::Departments : Clinical : ANASTHESIOLOGY
HISTORY / INTRODUCTION
 
 
The Department of Anaesthesiology was established as a full fledged department and integrated with the creation of the Coimbatore Medical College and Hospital in the year, 1965. 
 
The post-graduate Diploma in Anaesthesiology course was started in the year 1981 and is continuing to produce qualified specialists.

 
Over a period of time since its inception, the Department of Anaesthesiology is now catering to 15 surgical specialties, apart from playing a vital role in management of patients in the Trauma Ward and Intensive care Units.    

  
1.   Teaching Faculty
      Professor & HOD                                         :      01
      Associate Professors                                     :     0 4
      Assistant Professors                                      :      05
      Senior Residents                                           :      12
      Total Faculty                                               :      22 teachers


2.   Total Number of Operation Theatres       :      15

3.   Pre-anaesthetic Assessment Clinic            :      1

4.   Pain Clinic                                                   :      1

5.   Duty Anaesthesiologists (24 X 7)               :      2

 6.   No. of Surgical Specialties                         :      15

8.   Library – Central/Departmental               :      1 each

9.   Teaching Cubicle / Seminar Hall               :      1 each

10. Annual Operation Theatre Census (No of surgeries)

 
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
23959 23656 23524 26103 20145 21723 23611 23783 20707 20457 21740


 
 
Monthly Census for 2012 (No. of surgeries)
Jan Feb Mar Apr May June July Aug. Sept. Oct. Nov Dec
1402 1700 1689 1598 1888 1986 1939 1747 1982 2041 1875 1893
 
 


11.  No. of Anaesthesia Post Graduates

       DA post graduate diploma in Anasthesia : TWO SEATS

 

 

COURSES  HANDLED

 
UG Course :   M.B.B.S.
Paramedical Course : AnaesthesiaTechnician
 Certificate Course
PG Diploma Course : Diploma in Anaesthesia
LSAS (Life Saving Anaesthetic Skills) Training for MBBS Doctors. : 6 months training in anaesthetic management of obstetric emergencies including resuscitation, in semi-urban/ rural areas

 

INTAKE

 
M.B.B.S.                               :     150 students per year
Diploma in Anaesthesia        :     3 students per year
LSAS Training                       :     4 to 5 students for every six months

 Diploma in Anaesthesia         :    2 Years
LSAS Training                       :    6 Months
M.D. (Anaesthesia)                :    3 Years
 

ACADEMIC CURRICULUM 

A. TEACHING PROGRAMME / SYLLABUS FOR UNDERGRADUATES
 

Six classes for each batch of M.B.B.S. students are conducted at the Medical College Campus, Coimbatore Medical College on Saturday (2.30 – 3.30 p.m.)
i.    Introduction

  • Outline of History
  • Principal of General Anaesthesia
  • Pre-anaesthetic Assessment
ii.   Anaesthetic Drugs
  • Premedication
  • Induction agents
  • Muscle relaxants
  • Analgesics – Narcotics, NSAID’s, etc.
  • Local Anaesthetics
  • Volatile agents
  • Miscellaneous
iii. Anaesthetic Techniques/ Equipments
  • Laryngoscope
  • Endotracheal tubes, etc.,
  • Outline of Boyle’s apparatus
  • Complications of General Anaesthesia
iv. Spinal & Epidural Blocks, Nerve Blocks
  • Brief Anatomy & Physiology
  • Indications, techniques  and complications
  1. Cardiopulmonary Resuscitation
  • General Principles, techniques and training

 
B.   TEACHING PROGRAMME / SYLLABUS FOR THE P.G. Diploma in Anaesthesiology (D.A.) COURSE
 
  1. First Year: 
  • Applied Basic Sciences (3 Theory classes in the  Medical College every week).
  • Anatomy
  • Physiology
  • Bio-Chemistry
  • On-site teaching / training, in various Operation Theatres – Daily.
  • Clinical classes / Tutorials – Alternate days.
Second Year:
 
  • Anaesthesia and allied specialties
  • Daily elective theatre list of various specialties by rotation.
  • Daily emergency theatre list of various specialties by rotation.
  • I.M.C.U                                                             –     15 Days
  • I.C.C.U.                                                             –     15 Days
  • Trauma Ward                                                   –     15 days
  • Post Anaesthetic Care Unit                              –     By rotation
  • Pre-Anaesthetic Assessment Clinic                 –     By rotation
  • Clinical classes & Tutorials                               –     Daily
  • Journal Club discussion                                    –     Once a week (Tuesday)
  • Departmental Seminars                                   –     Once a fortnight
  • CME Programmes                                           –     Once a month.
 
