WELCOME TO NEONATAL INTENSIVE CARE UNIT DHAKA SHISHU HOSPITAL.

HISTORY OF ICU: The ICU was started in collaboration with JICA in 1993 October. All the equipments donated by JICA were meant for a Neonatal ICU but due to the needs of the hospital, pediatric patients were also served. So that now patients of both groups are served. After 5 years JICA

FROM AUGUST `06 TO JULY `07

TOTAL ADMISSION--------------379
IMPROVED---------------196 (51.7%) EXPIRED------------------155 (40.9%) DORB-----------------------28 (7.4%)

TOTAL ADMISSION AND OUTCOME

FROM AUGUST `06 TO JULY `07 Total Admission -- 379
DEATH 41% DORB 7%
IMPROVED 196 DORB 28 DEATH 155

IMPROVED 52%

FROM AUGUST, 2006 TO JULY, 2007

SL NO.

MONTH
August, 06

ADMISSION 33

DEATH 16

DORB 2

IMPROVED

1.

15(45.45%)

2.
3.

September, 06
October, 06

36
25

17
10

3
1

16(44.44%)
14(56%)

4.
5.

November, 06
December, 06

30
29

11
10
11

1
6 3 4 6 2

19(63.33%)
19(65.5%)

6.
7. 8. 9. 10.
11. 12.

January, 07
February, 07 March, 07 April, 07 May, 07 June, 07 July, 07

27
29 37 34 40 32 27

15(55.55%)
12(41.37%) 21(56.75%) 18(52.94%) 18(45%) 13(40.62%) 16(59.25%)

17 10 13 18 13 9

MONTHLY ADMISSION AND OUTCOME (FROM AUGUST `06 TO JULY`07)

100% 90% 80%

10 16 17 10 11 10 11 17 6 13 18 13

DEATH DORB IMPROVED

70% 60% 50% 40% 30% 20% 10% 0%

2 3 4 6

1 2 3

19 14 15 16

19 15 12 21 18 18 13

16

AUG SEP `06 `06

OCT `06

NOV `06

DEC `06

JAN `07

FEB `07

MAR `07

APR `07

MAY `07

JUN `07

JUL `07

DISEASE PATTERN IN ONE-YEAR ADMISSION

SL NO. 1.

DISEASE PATTERN
PNEUMONIA
WITH ASSOCIATE DISEASES

ADMISSION
52 111 60 8 40 13 16 6 6 6

DEATH
13 54 23 2 19 2 1 2 3 1

DORB
4 8 1 1 4 2 3 1 1

IMPROVED
35(67.3%) 49(44.14%) 36 (60%) 5 (62.5%) 17 (42.5%) 9 (69.23%) 12 (75%) 3 (50%) 3 (50%) 4 (66.67%)

PERINATAL ASPHYXIA
2.
3. 4. 5. 6. 7.
WITH ASSOCIATE DISEASES

PRETERM
WITH ASSOCIATE DISEASES

RDS
WITH ASSOCIATE DISEASES

SEPTICAEMIA
WITH ASSOCIATE DISEASES

GBS
WITH ASSOCIATE DISEASES

MENINGITIS
WITH ASSOCIATE DISEASES

8. 9. 10.

MUCONIUM ASPIRATION SYNDROME

ENCEPHALITIS
WITH ASSOCIATE DISEASES

BRONCHIOLITIES
WITH ASSOCIATE DISEASES

SURGICAL
11.
WITH ASSOCIATE DISEASES

31 30

13 14

3 4

15 (48.38%) 12 (40%)

12.

OTHERS

PNEUMONIA
Total admission 52
40 35 30 25 20 15 10 5 0
IMPROVED DEATH DORB

35(67.3%)

13(25%) 4(7.69%)

PRETERM
Total admission 60
DEATH 38% IMPROVED 36 DEATH 23 DORB 1 DORB 2% IMPROVED 60%

SEPTICAEMIA
Total admission 40

DEATH 47%

IMPROVED 17 DEATH 19 DORB 4

DORB 10% IMPROVED 43%

Perinatal Asphyxia
Total admission 111
60
49(44.14%) 54 (48.64%)

50 40 30 20 10 0 IMPROVED DEATH DORB

8( 7.2%)

MENINGITIS
Total Admission-- 16
12(75%)

12 10 8 6 4 2 0

3(18.75%) 1 (6.25%)

