PRE-ANESTHESIA CLINIC (PAC)

The PAC provides comprehensive patient-centered preoperative clinical service that aims at improving the outcome across the surgical continuum. It provides a safe and cost-effective way for patient preparation in advance for Anesthesia and Surgery.

The clinic is located on the second floor of the Out-Patient Clinic building. It is conducted daily. A senior anesthesiologist is assigned to assess patients who are referred from different specialties including general surgery, urology, ENT, obstetrics & gynecology, orthopedics and ophthalmology clinics.

Patients are evaluated by the anesthesiologist, investigations are ordered and reviewed. If the patient needs optimization prior to going ahead with the planned procedure, he/she is referred to the appropriate specialty. The PAC serves as an excellent opportunity for the anesthesiologist and the patient to discuss the anesthetic plan, postoperative analgesia and any queries that the patient might have.

A well planned admission for elective surgery avoids unnecessary last minutes cancelations or delays on the day of surgery and consequently reduces wasted operative time and cost of hospitalization. It yields high level of patient and surgeon satisfaction.

CHRONIC PAIN CLINIC

The pain clinic provides comprehensive management of patients with chronic pain (usually more than 3-6months) and when traditional or conventional therapies have failed.

The Pain Clinic is run twice a week by Dr. Ali Al-Abadi, the Pain Specialist. Patients are referred to the clinic from other specialists in SQUH as well as from other tertiary hospitals in Oman. Appointment is given to the patient to undergo a detailed assessment by the Pain specialist.  

The Pain Physician will explain to the patient regarding the causes of Pain, source of pain and available treatment options from pharmaceutical or Interventional Pain therapies. Regular follow up appointments to the Pain clinic are then given to review their responses to therapy. The Physician my escalate the doses of analgesic drugs or try more than one treatment option. Some Patients may not respond well to medical therapy and they may be given an option for interventional pain procedure. These are done in the minor operating room as day care cases.

Chronic Pain has Multimodal and Multi-disciplinary dimensions.  The Pain physician may request other relevant investigations such as MRI or sometime may decide the patient need to be seen by other specialties example physiotherapy, chiropractor, psychology, rheumatology, neurologist and or surgery.

The first respiratory therapist joined the department in April 2011. Currently, there are mine therapists working around the clock 7 days a week.

Respiratory Therapists provide essential services to patients in need, especially in the ICU and the High Dependency Units (HDU).  They take care of all mechanically ventilated patients in the ICU. They assist the intensivists in intubation, initiation of mechanical ventilation, weaning and extubation.  They also assist in bronchoscopy, and percutaneous tracheostomy.

Respiratory therapists administer bronchodilator therapy and if needed Non-Invasive Ventilation (NIV) to patients after they are extubated.

 Other services that the Respiratory Therapists take active participation in include cardiopulmonary resuscitations in the ICU, intra-hospital transfer of the mechanically ventilated patients, assessment of respiratory mechanics, performance of Arterial Blood Gas (ABG),  initiation and weaning of NIV for HDU patients.

They also help train nurses, nursing students and medical students on the management of NIV.

The Department of Anesthesia and Intensive Care provides anesthesia services for patients of all ages and for all types of operations and procedures.

These are not limited to the Main Operating Room. It extends to include Minor Operating Room, Delivery Operating Room, Magnetic Resonance Imaging (MRI), Interventional Radiology Suite (Angio Room), Interventional Cardiology Suite (Cath Lab), Endoscopic Retrograde Cholangio Pancreatography (ERCP) Room and Emergency Department (ED).

We also provide support services to the Neonatal Intensive Care Unit (NICU) and Pediatric Intensive Care Unit (PICU) for Vascular Access and Airway management.

In the Operating Room, patients of all ages including extremes of age are provided with quality anesthesia services for their procedures. Extremely premature newborn coming for emergency  laparotomy, parturient for high risk Cesarean section, elderly for open reduction of hip fracture, end-stage renal disease patient for kidney transplant, high risk coronary artery disease patient for combined coronary artery disease (CABG) and valve replacement are just examples of what we deal with.

A look at the number of cases that were performed in the operating room over the last 12 years shows a significant increase.

 In the year 2002, there were 5712 operations compared to 9953 operations in 2014 (an increase of 74.2%). The average number of cases done was 829 per month. In 2014, there were 5 mortalities (0.05%).

There were 7105 cases done in main operating room in 2014; of which emergency cases were 2643 (37.2%).  

The Intensive Care Unit (ICU) at our hospital is an 11-bed state of the art critical care area. It’s moving to become a closed ICU. Over the last 2-3 years, Intensivists and Anesthesiologists with special interest in critical care have been given the responsibility of managing patients in the unit. This has improved the care and streamlined clinical practice for a better outcome.

In addition to being a valuable resource for clinical patient care for SQUH, our ICU receives transfers from all over the country for further management of complex cases. It also plays a very vital role in the training of OMSB residents and teaching of CoMH students.

Pre-existing policies have been updated and new ones have been created for standardized patient management.

In 2014, our ICU admitted a total of 592 patients with an average of 49 cases per month. The average length of stay was 6.1 days