Dr Mohammed Faruk, H Memon, Consultant Intensivist, Head of Department – Critical Care Unit, Rajasthan Hospitals, Ahmedabad
Considering the field of intensive care, it has developed from just ECG monitoring to advance monitoring of patients to E-ICU management. Intensive care is developing all over the country and is reaching even small towns of India. With respect to ICU infrastructures, they are advancing from small units to well-developed units capable of managing all kinds of patients. This has been possible because of availability of advanced equipment. This development in equipment has started from standalone ECG monitoring to now available monitors, ventilators, CRRT machines, defibrillators, advanced software to manage ICUs remotely etc.
If we talk about monitors now we have an option to monitor (apart from routine monitoring) cardiac output, continuous EEG, sedation, EtCO2, bispectral index monitoring for evaluating anesthesia etc. Monitors are capable to summarize and visualize complex clinical data and their interactions. Even patients’ monitors can be viewed from distance. Monitors can send and receive patients data in a way can talk to each other.
If we move from monitoring to ventilators, new advanced ventilators with new modes are available to make ventilation safe for the patients and smart loop feedback to manage ventilation smoothly avoiding complications. Other advanced equipment like syringe pumps, infusion pumps, sequential compression device, cooling devices, rapid infusion device, continuous feeding devices – all have made the patients care advanced and precise by putting less burden on nursing staff and allowing care of patients with minimum errors.
E-ICUs. Nowadays, the management of critical patients in the remote areas has been possible with E-ICU management with the help of an expert managing remote ICUs with the help of junior staffs sitting in the units. Apart from monitoring this has extending to teaching and training of junior doctors as well as nursing staffs. This can be incorporated to reduce errors and improve care at this place.
Virtual reality and augmented reality. In few years it will be possible to manage patients and train the staff virtually. One can therefore be present at a remote location without being physically there. This is what I see in the future.