IMPROVED

DEATH

DORB

RDS
Total Admission-- 8
DORB 13%
IMPROVED 5 DEATH 2 DORB 1

DEATH 25%

IMPROVED 62%

GBS
Total Admission-- 13
DORB 15%

Death 15%

Improved 9 Death 2 DORB 2

Improved 70%

SURGICAL CASES
Total Admission-- 31
16 14 12 10 8 6 4 2 0 IMPROVED DEATH DORB

15 ( 48.3%) 13 ( 41.9%)

DISEASES
DIAPHRAGMATIC HERNIA TRACHEO-OESOPHAGEAL FISTULA INTESTINAL OBSTRUCTION OTHERS

ADMISSION
11 11 2 7

DEATH
2 5 1 5

DORB
3 -

IMPROVED
9 3 1 2

BRONCHIOLITES
Total admission 6

DEATH 17%

IMPROVED 4 DEATH 1

IMPROVED 66%

DORB 17%

DORB 1

MECONIUM ASPIRATION SYNDROME Total Admission-- 6

DORB 17%
IMPROVED 3 DEATH 2 DORB 1

DEATH 33%

IMPROVED 50%

ENCEPHALITIS
Total Admission-- 6
DORB 0%

DEATH 50%

IMPROVED DEATH 3 50% DORB 0

IMPROVED 3

OTHERS
Total admission 30

DEATH 47%

IMPROVED 12 DEATH 14 DORB 4

DORB 13% IMPROVED 40%

INCOME PER MONTH

q q q q BED CHARGE-----------------------6 * 1500 = 9,000/= * 30 =2,70000/= BLOOD GAS CHARGE (Paying Bed)------------------------ -= 54,000/= BLOOD GAS CHARGE (Non-Paying Bed)-------------------= 9,000/= BLOOD TESTS---------500Tk/DAY/BED--------------------- =90,000/= ------------------------------------------------------------------------------------------TOTAL INCOME PER MONTH =4,23000/=

EXPENDITURE PER MONTH

q q MEDICAL OFFICER---------------------------------------------=50,000/= NURSES--------------------------------------------------------------=90,000/= ---------------------------------------------------------------------------------------TOTAL EXPENDITURE PER MONTH =1,40,000/=

GRAND TOTAL INCOME PER YEAR----33,96000/=

Proposal For Revised Organogram

Department of ANAESTHESIA, Unit- INTENSIVE CARE UNIT
Sl No. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Name of the Post Consultant Intensives Registrar Asst. Registrar Medical Officer Trainee Research Asst. Nursing In charge Nursing Staff ICU Attendant Ward Boy/Aaya Peon Approved in 1998 1 1 2 8 1 10 1 3 Proposed in 2002 --Present

1 1 2 6 1 10 3 -

Proposed for 2007 1 2 2 1 10 1 1 12 2 4 1

Financial Involvement

Reasoning

INCREASE WORK LOAD

Safety of ICU

INTENSIVE CARE UNIT OF DHAKA SHISHU HOSPITAL

To run a Unique Intensive Care Unit like Dhaka Shishu Hospital ICU- requires following things--- At least Five (5) Pulse Oximeter for eight bedded ICU ---Now only one. At least Three (3) Ventilator Machine With Compressor for eight bedded ICU--- Now only Two.There is one machine but compressor out of order and irrepairable. Two (2) Syringe pump for eight bedded ICU--- Now only one. Two (2) Infusion pump for eight bedded ICU-------NIL. Two (2) Apnea Monitor for eight bedded ICU-------NIL. Two (2) Cardiac Monitor for eight bedded ICU--- Now only one. Two (2) Automatic Neonatal B.P Cuff with machine for eight bedded ICU-------NIL. Repair or purchase of Compressor.

Problems:
ICU is totally equipments based ward.Prompt repair and maintain Nance of all its equipments are necessary round the clock. There is no biomedical technician or engineer to maintain those machines.Also there is no fund separately allocated

PERSONNEL: There is a constant transfer of Doctors in and out of ICU.Trainee Doctors should be guided by senior M.O. However as per initial proposal of 6 permanent M.O for ICU,now there are only Two. There is also lack of higher training facilities and

POLICIES: Initially ICU was funded by JICA in the first 5 years and it was expected that DSH would be able to support financially the same after words.But unfortunately the policy to run the ICU has changed from time to time over the years and at best it has been inconsistent

Requests made from ICU are not promptly redressed or sometimes ignored.The processing is lengthy and requires frequent persuasion.Working conditions are very difficult and risky for all the personnel.Equipment which are out of order have never been replaced. I would take this opportunity to

THANKS TO ALL.