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  • Friday | 26-May-2017

Respiratory Critical care

Respiratory Critical care

Dr Rajnish Gupta Head of the Department View Profile
Dr Saroj Meena Chest Specialist View Profile
     

The Department of Respiratory Critical Care, created in the Institute in 2013, is headed by Dr Rajnish Gupta, Senior Chest Specialist. He is assisted in the administrative works  by  Dr  Saroj Meena, Chest Specialist. The department has a 14-bed Respiratory Intensive Care Unit, which has been operating since 1996. The department is providing clinical and administrative support for intensive care management of ICU patients in addition to the teaching, training and research activities. 

 Intensive Care Services  

The Department provides round the clock diagnostic and treatment facilities in the form of invasive / non-invasive mechanical ventilatory support and intensive care to all patients with critical medical illnesses of a pre-dominant respiratory nature. Many of them are referred from the other hospitals in Delhi/NCR or from other states and get admitted to ICU from emergency or are transferred from the wards of the Institute. Patients having undergone thoracic surgical interventions within the Institute are also transferred to ICU for immediate post-operative care. More than 600 seriously ill patients are being treated in ICU every year.    

The Department has set up a facility for providing invasive/non-invasive ventilation to patients of sputum positive TB in the Emergency ward, a facility, which is rarely available even in the premier institutes of the country.


Staff

Apart from the intensive care management by the faculty of the Department, provision of clinical care is the responsibility of all the Units of the Dept of TB & Chest Diseases as well as the Department of Thoracic Surgery for their respective patients. Assistance is provided by the Specilaists of the Deaprtments of  Anaesthesia, Medicine, Microbiology, Pathology, Paediatrics and other Depts. Trained Senior and Junior Residents, nursing staff and other supporting staff are available on round the clock basis. A Workshop Technician helps in maintenance of equipments. Availability of a physiotherapist, a psychologist and a medical social worker facilitates early mobilisation and psychological care of the patients.  

Infra-structure

The Department has 6 single rooms for patients requiring mechanical ventilation and 2 High Dependency Units with 4 beds each for providing care to other critical patients.Beds are well equipped with monitoring facilities through fixed bedside monitors and Central Nursing Station. The ICU has Invasive Mechanical Ventilators, Bi-level Positive Airway Pressure Non- invasive Ventilators, Arterial Blood Gas Analysers, De-fibrillators, ECG Machines and a number of Portable equipments (X-Ray Machine, Ventilators, Monitors, Fumigation Machines, Oxygen Saturation Probes, Suction Machines, Nebulisers, Syringe Infusion Pumps, Alpha Mattresses, and other miscellaneous equipments). Facilities of central air-conditioning, Central Oxygen Supply and Central Suctioning are also available. A UPS provides un-interrupted electrical supply to the ICU at times of need. Regular procurement of supplies and maintenance of equipments facilitates the provision of critical care.  

 

Teaching and Training

Regular teaching and training on critical management is being imparted to the senior residents, DNB students, junior residents, other doctors and nursing staff during their ICU postings. Lectures, seminars, journal clubs and case presentations are organized for the residents to cover the subject in their teaching curriculum. Training is being given to them in performing endo-tracheal intubations, handling of invasive/ non-invasive mechanical ventilation, performing various procedures like insertions of central venous catheterizations etc. and in taking critical clinical management decisions at crucial times. Beneficiaries have included the doctors and staff of the other Institutes as well.

 

Research 

Many research projects have been / are being carried out in the ICU. Some of them  have been published in well-known journals. These are as follows:

i)    To study the clinical profile and outcome of smear positive pulmonary tuberculosis patients requiringinvasive mechanical ventilation at National Institute of Tuberculosis and Respiratory Diseases.

ii)     To determine the Vancomycin and Linezolid susceptibilities among Methicillin Resistant Staphylococcus aureus isolates from Intensive Care Unit samples at National Institute of TB and Respiratory Diseases and identify the clinical characteristics of patients with resistant strains (In collaboration with Henry Ford Hospital, Detroit, U.S.A)

iii)       Performance evaluation of APACHE II Score for an Indian patient with respiratory problems.

iv)      To study the clinical profile and outcome of patients of acute respiratory failure requiring invasive mechanical support.

 v)        To determine blood lactate levels in patients with sepsis admitted to a respiratory intensive care unit and to correlate their hospital outcomes.