C.  CORE SYLLABUS FOR PG COURSES IN ANAESTHESIOLOGY
 
  • Basic Sciences related to Anaesthesia including Anatomy, Physiology, Pharmacology and Biochemistry.
  • Medicine applied to Anaesthesiology, Physics in Anaesthesiology, including Electronics, Computers and Lasers.
  • History of Anaesthesiology.
  • Pre- Anaesthetic Assessment and preparation.
  • Principles and Practice of Anaesthesiology including pre, per and post operative care.
  • Different methods of Anaesthetic Techniques.
  • Regional Anaesthesia including, spinal, epidural and caudal etc.
  • Local anaesthesia including nerve blocks, management of chronic pain.
  • Anaesthesia for Gen. Surgery and Specialties like Cardiothoracic, Neurosurgical, Orthopaedics, Geriatrics, Plastic surgery and Surgical endocrinology.
  • Paediatric Anaesthesiology and Obstetrics and Gynaecological procedures.
  • Blood transfusion and Fluid/Electrolyte balance.
  • Fires and explosions.
  • Theatre Sterilization procedures.
  • Oxygen therapy, management of both acute and chronic respiratory insufficiencies and ventilator man in I.C.U.
  • Critical Care Anaesthesiology.
  • Anaesthesia in abnormal environments like high attitude anaesthesia etc.
  • Complications in Anaesthesiology and their management, both per and post- operatively.
 
D.  ROUTINE ACADEMIC ACTIVITIES:
 
 
  • Clinical classes & Tutorials        – Daily
  • Journal Club discussion             – Once a week (Tuesday)
  • Departmental Seminars                                              – Once a fortnight
  • CME Programmes                    – Once a month.
 
 
E.    EDUCATIONAL AIDS:
 
  • Department Library – Journals & Text books
  • Central Library – Journals & Text books
  • Overhead Projector
  • White Screen
  • Laptop Computers
  • LCD Projector
  • Desktop Computer with internet connection
  •  

EQUIPMENTS
 
EQUIPMENTS IN THE DEPARTMENT / OPERATION THEATRES
 
The pre-assessment clinic, the patient waiting rooms, the Operation Theatres, the recovery rooms, the post-anaesthestic care unit and the pain clinic are all equipped with mandatory/desirable equipments as detailed in the MCI norms.  
 
  1. No. of Boyle Anaesthesia Machines (Including two Fabius Anaesthesia workstations )                                                                                         :     36 Nos.
  2. Multi-Parameter Monitors                                                                      :     20 Nos.
  3. Pulse Oximeters                                                                                     :  12 Nos.
  4. ECG Monitors                                                                                        : 3 Nos.
  5. Capnographs                                                                                          : 5 Nos.
  6. Neuro-muscular Monitors                                                                      : 7 Nos.
  7. Peripheral Nerve Locators                                                                     : 4 Nos.
  8. Anaesthestic Ventilator                                                                          : 6 Nos.
  9. Ventilators
    • “E-Vent” Ventilator                                                                       :   1 No.
    • “Trans-Med” Ventilator                                                                 : 2 Nos.
    • “Trans-Med” Non-Invasive Ventilator                                          :   1 No.
    • “Versa-Med” Ventilator                                                                 :   1 No.
    • “Drager - Savina” Ventilator                                                          :   1 No.
    • “Drager – Carina” Ventilator                                                         : 3 Nos.
  10. Defibrillators with Cardiac Monitor                                                      : 5 Nos.
  11. Fiber-optic Bronchoscope – (6 mm Adult)                                            :   1 No.
  12. Fiber-optic Bronchoscope – (2.4 mm Paediatrics)                                :   1 No.
  13. Oxygen (FiO2)  Analyzers                                                                     : 5 Nos.
  14. Adult Mannequin for CPR Training                                                      :   1 No.
  15. Paediatric Mannequin for CPR Training                                               :   1 No.
  16. Mannequin for IV Line Insertion Training                                            :   1 No.
  17. Airway Trainer                                                                                       :   1 No.
  18. Isoflurane Vapourisers                                                                           : 9 Nos.
  19. Sevoflurane Vapourisers                                                                        : 5 Nos.
  20. Over Head Projector                                                                               :   1 No.
  21. LCD Projector                                                                                        :   1 No.
  22. Laptop Computer                                                                                   :   1 No.
  23. Desktop Computer                                                                                 : 2 Nos.
  24. Syringe Pumps                                                                                       : 4 Nos.

