Some feet dragging over training intensivists

June 26, 2012, 9:52 pm

By Don Asoka Wijewardena

Of 25,000 patients admitted per annum to the Intensive Care Units (ICUs) in the government and the private sector hospitals, approximately 6,000 to 8,000 patients die as they do not receive 24-hour medical attention by resident intensivists. Although a medical officer is on-call duty, there is no ICU resident or an anaesthetist to provide 24-hour service in ICUs.

Consultant Anaesthetist and Intensive Care Medicine Professor Chula Gunasakara told The Island that a dire need for trained ICU specialists was currently felt due to the high fatality rate. Apart from surgical patients, patients who were suffering from acute dengue, chronic kidney failure, meningitis, cirrhosis and serious accident injuries were admitted to the ICUs for special treatment.

He said the Health Ministry had not taken action to train any adult intensivist. After a number of discussions, Health Minister Maithripala Sirisena, had approved the training of specialists to take care of the ICU patients. Although he had given the approval in 2011 to train doctors in ICU management it had not been conveyed to Post Graduate Institute of Medicine Director Professor Jayantha Jayawardena to date.

Critical Care Specialist Dr. S. H. Colambage said that ICU deaths could be minimised by training an adequate number of ICU specialists. An intensivist was a doctor competent enough to handle any type of ICU patient, he said. Most anaesthetists were detailed to the ICUs to cover the duties of intensivists. They had some sort of professional jealousy towards intensivists because they were under the impression that once the fully-fledged intensivists were appointed to the ICUs, they would be transferred to the peripheral clinics.

When contacted, Post Graduate Institute of Medicine Director Prof. Jayawardena said that the Secretary to the Health Ministry, Dr. Ravindra Ruberu, was in the process of consulting relevant authorities to commence comprehensive programmes to train intensivists.

He said it would take six to seven years to train an ICU specialist.

Professor Jayawardena said that he was expecting approval from the Health Ministry Secretary and the Registrar of the UGC to start training courses.