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Siyaa
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07.23.06 (2 years ago)
#11
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well , i m too a post grad from bjmc and may be i have seen bjmc anaesthsia very closely . and i am not so unaware about the work cuture as my three very gud friends are anaesthetist. Well u ask anywhere , answer wud be same , it wud come back to same point PROFICIENCY .
Well , anyways , not at all interested in dragging this issue any further.
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thakurda
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07.24.06 (2 years ago)
#12
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MD Anaesthesia
with critical care knowledge should be the incharge. The i/c of this ICU must not have any other clinical commitment.
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neo_the_one009
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07.25.06 (2 years ago)
#13
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| sgtkuks wrote: |
Hello Neo......nice thread.....anyways gettin quickly on the issue of whether who should manage the ICU/ CrCU........
Going by the Critical Care book.......Critical Care is essentially a multidisciplinary approach and cannot be thought of being handled by ppl from a single speciality.....It emphasises that CrCU is ideally managed by an Anaesthesiologist, Pulmonologist and Cardiologist.....it is not possible to be all of them for one person.......Being a student of <a href="http://www.rxpgonline.com/forum105.html">Anaesthesia
</a>
and after working in ICU for most of my first year....if i m to chose between an anaesthesilogist and a physician.....i wud go for an anaesthesilogist becos of faster reflexes ( I REALLY MEAN THAT)....in <a href="http://www.rxpgonline.com/forum105.html">Anaesthesia
</a>
we make really quick, almost single diagnosis(not much into differentials) of sudden disorders...whether in O.T. or in I.C.U....the knowledge and ability to intubate a patient in several ways....i mean nasal, blind nasal, oro-tracheal and even percutaneous tracheostomy..enables us to quickly control the airway.....knowledge and recognition of various breathing patterns in patients....knowledge of whole range of sedatives and even having experienced their intense side effects.....like immediate cardivascular collapse with Propofol.....sudden ICT increase with even a sedative/analgesic Ketamine drip.....both in O.T. and I.C.U.....enables us to be more vigilant managers of the ICU....As a subject, Critical Care is being given its due recognition in most of the <a href="http://www.rxpgonline.com/forum105.html">Anaesthesia
</a>
departments.......talking of MAMC <a href="http://www.rxpgonline.com/forum105.html">Anaesthesia
</a>
department, they have named the department as DEPARTMENT OF ANAESTHESIOLOGY AND PERI-OPERATIVE MEDICINE....so i think anaesthesiology is becoming a complete branch day by day......i don't know if ppl have much of the idea of PERI-OPERATIVE ECHOCARDIOGRAPHY which is offered as a fellowship in various countries and enables anaesthesiologists to perform Echocardiography in ICU/OT patients..moreover aftre doing <a href="http://www.rxpgonline.com/forum54.html">DM
</a>
Cardiac <a href="http://www.rxpgonline.com/forum105.html">Anaesthesia
</a>
one can even be incharge of an ICCU.....so i think and its not a biased opinion that Anaesthesiologists are manging ICUs in a better manner wherever they r......debate is invited. |
Well You are right friend,
But the basic problem is...especially in our ahmedabad...,I hv seen many leading icu/CrCUs where the i/c is an MD physician..
Even though that fellow is not knowing how to intubate efficiently/how to get a difficult LP,of emergency crico thyrotomy/IJV insertin/pulmonary cath insertion...or how to have pain management in post op patient..or how to manage patient on ventilators...wht is the basic ventilator settings and when to use which one???
Because most of d leading icu/CrCU s are in d premises of a leading hospitals...and they can get any help of anaesthetist any time for such problems....and thus they just manage this way....
So I m just curious whether there is same situation everywhere in India or not???
Thats why still the the society see an anaesthesiologist just as a person who just stand up in OT and anaesthetise the patient...!!!!!!!
I totally agree with U that today Anaesthesia
is about to be a COMPLETE BRANCH.......U hv to knowledge of all the medical speciality if u wanna be a successful anaesthesiologist...
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mohit2007
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02.12.07 (1 year ago)
#14
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Hi i have been in Anaesthesia
for 5 years now..I strongly feel that anesth is the only branch which has most to do with CCM.We read about all medical and surgical diseases critical care Physiology
..I think a medicine guy or pulmonology guy doesnt read that..or even if he reads that has no experience in dealing with physiological alterations related to these in stressfull situations..we on the other hand can antipate things faster ..A medicine guy can read pages about Rheumatoid Arthritis..but when time comes is he really goin to appreciate AA joint dislocation and its implication in intubation and so what he does is intubates the patient in emergency but breaks his spine..[i]But I think we as anaethetist are somehow being marginalized..A Example is that for a DM
in Critical Care in CCM and Pulmonlogy Anaesthtist are not eligible..Apne Ghar Ki Kheti HAi..Any ine can do whatevr he wants[/i][/b]..thats ridiculous because the very origin of CCM comes from the efforts of Anaesthesia
in Polio epidemics in history..
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sri4ever
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02.17.07 (1 year ago)
#15
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I totally agree with sgtkuks...in ICU u cannot handle pts like a OPD..MD medicine spend more time looking at a pt..so in a crtical care setting...its diffciult for them to get a hold of the faster working environment
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