Portable ultrasound- Siemens Sonoline SI 450

• Infusion pumps- Terumo 523, Terumo 527, JMS SP 500, Top 5100

• Enteral feeding pumps- Compact

• Bronchoscope- Olympus BF 40 with camera reorder and projection facilities

• Patient warming system- Snuggle warm SW 3000, Hot line fluid warmer

• ABG and electrolyte analyzer- Chiron Diagnostics 850

• Resuscitation & airway Teaching Learning Simulators- CPR trainer Resusci Anne, Laerdal Intubation trainer, Central & peripheral Vascular access trainer- Laerdal IV Torso, Laerdal Heartsim Interactive ACLS training system

• Airway devices- Laryngoscopes, tube changers, LMA, Proseal, Fastrach, Combitube, Trachlight, cricothyroidotomy sets, Percutaneous tracheostomy sets.

• MARS

• CRRT

• Hemodialysis machine

Treatments and procedures performed in the department of CCM includes the following:

• Different methods of airway management

• Percutaneous tracheostomy

• Ventilator support

• Central venous line placement

• Arterial line placement

• Invasive pulmonary artery hemodynamic monitoring

• Continuous pulse oximetry

• Continuous cardiac monitoring

• Hemodynamic monitoring

• Synchronized cardioversion

• Temporary pacemaker insertion and maintenance

• Continuous vasoactive and antiarrhythmic drug infusions

• Thrombolytic infusion

• Haemodialysis

• Peritoneal dialysis

• CRRT

• MARS

• Bronchoscopy

• TPN

• Pain relief

• Venous phlebotomy

• Arterial blood sampling

• Bladder catheterization

• Nasogastric tube placement

• Nasojejunal tube placement

• PEG

• Lumbar puncture

• Abdominal paracentesis

• Thoracentesis

• ICD tube placement

• Nutritional planning

• Resuscitation services in all the departments round the clock

• Emergency services round the clock

Medical/ Surgical ICU staff undertakes the patient retrieval services round the clock. For this the department has an intensive care/cardiac ambulance fitted with Multichannel Patient Monitor, Bird Avian transport ventilator, Piped Medical Gases and vacuum, Infusion pumps, defibrillator, pacemaker, all emergency drugs and instrumentation. The Critical Care and Emergency Medicine Department also undertakes aerial transport of critical patients from national and international hospitals. Last year we have transported 210 critically ill patients.

The emergency room of the hospital is situated on the ground floor. It has triage area, consultation and examination area, observation ward, minor OT, plaster and dressing room, ECG room, resuscitation room and doctors and staff rooms and patient waiting areas. All patient beds have piped gases, vacuum, Multichannel cardiac monitors from GE. The emergency room is also the nodal point of disaster management of the hospital. It is fully equipped to handle any type of emergency and resuscitation round the clock. Registrars from Medical/ Surgical ICU are posted in emergency room by rotation. Consultants of Critical Care and Emergency Medicine Department take periodic rounds in emergency.

Medical/ Surgical ICU has a basic introductory as well a very detailed academic program for the rotating residents of other departments and its own residents and fellows respectively. The program includes lectures, symposium, journal club, case discussion, adverse event outcome discussions, audit, equipment training and bedside teaching.

The doctors in training in the Unit are individually taught the techniques of oral and nasal intubation, optimal mechanical ventilation, weaning from mechanical ventilation, noninvasive techniques of mechanical ventilatory support and central venous and arterial line placements. The training related to intubations, central line placements are taught to them initially in a dummy so that they can practice repeatedly. We have a computer simulator for Arrhythmia detection and management for teaching purposes. They are also taught the philosophy of modern intensive care practice, the attitude of "DO NO HARM" in intensive care management, the importance of refined diagnosis in critically ill patients to achieve successful outcomes and the advantage of using noninvasive monitoring and measurements wherever possible.

