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IMPROVING THE CARDIOLOGY UNIT OF JAFFNA TEACHING HOSPITAL AND ENHANCING THE SERVICES PROVIDED. Dr.P.Lakshman Jaffna Teaching Hospital. Situation in General and Situation at Jaffna Teaching Hospital.

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improving the cardiology unit of jaffna teaching hospital and enhancing the services provided

IMPROVING THE CARDIOLOGY UNIT OF JAFFNA TEACHING HOSPITAL AND ENHANCING THE SERVICES PROVIDED

Dr.P.Lakshman

Jaffna Teaching Hospital

slide3

Health care facilities available at the developing countries are usually below the standard of developed countries.

slide4
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.

slide5

Jaffna peninsula is one of the worst affected areas during this conflict

Impact clearly visible in all spheres of life

slide6
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.

slide7
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.

continue
Continue….
  • 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.
present cadiology unit
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
PRESENT CADIOLOGY UNIT Continue…….

Exercise treadmill section

Echocardiography section

slide12

Out patient clinic

Rehabilitation clinic

slide14
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.

slide15

In addition 190 patients with serious cardiac ailments were transferred by air for further investigation and management with the help of ICRC

slide16
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
slide17
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.

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
  • Establishment of a high dependency unit will enhance the

efficient usage of CCU beds

  • HDU beds could be utilized to observe patients after procedures.
slide21
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
ESTIMATED COST TO ESTABLISH A CARDIAC CATHETERIZATION LABORATORY
  • Philips IntegrisAllura X per FD10C Digital Cathlab
  • US $ 800 000
  • Euro Colombus Digital Cathlab
  • US $ 520 000
slide23
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
slide24
Running cost and the consumables could be obtained from the Ministry of Health once a unit is established.
3 expansion of coronary care unit
3. EXPANSION OF CORONARY CARE UNIT
  • Increasing the bed strength to ten
  • Further training for the Doctors / Nursing staff
4 establishment of cardiac ward
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
upgrading cardiac rehabilitation clinic
UPGRADING CARDIACREHABILITATION CLINIC
  • Rehabilitation clinic functions with bare minimum facilities
slide28
Present staff who man this clinic

need further training

slide29
Apart from this equipments are also needed to enhance the present activities
          • Audio visual aids
          • Health education materials

booklets and leaflets

slide30

THANK YOU

“SERVICE IS THE RENT WE PAY FOR THE ROOM WE OCCUPY ON EARTH”