Anestisiologi & Rawatan Rapi – Hospital Umum Sarawak

Name Of Department :	Department of Anaesthesiology and Intensive Care
Location :	Main Operating Theatre – Level 3, Clinical Block ICU – Level 3, Clinical Block Trauma OT – Level 2, Clinical Block Maternity OT – Level 4, Main Block Anaesthetic and Pain Clinic – 3^rd floor, Specialist Clinic
Head Of Department :	Dr. Teo Shu Ching

Introduction:

Department of Anaesthesiology and Intensive Care is one of the important department providing specialty services in Hospital Umum Sarawak. We provide perioperative care and intensive care service for patients from Sarawak. We are also the referral centre for major complex medical and surgical cases from multiple subspecialties available in the hospital besides serving as training centre for master programs in anaesthesia, advanced diplomas and post basic for allied health.

Mission:

Provide optimal patient care that promotes rehabilitation, with quality, efficiency and comprehensiveness to ensure fast recovery and return of function.

Objectives:

To provide comprehensive service for perioperative care, intensive care and appropriate pain management that is effective and professional
To promote teamwork within the department as well as with other clinical disciplines and staffs to achieve better care for patients.
To promote educations in anaesthesia, intensive care, resuscitation, pain management and organ donation to all category of staffs.

To promote “Quality Assurance Projects” as effort to improve quality of service.

Functions:

To provide safe anaesthesia service to ensure quality recovery.
To provide safe surgical assistance and operating room environment for safe surgery.
To provide acute and chronic pain services.
To provide intensive care service and ventilation care beyond ICU.
To coordinate training programs in related field for all category of staffs.

Services:

1. Anaesthesia Services in OT and outside of OT

Since 2001, Main Operating Theatre (OT) has been moved to Level 3 of Clinical Block. With initial of 8 operating rooms (OR) for multiple subspecialties, we have further renovated two more ORs to include 1 with built-in CT Scan (started functioning 2015). Trauma OT is located near ED at level 2 whereas Maternity OT is located near labour ward which is level 4 Main Block.

2 emergency OR’s are operating 24 hours whereas 3^rd team is available at night that allows 3 emergency OR’s to run.

The scope of anaesthetic services provided includes:

Anaesthesia for elective and emergency surgeries for all subspecialty surgical services (General Surgery and its subspecialties, Orthopaedics with its subspecialties, ORL, Urology, Neurosurgery, Paediatric Surgeries, Plastic and Reconstructive Surgeries, Dental and its subspecialties, Ophthalmology and its subspecialties, Obstetrics and Gynaecology with its subspecialties)
Anaesthetic Clinic for Pre-operative assessment and optimization for patients.
Remote area anaesthesia which includes MRI, CT scan, Interventional and diagnostic radiology, electroconvulsive therapy (SGH and Hospital Sentosa), Respiratory Interventional procedures, ERCP

Anaesthesia for cases in Cluster Hospitals (Serian and Bau Hospital).

2. Intensive Care and Respiratory Hemodynamic Unit

We have an 18-bedded adult ICU to support critically ill patients which is located next to Main OT. Due to the low capacity, patients are frequently ventilated in acute bays as well as neurosurgical high dependency unit. Average admissions per year is 1100-1200 with average length of stay of less than 5 days. ICU is led by an intensivist with a team of 1 anaesthetic specialist in ICU, 1 specialist taking care of ventilated patients outside of ICU and 9-10 medical officers who are rotating 2 weekly in ICU. To provide better bridging of care to patients who may still need close monitoring but not artificial ventilation, our Critical Care Outreach Team consists of a dedicated team of medical officers will follow through their care to ensure closer monitoring and deterioration of condition is detected early prior to significant physiological failure based on MEWS (Modified Early Warning Score).

Respiratory Hemodynamic Unit is facilitating the care of all airway related adjuncts, ventilators and procedures assisting difficult intubation. Our aim is to provide continuum of care with adherence to infection control protocols.

3. Acute and Chronic Pain Service

Our pain service is led by our own anaesthetic specialist, a dedicated team of 1 specialist, 4 medical officers rotating weekly and trained nurses. Chronic Pain Clinics are operative on Wednesdays and Thursdays whereas referrals are accepted and reviewed daily. We have visiting Pain Specialist on a monthly basis. We are also leading the hospital committees in accreditation exercise for Pain Free Hospital.

The scope of acute and chronic pain services provided includes:

24-hour services for in-patient consultation services for patients with acute postoperative, post-trauma, post-burn, obstetrics as well as acute exacerbation of chronic pain.
Providing sedation and pain management during dressing changes in burn patients and STO in paediatric patients.
Collaborate with O&G department in running antenatal classes and patient education on obstetric analgesia
Collaborate with Oncology Department on chronic pain management among cancer patients
Monthly procedure list for chronic pain patients who require interventional pain management

4. Anaesthesiology Clinic

The clinic is located at 3^rd Floor of Specialist Clinic since 2017. It is manned by 2-3 medical officers, 3 nurses and a specialist. Another 2 medical officers are tasked to review preoperative assessment and optimisation for in-patients and emergency surgeries posted to Main OT. Each year we see about 4000 cases in anaesthetic clinic.

Activities:

Anaesthesia Service in OT