BENGALURU: Karnataka is short of intensivists, who are specialised doctors trained to work in the ICU. Experts estimate that there are only around 1,000 in the State and 15,000 in India. Right now, ICUs — mostly filled with Covid-19 patients — are mostly managed by anaesthetists as their expertise overlaps with intensivists, when it comes to duties such as operating the ventilator.
“Covid patients develop a severe form of lung injury called ARDS (Acute Respiratory Distress Syndrome). These patients require a ventilator for survival. To manage such a patient, a hospital requires a very skilled intensivist. None of the medical colleges in Bengaluru have a separate critical care department, as the Medical Council of India, which governs them, has not mandated it,” said Dr T R Chandrasekhar, Member, Critical Care Society, Bengaluru, and Intensivist, Institute of Gastroenterology Organ Transplant, Victoria Hospital.
There are around 500 intensivists in Bengaluru but having a separate department for them in medical colleges would have ensured us 100 more intensivists per year, he added.There are Doctorate of Medicine courses and Diplomate of National Board courses in critical care available. Fellowships and courses in the same are also offered by the Indian Society of Critical Care Medicine.
Victoria Hospital, which comes under Bangalore Medical College, for instance, does not have a separate department for critical care and the ICUs are managed by surgical or anaesthesia departments, along with their duties in the operation theatre.
In Rajiv Gandhi Institute of Chest Diseases, there is only one in-house intensivist but as he is aged 50 plus, he has been put off Covid duty. “As we have a shortage, Bangalore Medical College and Research Institute is supplying four intensivists. The shortage is there everywhere, but more so in hospitals which are not attached to medical colleges,” said Dr C N Nagaraj, Rajiv Gandhi Institute of Chest Diseases.
Private hospitals are better off having a full team of anaesthetists and intensivists as they too train them. It is because of the dearth in district government hospitals that the Critical Care Support Team was set up by the government to lend specialist access through tele-ICU to government doctors treating severely ill Covid-19 patients.