The department has a high profile in accredited professional societies. . Dr BK Rao is the vice-president of the International Trauma Anaesthesia and Critical Care Society (Indian Chapter) and a member on the Academic Council of Anaesthesia in the Aligarh Muslim University, a recognized teacher in critical care medicine from DNB, Indian Society of Critical Care Medicine and the College of Critical Care Medicine. He has been the critical care chapter convenor for the 2003 and 2004 annual conferences of Indian Society of Anaesthesiologists.

This department presents some of the best award-winning clinical research papers at National Conferences of Critical Care Medicine & Pulmonology. Last year the department has presented papers/delivered lectures in 47 conferences. We have also published 20 articles in the last two years.

Critical Care and Emergency Medicine Department holds a two-year post-doctorateDNB course in Critical Care Medicine. Two candidates are taken every year. The candidate rotates through all the intensive care units and faculty drawn from the depts of Critical Care and Emergency Medicine Department, Pulmonology, Internal Medicine, Surgery, Nephrology, Paediatrics, Cardiology, Gastroenterology, Neurology and Neurosurgery.conducts a well-structured teaching program for him. 

Critical Care and Emergency Medicine Department holds a one-year Post Doctorate certificate course in Critical Care Medicine. Department also conducts one-year Indian Society of Critical Care Medicine Fellowship (2 seats) and one-year College of Critical Care Medicine Certificate course ( 2 seats). The candidate rotates through all the intensive care units and a well-structured teaching program is conducted for him by faculty drawn from the depts. of Critical care medicine, Pulmonology, Internal Medicine, Surgery, Nephrology, Paediatrics, Cardiology, Gastroenterology, Neurology and Neurosurgery.

Critical Care Training Programme for Nurses

The Dept. of Critical Care & Emergency Medicine is conducting a 6-month long training programme for critical care nurses. This programme follows a modular format in which there is a contact day for one day every month. In each module, there are didactic lectures, interactive sessions and workshops for various topics of importance in day-to-day management of critically ill patients.

After each module, the nurses are given a project to complete during the intervening period. Assessment is done in the last module and two candidates are awarded for their performance.

It is envisaged that this programme will develop into a certificate course in critical care nursing.

FellowshipApplicationForm.pdf

The department of Critical Care & Emergency Medicine has a dedicated library situated in the doctors lounge, which contains all major books, journals related to critical care, SCCM publications, guidelines, monographs and audiovisual material in the form of videocassettes, CD-ROMs. The department has 4 dedicated computers with printing facility and Internet with round the clock access to database like Ovid and Medline. The hospital subscribes to most of the major international journals available online. The Critical Care and Emergency Medicine Department has developed its own data management software, which is used in the Medical/ Surgical ICU and has its own projection facilities in the form of OHP and Multimedia. A hand on training on mannequins/simulators is provided by the department to the residents and nursing staff.

Facilities, processes, protocols and patient outcome in the Intensive Care Unit are under constant peer review by colleagues of the Medical/ Surgical ICU user Departments. There is an exceptional amount of interdepartmental consultation, which is encouraged at all levels for optimal patient evaluation, diagnosis and management.

There are regular (weekly) Departmental meetings to present and discuss difficult medical cases; morbidity and mortality discussions and interdisciplinary discussions are held whenever necessary for difficult decision-making.

A medical audit of annual admissions, severity of illness scoring (Apache II), SAPS II and predicted and actual outcome analysis, ICU procedures, diagnostic and treatment is done every year and measures taken to assure quality care. The audit report is regularly submitted to the hospital authorities for perusal.

To standardize the ICU care and to improve quality care, more and more ICU policies, procedures and protocols are laid down and are produced as an ICU manual for ready reference. This manual undergoes periodic reviews to include changes based on newer standards of care and a feed back from our own audit results.

The Critical Care and Emergency Medicine Department is currently undertaking an International Randomized Placebo controlled Double Blind trial named "Efficacy and safety of Drotetrecogin Alpha (Activated) in adult patients with early stage sepsis". (ADDRESS: Administration of Drotetrecogin Alpha (activated) in early stage severe sepsis).

Dr. B.K. Rao is the Principal Investigator of this study.

Photo Gallery

Medical/Surgical ICU

MARS in ICU