 
 
 
EQUIPMENTS IN THE CENTRAL CASUALTY DEPARTMENT.
 
  1. Ventilator – “Drager”                                 :    2 Nos.
  2. Pulse Oximeters                                          :    2 Nos.
  3. Multi Parameter Monitors                          :    6 Nos.
  4. Defibrillator                                                :    1 No.
  5. Ambu bag with Masks                               :    2 Nos. (Adult & Paediatric)
  6. Laryngoscope with 4 blades                      :    2 Nos.
  7. Endo-Tracheal Tubes                                 :    Different sizes
  8. Laryngeal Mask Airway                            :    Different sizes
  9. Suction Apparatus (Mobile)                       :    2 Nos.
  10. Emergency Drug Cart                                :    1No. (With necessary drugs)
  11. Central supply for Oxygen & Suction       :    5 Ports each.
  12. Oxygen Concentrators                               :    4 Nos.
  13. Nebulizers                                                  :    2 Nos.
  14. IV access – Venflons & CVP catheters     :    Various sizes (Adult & Paediatric)
 

 
LIBRARY FACILITIES
 
The central college library and the hospital departmental library are replete with the older and latest editions of standard textbooks / journals in Anaesthesiology. They contain a vast storehouse of knowledge pertaining to the specialty, which is an extremely useful guide for under-graduates, post-graduates and the teaching faculty.


 
CENTRAL COLLEGE LIBRARY:
 
  • Books pertaining to Anaesthesiology           :    1018 Books + 4 Journals
  • Purchase of latest editions                            :    Over 100 books pertaining to Anaesthesiology have been purchased in the last 3 years.
  • Journals                                                         :    Three international journals and the Indian Journal of Anaesthesiology are being subscribed to regularly.
  •  
 
DEPARTMENTAL LIBRARY:
 
  • No of standard textbooks including latest editions                               :   214
  • No of Journals and Periodicals
  1. Anesthesiology Clinics of North America                                            :   24 Issues
  2. British Journal of Anesthesia                                                                :   24 Issues
  3. Anesthesiology – The Journal of the American Society of Anesthesiology          :           12 Issues
  4. Indian Journal of Anesthesia                                                                :   24 Issues

 
GENERAL INFORMATION
 
  • Year/month upto which Indian Journals available        :    Current
  • Year/ month upto which Foreign journals available                :           Current
  • Internet /Medlar/ Photocopy facilities                                     :           Available
  • Library  timing : Working days                                                :           8 AM to 8 PM
    • Holidays                                                                                       :      9 AM to 1 PM
  • Reading facility out of routine library hours                            :           Available

PATIENT CARE SERVICES / INFRASTRUCTURAL FACILITIES
 

SERVICES PROVIDED

 
  • Anaesthetic services for Elective Surgeries                         :   6  days per week
  • Anaesthetic services for Emergency Surgeries                    :   Round the clock (24 x 7).
  • Pre- Anaesthetic Assessment Clinic                                     :   Daily.
  • Pain Clinic                                                                            :   Twice weekly.
  • Accident, Emergency and Resuscitation services                :   Round the clock (24 x 7).
  • Supportive care for IMCU, ICCU, Trauma Ward, Head Injury Unit, Labour Ward ICU, General Surgical ICU, Paediatric Surgical ICU, Neonatal ICU, etc.                                                                                   :   Round the clock (24 x 7).
  • The TN Chief Minister’s Comprehensive Health Insurance Scheme:
  •  
  • This scheme has brought about a revolution in health care throughout the state, wherein highest standards of specialty health care have been provided to innumerable patients who otherwise cannot financially access them. 
  •  
 

INFRASTRUCTURAL FACILITIES

 
There are 15 air-conditioned Operation Theatres (OT’s)  containing 36 operating tables, with all modern equipments and facilities incorporated, including:
 
  • Anaesthetic machines with hypoxic guard
  • Breathing circuits and modern vaporizers
  • An efficient “Manifold system” to deliver central supply of vital gases and suction.
  • Non-invasive multi-parameter monitors (For HR, ECG, SpO2, NIBP, ETCO2)
  • Nerve locators for precision in regional nerve blocks and palliative pain relief.
  • A proven sterilization process as per accepted guidelines is followed in all OT’s.
  • The patient waiting rooms and the recovery rooms are fully equipped / staffed, and are incorporated within each OT complex.

