Anaesthesia & Intensive Care
Introduction
The Department of Anaesthesia and Intensive Care stands as a cornerstone
within Hospital Kuala Lumpur, ranking among its largest departments. Serving
as a vital hub for perioperative and intensive care services, it caters to a
substantial patient base primarily from the Klang Valley region and extends
its reach nationwide, serving as a pivotal referral center for the country.
Despite prevailing notions of downsizing within Hospital Kuala Lumpur, the
administration of anaesthetics continues to surge annually, with a tally of
up to 24,000 cases recorded last year alone. Recently, the Intensive Care
Unit (ICU) unveiled a new wing, augmenting its capacity to 24 beds, with
plans underway to further expand to a 30-bedded ICU.
As a pivotal cog in the national healthcare referral system and a training
epicenter, the department shoulders a unique responsibility, perpetually
strategizing and enhancing policies governing standards of care, training
protocols, equipment provisions, and other facets pertinent to anesthesia
and intensive care across all hospitals under the Ministry of Health's
purview.
Services
The Department of Anaesthesia and Intensive Care extends a comprehensive
array of anesthetic services, facilitating procedures across various
multidisciplinary surgical units within Hospital Kuala Lumpur. The preceding
year witnessed nearly twenty-four thousand anesthesia procedures within the
hospital. The recently inaugurated primary OT complex, operational since
early March 2005, boasts 12 fully equipped operation theaters (OTs),
integrated with state-of-the-art anaesthetic machines and the Anaesthetics
Information Management System (AIMS). Specialized procedures in urology,
neurology, pediatrics, and maternity care are conducted in designated
peripheral buildings, adding up to a total of 14 operation theaters.
The general ICU, situated on the 3rd floor of HKL's main building, recently
expanded with a new wing, elevating the bed count to 24 ventilated units,
with an additional 6 beds nearing completion.
The department's scope of anesthetic services encompasses:
1. Provision of anesthesia for elective and emergency surgeries across
general and subspecialty surgical domains.
2. Operation of an Anesthetic Clinic for pre-operative assessment of
surgical patients.
3. Administering anesthesia for procedures such as MRI, CT scans,
interventional and diagnostic radiology, radiotherapy, electroconvulsive
therapy, dermatological laser treatments, endoscopies, and other non-OT
procedures.
Anaesthetic Clinic
Established in 2006, the Anaesthetic Clinic offers pre-anesthetic
consultations and patient optimization across all surgical specialties,
addressing the escalating demand for operative medical interventions.
Situated on the 4th floor above the main OT, the clinic offers consultations
led by specialist anaesthetists and rotating medical officers, supported by
a team of three nurses.
Upon referral from primary teams, the clinic conducts comprehensive patient
assessments, collaborating with requisite specialties to optimize patient
conditions at a specialist level well ahead of scheduled surgeries.
Obstetrics Anaesthesia
The Maternity OT, housed on the second floor of the Maternity building,
comprises three OTs designated for elective cesarean sections, emergency
obstetric cases, and laparoscopic or daycare procedures. The anaesthetic
team comprises one consultant anaesthetist, one anaesthetic specialist, and
four anaesthetic medical officers.
Obstetrics Analgesia Service
Commencing on January 15, 1999, the Obstetric Analgesia Service (OAS)
features a specialist anaesthetist, rotating anaesthetic medical officer,
and three dedicated staff nurses. Integral to HKL's obstetric services, the
OAS administers labor analgesia to approximately 1000 patients annually,
employing techniques such as epidurals, combined spinal-epidurals, spinals,
and fentanyl patient-controlled analgesia.
Pediatric Intensive Care Unit
Upgraded to a 10-bed unit, the Pediatric Intensive Care Unit (PICU) now
resides on the first floor of the Pediatric Institute, operating as a
multi-disciplinary facility under the auspices of the Department of
Anaesthesia & Intensive Care.
Presently, the PICU is managed by three full-time anaesthetic consultants,
one pediatric intensivist, two anaesthetic specialist trainees, and four
medical officers. While anesthesiologists oversee patient care, the unit
emphasizes a multidisciplinary approach, fostering regular consultations
with pertinent pediatric specialties.
The PICU employs approximately 45 staff nurses, led by two nursing sisters
and six attendants.
Pediatric Operating Theatre
Adjacent to the PICU on the first floor of the Pediatric Institute, the
Pediatric OT complex houses four theaters, three for elective surgeries and
one dedicated to emergencies. Annually, the complex conducts around 2500
procedures, spanning surgical, orthopedic, dental, ENT, neurosurgical, bone
marrow transplant, and medical interventions. Anesthetic techniques include
caudal, lumbar, and thoracic epidurals, subarachnoid blocks, regional
plexus, nerve blocks, and general anesthesia.
Acute Pain Service (APS)
Initiated in July 1993, the APS manages postoperative pain primarily in
adult patients, featuring a specialist anaesthetist, rotating medical
officer, four specialized APS nurses, and a dedicated APS facility. A
separate APS caters to pediatric patients within the Pediatric Institute.
Organization of the Service
Patient selection primarily hinges on daily elective and emergency operation
lists. The service operates round-the-clock, staffed by a specialist
anaesthetist, rotating medical officer, and four APS nurses during standard
hours.
Twice-daily ward rounds by the APS team ensure patients receive adequate
pain relief, with meticulous review of Nursing Observation Forms, containing
vital metrics such as pain scores, sedation levels, respiratory rates,
nausea, and vomiting incidences. Continuous audit and data collection inform
service enhancements, encompassing patient details, techniques employed,
drug usage, pain scores, complications, and side effects.
Intensive Care Unit
The Kuala Lumpur Hospital General Intensive Care Unit, accredited as a Level
3 facility, boasts 30 beds, situated on the third floor of the hospital's
main block. Formerly known as Ward 10, the ICU commenced operations on
August 26, 1998, with 16 beds, now expanding to accommodate 14 additional
beds in the adjacent new wing.
The daily clinical operations are managed by two intensivists, two intensive
care subspecialty trainees, two specialist anesthetists, and six medical
officers. After-office hours, one on-call specialist and three medical
officers oversee ICU management. The ICU is supported by four nursing
sisters, 89 staff nurses, 10 attendants, and four medical assistants
specializing in respiratory care.
Contact Information
Tel: 603 - 2615 5160
Fax: 603 - 2691 3815
Email: anestesiologi@hkl.moh.gov.my.
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