“DEPARTMENT OF ANAESTHESIOLOGY AND INTENSIVE CARE”

Introduction

The Department of Anaesthesiology and Intensive Care at Bir Hospital provides state-of-the art clinical care to patients in all aspects of Anaesthesia, Perioperative care, Critical care and Pain management.

The Department is proud of what it has become and constantly endeavors to provide optimal patient care, teaching, training and research of the highest caliber.

Our Goals

• To deliver the safe anaesthesia and critical care services

• To provide best quality patient care - while working safely and efficiently

• To teach and share our expert knowledge and skills - with our students, trainees and peers

• To continuously improve ourselves - and seek opportunities to advance through education, training and research

• To be local and international leaders in our areas of expertise

Departmental Activities:

I) Clinical Services:

  1) Anaesthesia Service:

The department is dedicated for safe anaesthesia service for all Emergency surgeries /24 hours.

We provided the anesthesia services for Elective surgeries of following specialties:

1. Anaesthesia for General surgery

2. Anaesthesia for Gastrointestinal surgery

3. Anaesthesia for Urosurgery,

4. Anaesthesia for Orthopedic surgery,

5. Anaesthesia for Trauma surgery

6. Anaesthesia for ENT & HNS surgery,

7. Anaesthesia for Dental and Maxilla-facial surgery,

8. Anaesthesia for Neurosurgery,

9. Anaesthesia for Cardio-Thoracic and vascular surgery,

10. Anaesthesia for Burn and plastic surgery

11. Anaesthesia for Organ (Kidney) Transplant surgery.

12. Anaesthesia for Day care surgeries or procedures like Endoscopic procedures, Brachytherapy, Radiodiagnosis and other minor surgical procedures.

13. Monitored Anaesthesia Care and Sedoanalgesia

14. Regional anaesthesia

15. Apart from this, the department entertains calls for resuscitation and CPR, Dialysis Catheter/CVP/Difficult Cannulation, Emergency Intubation and attending crash calls throughout the hospital, round the clock.

2) Intensive Care Service:

The state-of-the-art Intensive Care Unit (Anaesthesia ICU) is owned by the department and takes care of critically ill patients from all the medical and surgical specialties. The AICU is a level-III ICU which is currently running 18 beds. The patient management is led by an extremely skilled team of Intensivists/Anaesthesiologists. Round the clock patient care is provided by the ICU-trained Nurses, Medical Officers and senior residents of MD Anaesthesiology along with the Critical Care Fellows. The Department also looks after the critically-ill and mechanically ventilated patients in various other specialty-ICU like Neuro-ICU, Pulmo-ICU, Medical-ICU, CTVS-ICU, Transplant-ICU and CCU.

3) Pre-anaesthesia Clinic (PAC)

Pre-Anaesthetic Checkup (PAC) is mandatory for all surgical patients requiring anaesthesia services. Outdoor patients who are being planned for surgeries or procedures are required to be examined and screened for readiness at the PAC Clinic located at the 3rd floor of the OPD building. It runs every day (from Sunday to Friday) from 10 am to 3 pm. Final detailed PAC is carried out for all the inpatient surgical cases at the bedside a day prior to their procedure.

4) Postoperative Care

Department also manages the patients after surgery and anaesthesia in postoperative ward, where patients are continuously monitored. There is also provision of mechanical ventilation whenever required.

5) Acute pain management services:

The department not only focuses on intraoperative periods but also given an importance for optimal post-operative pain management by using Multimodal Analgesics, Regional blocks, Peripheral nerve blocks and Continuous catheters, Patient Controlled Analgesia (PCA) techniques etc.

6) Non operative room Anaesthesia services (NORA):

The Department provides the anaesthesis services outside the operation theaters also for procedures like ERCP, CT Scan, MRI suite and Cath-Lab.

II) Academic Activities:

A) Post Graduate Program:

• MD Anaesthesia residency: The department in coordination with the Anaesthesiology Subject Committee runs a three years postgraduate MD Anaesthesiology program.

• Special Postings from other Departments

1. ICU Posting of

• MD Internal Medicine: Residents of MD Internal Medicine are posted in Anaesthesia ICU for 1 month for the exposure of critically ill patients.