 

LIST OF OPERATION THEATRES – In main Operation Theatre Complex

 
  1. Main Operation Theatre – 1
  2. Main Operation Theatre – 2
  3. Main Operation Theatre – 3
  4. Main Operation Theatre – 4
  5. Obstetrics & Gynaecology Operation Theatre
  6. Family Welfare Operation Theatre
  7. Paediatric Operation Theatre.
  8. Neurosurgery /  Plastic Surgery Operation Theatre
  9. E.N.T. /  Urology Operation Theatre
  10. Ophthalmology Operation Theatre
  11. General Emergency / Trauma Operation Theatre
  12. Obstetrics & Gynaecology Emergency Operation Theatre
  13. Operation Theatre attached to Casualty
  14. General Surgery Minor Operation Theatre
  15. Orthopaedics Minor Operation Theatre
 

LIST OF SPECIALTIES

 
  1. General Surgery                                                         :       6 Units
  2. Surgical Gastro-Enterology                                       :       (Incl in Gen Surg)
  3. Surgical Oncology                                                     :       (Incl in Gen Surg)
  4. Orthopaedics                                                              :       3 Units
  5. Obstetrics & Gynaecology                                         :       3 Units.
  6. Family Welfare                                                           :       1 Unit
  7. Paediatric Surgery                                                      :       1 Unit
  8. Ophthalmology                                                           :       1 Unit
  9. ENT                                                                            :       2 Units
  10. Cardio-thoracic & Vascular Surgery                          :       1 Unit
  11. Plastic Surgery                                                            :       1 Unit
  12. Neuro-surgery                                                             :       1 Unit
  13. Urology                                                                       :       1 Unit
  14. Dental & Oro-Facio-Maxillary Surgery                      :       1 Unit
  15. Psychiatry ECT (Electro-Convulsive Therapy)           :       1 Unit

PROCEDURAL PROTOCOL

 

Elective OT’s:

 
8.30 AM     :      Anaesthesia workstations, airway equipments, emergency medicines, other anaesthesia related equipments are checked and kept ready
 
8.40 AM   :     Patients are received in the pre -op assessment room and an immediate review and real-time judgement of their current fitness for surgery evaluated.
 
                        Intravenous access will be evaluated/started, and premedication appropriate for the patient administered.
 
8.50 am    :     Patients are shifted into the respective OT’s. Monitors are connected. Appropriate anaesthetic techniques / drugs are provided to the patient. Vital parameters are continuously monitored and documented in the standard Anaesthesia chart.
 
9.00 am    :     Surgical procedures usually start.
 
                        After the surgical procedure is over, and the patient recovered from Anaesthesia, they are  shifted to the  observation room where vital parameters are monitored continuously.
 
                        Patients undergoing complex surgical procedures or those who need intensive support will be shifted to Post Anaesthesia Care Unit.
 

Emergency OT’s :

 
Patients who require emergency surgeries are instantly evaluated, clinical condition assessed and judged vis-à-vis the urgency of surgical intervention, and clinical status optimized if time permits, before the start of  surgery.

 

PRE-ANAESTHETIC CLINIC

 
A fully equipped and staffed Pre-Anaesthetic Assessment clinic for elective surgeries works for six days in a week. Post-graduates are posted to the PAC in turns.  
 

POST ANAESTHETIC CARE UNIT/TOTAL NO OF BEDS

 
There is a Post Anaesthetic Care Unit comprising of 4 beds, in addition to other Intensive Care Units, with all necessary equipments / monitoring facilities conforming to the mandatory requirements.
 

Number of Beds

  • No. of beds under the control of Department of Anaesthesia
  • Casualty                                                                        :         8 Beds
  • Intensive Care Units
    • IMCU                                                                    :         8 Beds
    • ICCU                                                                     :         4 Beds
    • Trauma Ward ICU                                                :         4 Beds
    • Neuro Ward ICU                                                  :         4 Beds
    • Neonatal ICU                                                        :         6 Beds
    • Paediatric ICU                                                      :         11 Beds
    • Labour Ward ICU                                                 :         4 Beds
    • Surgical ICU (General)                                         :         4 Beds
    • Cardio-thoracic surgery ICU                                :         4 Beds
    • Post Anaesthetic Care Unit                                   :         4 Beds
 

