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Critical Care Medicine
The Critical Care Medicine Department was established in 2004 to provide comprehensive care for all patients requiring intensive care support and critical care consultation. The department composed of both medical and surgical intensive care units, of which are around 40-bed, and a 12-bed respiratory care center. In addition to 24-hour critical care service, we can also provide urgent and emergency procedures such as bedside insertions of intra-aortic balloon counter-pulsation pump (IABP), extracorporeal membrane oxygenation (ECMO) support, temporary transcutaneous and transvenous pacemaker insertions. We also perform bedside pericardiocentesis, thoracentesis, paracentesis, tracheostomy creation, diagnostic and therapeutic pan-endoscopy and bronchoscopy, as well as central arterial and venous catheter insertions providing access for hemodialysis, central floatation pulmonary catheters (Swan-Ganz), pulse control cardiac output (PiCCO) and FlowTrac devices for invasive hemodynamic monitoring. Our intensive care units also provide invasive and non-invasive positive pressure ventilation, and round-the-clock hemodialysis services depending on our patient’s needs. We are equipped with portable conventional and cardiac ultrasound devices that could aid us in performing both diagnostic and therapeutic examinations and procedures. Through this, we have performed bedside echo-guided percutaneous abscess drainage and percutaneous transhepatic gall bladder drainage (PTGBD) for very critical patients that could not be transported or moved to the radiology department. We have two negative pressure isolation rooms and highly trained personnel, together allow us to treat and care for severely immuno-compromised and highly contagious or infectious patients, like neutropenic patients, patients with pulmonary tuberculosis and influenza virus (H1N1). Our team comprises full-time intensivists, fellows, senior multi-disciplinary residents, pharmacists, dieticians, respiratory therapists, physician assistants and senior nurse practitioners. We also have social service personnel that help indigenous patients with financial problems. Currently, we are the central hub of our hospital’s therapeutic tree providing and receiving 24 hours of consultations, assistance and referrals from the different department and subspecialties. Our department staffs have participated and have presented their researches in different international symposia, and have more than 40 manuscripts published in both national and international peer-reviewed (SCI-ranked) journals encompassing multi-disciplinary researches.
In summary, our principles and goals are three-pronged. 1) To provide proper and correct evidenced-based treatment to critical patients; 2) To provide, teach and share our knowledge and experience to residents, nurses and physician assistants nurses practitioners; and 3) to better our own knowledge by performing and participating in different researches inside and outside our hospital. These factors, together with the availability of state-of-the-art equipment and facility would enable us to provide a complete, proper, timely and prudent care to critical patients entrusted in our care.
Future perspectives：
After consultation and collaboration with our nephrology department, our department is currently planning of establishing and acquiring a machine capable of providing continuous renal replacement therapy (CRRT), to provide continuous hemodialysis or hemofiltration to very critical patients with unstable vital signs. Moreover, our department is already in the process applying for eligibility for fellowship training in critical care medicine. This would enable us to train aspiring senior residents with an interest in critical care, and in turn would broaden our staff for future expansions of the department of critical care in this hospital.
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