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Dr.P.Lakshman Jaffna Teaching Hospital
Transcript of Dr.P.Lakshman Jaffna Teaching Hospital
Dr.P.Lakshman
Jaffna Teaching Hospital
Situation in General and Situation at Jaffna Teaching
Hospital
Health care facilities available at the developing countries are usually below the
standard of developed countries.
Situation in regions riddled with armed conflict is even worse
Our home land – North and Eastern region of Srilanka has both features
Part of a developing country Affected by a protracted conflict for nearly 25 years.
Jaffna peninsula is one of the worst affected areas during this conflict
Impact clearly visible in all spheres of life
Population of Jaffna 1981 – One million 2007 – Half a million
Several thousand people left the region and took refuge in other
countries continue their life in camps for internally
displaced people or moved to other safer areas.
Most of the people who have left the country are from the upper strata of society which consisted the most affluent and educated families.
Paved way to a severe dearth of professionals and health sector is the most affected
Almost all the hospitals have lack of facilities
Considerably increased the work load of Jaffna teaching hospital.
Cardiology service is available only at Jaffna
Teaching Hospital.Thus it has become a service
to the entire peninsula-in other words to the northern
province.
PRESENT STATE OF THE CARDIOLOGY UNIT.
Cardiology unit was established at Jaffna Teaching Hospital in 2005 with the generous contribution of Dr.G.R.Handy memorial trust in memory of Dr.G.R.Handy who was the pioneer cardiologist in Sri Lanka.
Continue….
PRESENT CADIOLOGY UNIT
A Coronary Care Unit with 7 beds Cardiac Investigation unit Echo, Exercise Treadmill, Holter monitor Out Patient Clinic – twice a week Cardiac Rehabilitation clinic Newly established cardiac ward with 18 beds future high dependency unit…?
PRESENT CADIOLOGY UNIT Continue…….
Echocardiography section
Exercise treadmill section
Out patient clinic Rehabilitation clinic
Newly established cardiac ward with 18 beds - future high dependency unit…?
January to December 2007 578 patients admitted to CCU
further 4959 patients with heart related conditions treated at EU
another 3483 patients at the medical wards
Directly admitted to Jaffna Teaching Hospital or being transferred from
other hospitals.
In addition 190 patients with serious cardiac ailments were transferred by air
for further investigation and management with the help of ICRC
Only mode of transport available for transfer of patients to Colombo from
Jaffna Twice a week Each trip about 5-8 patients transferred Patients face tremendous hardships during this process.
190 patients transferred to Govt. hospitals Several hundred patients had gone to
private hospitals on their own Apart from this a huge number who couldn’t
afford a trip to Colombo managed medically in Jaffna
We have lost few patients while awaiting transfer or during transfer
A 19 year old boy with atrial myxoma died in CCU while awaiting transfer
A 30 year old gentleman with severe aortic stenosis who was awaiting for AVR died during transfer.
If proper facilities are available in Jaffna Teaching Hospital all these
patients would have been benefited.
SUGGESTIONS TO IMPROVE THE
CARDIAC SERVICES
1. ESTABLISHMENT OF A HIGH DEPENDENCY UNIT
High dependency unit is important to manage patients who no longer needed to be in the CCU but not yet ready to be transferred to ordinary wards
Thus it was planned to establish a high dependency unit and it is not yet materialized
Establishment of a high dependency unit will enhance the efficient usage of CCU beds HDU beds could be utilized to observe patients after procedures.
CARDIOLOGY HIGH DEPENDENCY UNIT ESTIMATED COST
Cardiac Bed 10 x 80 000 800 000
Mattress 10 x 5 000 50 000
Defibrillator 1 x 650 000 650 000
Cardiac monitor 2 x 600 000 1200 000
ECG recorder 1 x 150 000 150 000
Pulse oxymeter 2 x 140 000 280 000
Syringe pumps 10x 140 000 1400 000
sphygmomanometer 4 x 7500 30 000
sucker 2 x 40 000 80 000
Total cost SLR= 4.64million (US$ = 46 400)
• Coronary angiogram• Percutaneous coronary intervention• Pacemaker implantation• Balloon valvuloplasty especially PTMC• Device closure of congenital defects
2. ESTABLISHMENT OF A CARDIAC CATHETERIZATION LABORATORY WITH FACILITIES FOR INVESTIGATION AND
INTERVENTION
ESTIMATED COST TO ESTABLISH A CARDIAC CATHETERIZATION
LABORATORY
Philips Integris Allura X per FD10C Digital Cathlab
US $ 800 000
Euro Colombus Digital Cathlab
US $ 520 000
Necessary human resources available at JTH
Two cardiologists with necessary training
Nursing and paramedical staff who could be trained in Colombo – NHSL
If facility is available at JTH Many lives could have been saved Transfers to Colombo would have been greatly reduced
Running cost and the consumables could be obtained from the Ministry of Health once a unit is established.
3. EXPANSION OF CORONARY CARE UNIT
Increasing the bed strength to ten
Further training for the Doctors / Nursing staff
4. ESTABLISHMENT Of CARDIAC WARD
Patients who are being treated at cardiology unit are transferred to medical wards later for further management
It would be beneficial for the patients if ward facilities are available
Thus it is planned to establish a ward with 40 beds
5. UPGRADING CARDIACREHABILITATION CLINIC
Rehabilitation clinic functions with bare minimum facilities
Present staff who man this clinic need further
training
Apart from this equipments are also needed to enhance the present activities
Audio visual aidsHealth education materials booklets and leaflets
“SERVICE IS THE RENT WE PAY FOR THE ROOM WE
OCCUPY ON EARTH”
THANK YOU