The Anesthesia Department has a staffing of 37 members, comprising of 12 senior consultants , 4 senior specialists , 10 specialists , 4 junior specialists, 7 medical officers and 3 respiratory therapists. A good number of Omani Anesthesiologists are in training, both in Oman and overseas. There has been a marked interest in taking up Anesthesiology amongst Omani doctors in view of the opportunities available and the extensive range of experience available in the Sultanate. With the current demands, the department is poised to expand the services offered at present. The department aims to maintain a high standard of professionalism while providing a first class service to the general public.
STAFFING
Dr. Maher Al Bahrani, MD, Dip American Board, ABACCM, FCCP, Sr. Consultant & Director of Department
Dr. Abdul Wahab Zarroug, MB.ChB, DA, FFARCS (Ireland), Sr. Consultant & Deputy Head of Department
Dr. O.S.G.Silva, MBBS, DA (Eng), LRCP (Lond), MRCS (Eng) FRCA (Eng), Sr. Consultant
Dr. Mohan Mathews, MBBS, DA, MD (India), Sr. Consultant
Dr. Madan Mohan Maddali, MBBS, MD (India), Sr. Consultant
Dr. Mamie Zachariah, MBBS, MD (India), Sr. Consultant
Dr. Athma Prasanna, MBBS, DA, MD (India), MNAMS (India), Sr. Consultant
Dr. Sadanandan Prakash, MBBS, DA, MD (India), FFARCS (Ireland) EDIC, Sr. Consultant
Dr. Mathew Mathew John, MBBS, MD (India), Sr. Consultant
Dr. Rajagopalan Nair, MBBS, DA, MD (India), Sr. Consultant
Dr. Swatanthra Misra, MBBS, MD, DM (India), Sr. Consultant
Dr. Kinnari Bhatt, MBBS.MD (India), PDCC (India), Sr. Consultant
Dr. Elizabeth George, MBBS, DA, MD (India), Sr. Specialist
Dr. Juhi Chandwani, MBBS, MD (India), FFARCS, EDIC, Dip National Board (India), Sr. Specialist
Dr. Sandeep Kantoor, MBBS, MD (India), Sr. Specialist
Dr. Kaza Sangeeta Rao MBBS, MD (ndia), Sr. Specialist
CLINICAL ANAESTHESIA SERVICES
The Department provides anesthesia services for patients referred by the surgical and medical departments. Besides the 9 operating theatres, the Anaesthesia Department covers Radiology (CT,MRI, Angiography), Cardiac Cath, Lithotripsy, Radiotherapy ,Endoscopy and Obstetric Delivery Suites. The surgical specialities include General Surgery including Laparascopic and Vascular Surgery, Adult and Pediatric Cardiac Surgery, Paediatric Surgery (including Neonatal), Urology, Renal Transplants and Gynaecology- Obstetric (including epidural) services. An eight bedded post-anaesthesia recovery room is operational 24 hrs.
Besides provision of routine anaesthesia services as above, the workload of the Department includes:
- Twenty four hour emergency cover for the operating theatres, emergency (including CPR) services.
- Evaluation of patients outside the ICU who may require ICU services.
- Consultation and follow-up of ventilated patients in wards.
- Daily evening rounds are conducted by consultants and attending staff. All surgical patients are seen preoperatively the previous evening and also in the Pre-Anaesthetic clinic, which is conducted daily in the outpatients dept.
- A Pain Therapy clinic is also conducted by a Consultant Anaesthetist. A 24-hour exclusive pain therapy service is being planned. A full time Obsteric Epidural service is currently provided.
The department has prepared treatment protocols and guidelines for the operating theatres and the Intensive care unit.
ADULT ICU
The Critical Care Unit is a subdivision of Department of Anaesthesia providing sophisticated, compassionate and expert care to critically ill patients in our Hospital. The department’s approach to care emphasizes ethical principles, evidence based medicine and cost-effectiveness. Quality patient care is optimized through a multidisciplinary team approach, with anaesthetist-intensivists being the nodal point of care. The model involved is of a semi open type, with the Critical care team being in- charge of the patient in the ICU and with relevant help from other specialties as needed for patient care. This team approach, coordinated under the direction of a Critical care Consultant is meant to provide patients with the highest level of care based on the latest scientific evidence.
The Adult Intensive Care Unit (AICU) provides patient care in a dedicated 8 bedded (including 3 isolation rooms) unit located in the Level 1 of the Hospital building. It is located in the common critical care area adjacent to the Pediatric ICU, Post-cardiac Surgery Unit and cardiac catheterization laboratory. The Operation Theatre is located in the same floor. Thus any intra-operative case requiring ICU care can be shifted conveniently to the ICU. The ICU is based on a level 3 multidisciplinary model with an equal mix of cases coming from medical and surgical specialties.
The following services are rendered in the ICU by the ICU team:
- Advanced mechanical ventilation.
- Invasive monitoring and hemodynamic support.
- CVVHD
- Percutaneous tracheostomy
- Chest tube insertion.
- Critical care echocardiography
- Nutrition (enteral and parenteral)
Apart from providing dedicated services to the ICU the ICU team also supports the other departments in following areas:
- Clinical support for the seriously ill patients in the Medical and surgical High Dependency units.
- Invasive line insertion (including central line, arterial line)
- Patient transport for imaging and other activities requiring patient mobilization if they are on ventilator.
- Non invasive and invasive ventilation.
In response to data that suggests that outcomes of critically ill patients can be improved when full-time staff intensivists are immediately available to care for them, the department of Anaesthesia has a vision to develop a dedicated team for the ICU Division.
The department has 2 full time dedicated Senior Consultant and 2 full time dedicated senior Specialists apart from the other contributing doctors with interest in ICU from the Department of Anaesthesia. Round the clock Consultant cover is provided in the ICU along with the in house dedicated medical staff, who are of senior level with good experience in critical care.
Nursing care is provided by a strong team of 41 dedicated nursing staff of multinational origin being led by 1 nursing officer and 4 senior nurses.
ICU is also supported by a team of respiratory therapist, 4 in number who assist the ICU team in the ventilator management of the critical patient in ICU and elsewhere in the hospital. The respiratory team is also responsible for the day to day maintenance of the ventilators and others critical care respiratory equipments.
The ICU has the latest equipment, including modular monitors (with an interfaced central monitor), state of art Evita 4 and Hamilton ventilators, CVVHD machine and an ABG machine. Future plans include an advanced echocardiography machine and a bronchoscope dedicated for the ICU.
EDUCATIONAL ACTIVITIES
The department holds weekly CME activities (journal club lectures, mortality morbidity reviews) which also encourage trainees and residents to participate. ICU grand rounds are conducted once a week. Quality Assurance meetings are also held periodically.
The department conducts regular lectures for Anaesthetic residents and trainees, in addition to clinical teaching on a daily basis. Trainees from other specialities (medical surgical , allied health and ambulance services) are also trained by the department.
Clinical meetings and workshops in association with the Oman Society of Anaesthesia and critical care are held periodically.
We take pride in the fact that ICU at the Royal Hospital is one of the most sought after training centers for the resident doctors in various medical subspecialties. It is popular with the students and residents because of the variety of cases they witness and relevant hands-on training, under supervision of senior staff. Regular flow of post graduate medical students is seen throughout the year where resident are exposed to the recent evidence based management of the critical patient with the most advanced technology employed, thereby building up the workforce for tomorrow.
Regular CME and case presentations are undertaken by the resident doctors under supervision of Consultants to nurture them as clinicians with good academic base.