• MD General Practice: Residents of MD General Practice are posted in AICU for 1 month for the exposure of critically ill patients.

2. Anaesthesia Posting of

• MD General Practice: Residents of MD General Practice are posted in department for two months for the exposure of Anaesthesiology.

• MS ENT and HNS: Residents are posted in the department for 15 days for the exposure of Anaesthesiology.

• MD Anaesthesiology from Other Universities: MD Anaesthesia residents from Pokhara Academy of Health Sciences, Kathmandu University, Dhulikhel Hospital and other Universities are posted for one month for the exposure of Neuro-anaesthesia and Neuro-Critical Care.

 B) Fellowship Program

   The department also runs a One year’s Critical Care Fellowship

C) Other Program:

 Anaesthesia Assistant Course (AAC): The department also runs the AAC Program under Academic council of NAMS. The AAC program is a one year course for staff nurses (SN) and health assistants (HA) which is intended to train them on the basic anesthesia skills.

D) Training Programs:

The Department provides different clinical training to enhance the skill and knowledge of hospital staffs and Residents:

 Advanced Cardiac Life Support: The department provides ACLS training to hospital staff and all the post graduate residents, which is the mandatory course of MD/MS/MDS program.

 Critical Care Nurse Training: The department provides short term Critical care nursing course to the working Nursing staff of different Critical care units and post operative wards. New ICU is the training site for Bachelor of Nursing (BN) Critical Care.

 Essential Critical Care Training: The department conducts ECCT training for the ICU Nurses, Medical Officers and Residents. It also supports and supervises the ECCT training at various other institutes conducted by the National Health Training Centre (NHTC).

III) Human Resources of the Department:

Faculties according to their major contribution to the specialty.

S.N	Name	Designation	Speciality
1	Prof. Dr Ravi Ram Shrestha, MD, fellowship critical care	Chief Consultant Anesthesiologist	Intensive Care
2	Dr. Pradip Raj Vaidya, MD, fellowship crirical care	Anesthesiologist
3	Dr. Subha Kalyan Shrestha, MD, DM critcal care	Consultant Anesthesiologist
4	Dr. Ritu Pradhan, MD	Chief Consultant Anesthesiologist, HOD	Neuro Anesthesia
5	Dr. Shubhash Regmi, MD	Senior Consultant Anesthesiologist
6	Dr. Gaurav Ratna Bajracharya, MD	Anesthesiologist
7	Dr. Luna Sharma Khanal, MD	Senior Consultant Anesthesiologist	General Anesthesia
8	Dr. Sandeep Kiran Pradhan, MD	Consultant Anesthesiologist
9	Dr. Aayush Shrestha, MD	Anesthesiologist
10	Dr. Abhay Pokharel, MD	Chief Consultant Anesthesiologist	Transplant Anesthesia
11	Dr. Anuj Jung Karki, MD	Senior Consultant Anesthesiologist
12	Dr. Pradip Koirala, MD	Anesthesiologist	Uro Anesthesia
13	Dr. Bimlesh Shah, MD	Anesthesiologist
14	Dr. Abiral Nidhi, MD	Anesthesiologist
15	Dr. Bidur Baral, MD	Anesthesiologist	Gastro Anesthesia
16	Dr. Nirman Gyawali, MD	Consultant Anesthesiologist
17	Dr. Bindu Laxmi Shah, MD, fellowship critical care	Anesthesiologist	ENT/Dental Anesthesia
18	Dr. Mona Rajbhandari, MD	Anesthesiologist
19	Dr. Puspa Raj Poudel, MD	Senior Consultant Anesthesiologist	ERCP/NORA
20	Dr. Surendra Bhusal, MD	Anesthesiologist	Cardiac Thoracic & Vascular Anesthesia
21	Dr. Rupesh Gami, MD,fellowship crirical care	Senior Consultant Anesthesiologist

Team of Intensive Care Unit (24 hours) Team of Anesthesiologist for General Surgery & GI Surgery () Team of Anesthesiologist for Urosurgery () Team of Anesthesiologist for Neurosurgery () Team of Anesthesiologist for Thoracic and Vascular Surgery () Team of Anesthesiologist for ENT, Head Neck Surgery and Dental surgery ()