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Services

Hospital Services

The services include a wide range of anesthesia care, chronic & acute pain management, resuscitation, intensive and critical care support provided in a hospital setup. Pre-Anesthetic assessment of the patient especially for complex surgeries before administering anesthesia is an integral part.

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Emergencies

Private hospitals often receive a number of calls on emergency especially during afterhours and group attends to these cases, stabilizes them and assists in operating immediately or at a later time.

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Obstetrics

Obstetric analgesia and anesthesia services are provided by us. Advanced epidural and spinal pain relief techniques are used to meet the needs of woman in labor. Anesthesia both regional and general are provided for emergency and elective Caesarian section as well as for general obstetric procedures.

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Critical Care Services

Critical care service is provided to patients who are the risk of immediate life threatening conditions in which vital organs are involved. Goal is to maintain the vital organ system functioning and improve the patient’s condition using advanced diagnostic and therapeutic technology.

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Pain Management

Acute and Chronic pain management services are provided in hospital and multi-specialty clinic setup. This help to provide pain relief to patients after surgery, injury or during illnesses including cancer.

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COVID19 Airway Principles

            COVID-19 Airway management principles Tracheal intubation of the patient with COVID-19 is a high-risk procedure forstaff, irrespective of the clinical severity of disease. In severe COVID-19 it is also a high-risk procedure for the patient Limit staff present at tracheal intubation: one intubator, one assistant and oneto administer drugs/monitor patient. Create a COVID-19 tracheal intubation trolley that can be used in ICU or elsewhere. PPE is effective and must be worn. Wear full PPE at all times. Consider doublegloving. Defog goggles and/or eye wear if possible. Touch as little as possible inthe room to avoid fomites. Intubate in a negative pressure room with >12 air changes per minute wheneverpossible. Everyone should know the plan before entering the room – use a checklist to achievethis. Plan how to communicate before entering the room. The algorithm/cognitive aid you plan to use should be displayed in or taken into theroom. All preparations of airway equipment and drugs that can take place outside the roomshould do. Use a kit mat if available. The best skilled airway manager present should manage the airway to maximise thefirst pass success. Focus on safety, promptness and reliability. Aim to succeed at the first attemptbecause multiple attempts increase risk to sick patients and staff. Do not rush butmake each attempt the best it can be. Use reliable techniques that work, including when difficulty is encountered. Thechosen technique may differ according to local practices and equipment. Withprior training and availability this is likely to include: preoxygenation with a well-fitting mask and a Mapleson C (‘Waters’) oranaesthetic circuit, for 3-5 minutes. videolaryngoscopy for tracheal intubation; 2-person, 2-handed mask ventilation with a VE-grip to improve seal; a second-generation supraglottic airway device (SAD) for airway rescue, also toimprove seal. Place an HME filter between the catheter mount and the circuit at all times. Keep it dryto avoid blocking. Avoid aerosol-generating procedure, including high-flow nasal oxygen, non- invasive ventilation, bronchoscopy and tracheal suction unless an in-line suctionsystem is in place. Full monitoring, including working continuous waveform capnography before, duringand after tracheal intubation. Use RSI with cricoid force where a trained assistant can apply it. Take it off if itcauses          difficulty. To avoid cardiovascular collapse use ketamine 1–2 mg.kg-1, rocuronium 1.2 mg.kg-1 orsuxamethonium 1.5 mg.kg-1. Have a vasopressor for bolus or infusion immediately available for managinghypotension. Ensure full neuromuscular blockade before attempting tracheal intubation. Avoid face mask ventilation unless needed and use a 2- person, low flow, low pressuretechnique if needed. Intubate with a 7.0-8.0 mm ID (females) or 8.0-9.0 mm ID (males) tracheal tube with asubglottic suction port. Pass the cuff 1-2 cm below the cords to avoid bronchial placement. Confirmingposition is difficult wearing PPE. Inflate the tracheal tube cuff to seal the airway before starting ventilation. Note andrecord depth. Confirm tracheal intubation with continuous waveform capnography – which ispresent even during cardiac arrest. Use a standard failed tracheal intubation algorithm with a cognitive aid if difficultyarises. Communicate clearly: simple instructions, closed loop communication (repeat instructions … Continue reading COVID19 Airway Principles

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