December 2014

Safety is Paramount

Dr SSC Chakra Rao

More than workstations, we need basic equipment that are more helpful, says Dr SSC Chakra Rao, President, Indian Society of Anaesthesiologists

Dr SSC Chakra Rao

Dr SSC Chakra Rao,
Indian Society of Anaesthesiologists

Your views on the latest technologies in Anaesthesia.

Anaesthesia is not a therapeutic state. There needs to be a word of caution and safety in addition with more awareness to increase the depth of anaesthesia across hospitals and clinic, which is more important. We know that almost all Anaesthetic drugs depress the Cardiovascular system hence caution is needed as certain patients with poor functional capacity can decompensate and have an impact on their health. In these information critical environments, equipments such as workstations are high it can be used in OT and for information on critical parameters in the ICU. Otherwise more than workstations, we need basic monitoring machines are more helpful. The workstation is just like any other anaesthesia it can be used to provide a one device that holds all the critical information on key parameters of the patient. However, there are standards for these products that are not maintained except for leaders in the workstation segments. In India, the need of the hour is not a high tech machine; instead we need quality basic equipments.

We have also given standard protocols for procedures but we do not have the powers to ensure implementation of the same


Your views on the progress of Anaesthesia and its evolution in medical field.

As the skills of the Anesthetists are increasing the technique is improved. As the safety will increase in Anesthesia the techniques will keep on improving. It depends on the understanding of physiology and biochemistry of the body. One can improve the skills by the understanding of the human mechanism, blood flow and circulations. We are doing focused skill training programmes in our Centres for Skill Development and Training located in three cities, and we are also training the third world countries such as African countries. India is vast country with many university and medical colleges giving education on Anesthesia. However these are not of benchmark quality and they need a revamp to be of global standards. The students who finish their studies and are entering the hospital environment are not ready for the job. This biochemdue to lack of available techniques that are taught to them that leads to sub-standard anesthetics in the healthcare ecosystem. ISA is providing a platform for skill development. We have also given standard protocols for procedures but we do not have the powers to ensure implementation of the same. India has to start somewhere on the standard protocols in the OT to ensure safety of the patient that is sacrosanct. We have also suggested for the inclusion of Anaesthesia as a subject in the undergraduate curriculum of MBBS, where we can catch the doctors when they are young and teach and create awareness among the medical students. This way of imparting knowledge of resuscitation and basic life support will help them to serve better.

Your recommendations for the Government.

We have recommended minimum essentials in operation theatre such as continuous supply of oxygen cylinders, Boyles machine with two oxygen and a nitrous oxide input connections. One small oxygen cylinder mounted on Boyles other than jumbo or central line and nitrous oxide cylinder along with cylinder valve opener should be available. Boyles machine with hypoxic guard safety system working suction machine with all connectors, tubings, and catheters, multi-parameter monitors including pulse oxymeter, ECG, NIBP, EtCO2 in Laparoscopy, thermo probe for temperature monitoring for pediatric patient and a defibrillator among others.

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