Recovery Room Bed strength

 
  • Main OT – 1
:    8 Beds
  • Main OT – 2
  • Main OT – 3
  • Main OT – 4
  • Obstetrics & Gynaecology  OT
:    2 Beds
  • Neuro and Plastic Surgery  OT
:    2 Beds
  • E.N.T. / Urology OT
:    2 Beds
  • Paediatric OT
:    4 Beds
  • Family Welfare OT
:    1 Bed
  • Ophthalmology OT
:    1 Bed
  • Orthopaedics Minor surgeries (reductions etc) OT
:    1 Bed
  • General Emergency OT
:    2 Beds
  • Obstetrics & Gynaecology Emergency OT
:    1 Bed
  • OT attached  to Casualty
:    1 Bed
  • General Surgery Minor  OT
:    1 Bed
 
 
 

PAIN CLINIC

 
A fully equipped and staffed  Pain Management Clinic is functional with special attention to:
 
  • Patients suffering from terminal malignancy.
  • Patients with intractable neuralgic pain.
  • Patients suffering from ischaemic limb pain.
  • Obstetric analgesia.
 
 
EMERGENCY RESPONSE 

Two Duty Anaesthesiologists and post graduates are available round the clock as first responders to handle emergency calls from the:
  • Various Intensive Care Units
  • Trauma Ward.
  • Labour Ward.
 as per recent resuscitation guidelines.
 
 

 CENTRAL STERILE SUPPLIES DEPARTMENT (CSSD)

 
An exclusive CSSD centre has been constructed, with sub-sterilization  centres
Equipements available  :                                                             
a.     Autoclaves
        18 KW            – 2 Nos.
        36 KW            – 1 No.
        10 KW            – 1 No.
 
b.     Ethylene oxide Gas Sterilization – 2 Units. In-service arrangement present.
        Average volume per day                                                  :   200 (Bins, trays & packs)
        Arrangements for sterilization of mattresses & blankets :   Done in the Steam Laundry.
 
Staff available in CSSD                                                              
Matron                                 :      1
Staff Nurses                        :      4
Technical Assistants           :      3
Junior Engineer                   :      1
Ward Boys                          :      3
Sweepers                            :      3
 

BLOOD BANK AND INVESTIGATIVE/LABORATORY FACILITIES

 
A fully equipped and licensed blood bank, with whole blood and various components functions round the clock for urgent requirements. Mandatory blood storage facilities and investigative facilities to screen for diseases like HIV, HBsAG, HBC etc are available.
 
An average of 45-50 units of blood/components is being used in the hospital per day.
 
A central radiology department and central investigative/laboratory facilities function in the hospital premises. In addition, radiology and lab investigations are available round the clock for emergencies under the following departments:
  • Radiology
  • Biochemistry
  • Pathology
  • Microbiology
 
In view of the sheer volume of visiting out-patients and admitted in-patients, the average workload in the above four departments are very high.
Both the central and 24-hour labs and the radiology department are adequately staffed and possess adequate facilities and equipment.

 
ANNUAL OT STATISTICS-2012
 
Since the institution is geographically and strategically located as a tertiary referral centre for the surrounding 3 districts and even parts of a neighboring state, the average operative and critical care workload can be compared with some of the best medical colleges in India.
 
An average of 32 major surgical procedures and 27 minor procedures are conducted every day under anaesthesia.
 


 
MONTH Elective surgeries Emergency surgeries Total surgeries Grand Total
Major Minor Major Minor Major Minor
JAN 588 528 259 27 847 555 1402
FEB 679 718 248 55 927 773 1700
MAR 848 440 354 47 1202 487 1689
APR 756 491 317 34 1073 525 1598
MAY 875 598 364 51 1239 649 1888
JUN 856 770 321 39 1177 809 1986
JUL 903 730 267 39 1170 769 1939
AUG 823 571 327 26 1150 597 1747
SEP 896 743 313 30 1209 773 1982
OCT 811 864 324 42 1135 906 2041
NOV 737 781 324 33 1061 814 1875
DEC 791 753 326 23 1117 776 1893
TOTAL 9563 7987 3744 446 13307 8433 21740
 
 


 
Elective Surgeries   Emergency surgeries
Major 9563 17550   Major 3774 4220
Minor 7987   Minor 446



 
 
Total Surgeries
Major 13343 21740
Minor 8397
 

 

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