Abstract
To survey the facilities, functioning characteristics, bed strength, manpower, operational practices and the distribution of the Intensive Care Units (ICU) of Government Hospitals in Sri Lanka. A cross-sectional observational study. Interview of the sister or the nurse in charge of each unit by telephone using a structured questionnaire. Department of Anaesthesiology, Faculty of Medicine, University of Peradeniya. All intensive care units of the government hospitals in Sri Lanka. Bed strength, facilities, functioning characteristics, manpower and equipment. Fifty two intensive care units were identified in the island. Two units could not be contacted over the telephone and one refused to participate. Of the 49 ICUs studied 28 (57.1%) were located in teaching hospitals, six (12.2%) in provincial hospitals, 13 (26.5%) in base hospitals and two (4.1%) in special hospitals. Twenty five (51%) of the 49 ICUs were multidisciplinary, three (6.1%) general medical, four (8.2%) general surgical and the remainder were of medical, surgical and paediatric subspecialities. The minimum acceptable standard of a ventilator: bed ratio of 1:1 was seen in 28 (57%) and a nurse : bed ratio of 1:1 was seen in 37 (75.5%) ICUs. A 24-hour resident medical officer was available in 46 (93.9%) of the 49 ICUs. ICUs are mostly located in larger cities. The lowest ICU coverage (one ICU for about 1.2 million people) was seen in the Uva Province. ICUs in Sri Lanka are mainly located in teaching hospitals. The standards and management strategies vary widely.
Highlights
Intensive care has emerged as a distinct speciality in the world over the last 40 years [1]
Fifty two intensive care units were identified in the island
Intensive Care Units (ICU) are mostly located in larger cities
Summary
Intensive care has emerged as a distinct speciality in the world over the last 40 years [1]. The importance of mechanical ventilation was realised during polio epidemic in Copenhagen in 1952 where the mortality rates reduced from 90% to 40% following its introduction [2]. This led to the recognition of the importance of close monitoring and vital function support in the treatment of life-threatening diseases. Information on intensive care services in Sri Lanka is scarce. Studies in other countries have looked into services provided and improvements in outcome [4]. The adequacy of medical and nursing staff [2,5], therapeutic interventions, and clinical outcome in patients [6,7] have been studied extensively in these countries
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