February 2014

Critical care has to be Comprehensive and Personalised

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Designed to cater to medical, surgical and cardiac patients and equipped with latest workstations and monitoring mechanisms for intensive care to each patient, Dr Yogesh Velaskar, Consultant Physician and Intensivist, Hinduja Healthcare Surgical, Khar, shares insights on management of critically-ill patients at the hospital

ehealthWhat is the first line of action for a critical patient coming to the hospital?
We understand that for patients with severe injury, illness or life-threatening condition each second is crucial for survival. To ensure that the patient receives the correct treatment even before they reach the hospital, we have trained doctors present in the ambulance and they update the hospital and doctors on the status of the patient much before he reaches the hospital. In addition, we have trained our staff and casualty doctors on necessary procedures as in the casualty department they are the first to come in contact with critically ill patients. Here, 60 – 70 percent of the required medical assistance and care is already given so that the patient is adequately stabilized by the time he reached the ICU. In case of emergency cardiac cases when the patient arrives at the hospital and needs an immediate angioplasty, we shift the patient from the Casualty department directly to the Cath Lab to save on time and stabilize his condition. In addition, at each examination point of the patient, the data and parameters of his/her condition is captured at the central workstation of the ICU for the doctor to analyse much before the patient comes to the ICU physically. This ensures that the ICU team is prepared with patient condition and the preparatory work is co-ordinated. Our aim is to deliver on quality with personalized care.

Please help us on the workstations and their benefits?
Workstations are important for monitoring of vital parameters of each patient. We have central table and central monitor that collates all data from various machines and gives us all the information of all patients as it is not possible for the doctor to be at each bedside at one time. However the Consultant can just visit the centre table and take a quick update of all the data and parameters of each individual patient at one place. Even after surgery, all information and data comes to the centre monitor and provides all the vital parameters to be monitored on one screen thus making it convenient for the doctor team. This also gives our ICU team enough time to interact and engage with patients. ehealth

“Today each technique has an evidence based approach and strong support of real time image-guided technologies such as Sonography, X-Ray, Doppler etc.”

What are some exciting trends in critical care that are coming up?
Arrival of non-invasive techniques and newer technological advances, including gadgets have made way for newer ways of engaging with the patient. Today each technique has an evidence based approach and strong support of real time image-guided technologies such as Sonography, X-ray and Doppler. Video conferencing with global experts for conducting live surgeries of complicated cases have become a reality which is good. In the developed world there is a practice wherein they have installed monitoring devices at homes of critically ill patients to capture vital data that is relayed to the hospital ICU. In case of an emergency the hospital can provide immediate care guiding the patient on remedial action or by connecting with a general practitioner located closest to the patient for treatment. This model promises vital expertise and faster response time from available experts at extremely low cost as it cuts away travel time and hospital admission processes. This is something that ICU facilities in India can replicate in the not too distant future. Another trend we see if from a reporting standard is that as people have become more aware of the consumer act hence it is only a good practice for any hospital to follow an evidence based reporting and treatment methodology.

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