OT audit 2016

1. OT CENSUS
1st JANUARY 2016 TO 31st DECEMBER 2016
DEPARTMENT OF NEUROANAESTHESIOLOGY
JPNATC AIIMS
NEW DELHI

2. 0
20
40
60
80
100
120
140
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
125
105 108
114
104
99
90
120
96 98
116
105
NO.OFCASES
MONTH
TOTAL NO. OF NEURO SURGERY CASES= 1280

3. CASE DISTRIBUTION
ROUTINE CASES EMERGENCY CASES
513 CASES
(40%) 767 CASES
(60%)

4. SEX DISTRIBUTION
MALES FEMALES
181 (14%)
1099 (86%)

5. AGE DISTRIBUTION
ADULT PAEDIATRIC GERIATRIC
51(4%)
124 (10%)
1105 (86%)

6. NEUROSURGICAL PROCEDURES
0
50
100
150
200
250
300
350
400
450
DECOMPRESSIVE
CRANIOTOMY
CRANIOPLASTY CERVICAL SPINE DORSOLUMBAR
SPINE
VP SHUNT
414
149
220
142
70

7. NEUROSURGICAL PROCEDURES
0
20
40
60
80
100
120
140
160
BRACHIAL
PLEXUS INJURY
OMAYA DRAINS INFECTED BONE
REMOVAL
OTHERS
145
4 14
122

8. ANAESTHESIA MANAGEMENT
GA MAC
49 (4%)
1231 (96%)

9. AIRWAY MANAGEMENT
200
120
777
159
FOB ASSISTED INTUBATION SAD DL ETI VAL ETI

10. ASA STATUS
ASA 1 ASA 2 ASA 3 ASA 4 ASA 5 ASA 6
173 (13.52%)
53 (4.14%)
513 (40.07%)
259 (20.23%)
282 (22.03%)

11. CO-MORBIDITIES
0
20
40
60
80
100
120 108
16
41
8
21
27
0
6

12. PATIENT POSITIONING
882 (68.90%)
SUPINE PRONE LATERAL
887 (69.30%)
362
(28.29%)
31 (2.42%)

13. CENTRAL VENOUS LINE PLACEMENT
IJV SCV
87 (25.22%)
258 (74.78%)

14. USE OF CELL SAVER - 22
INCIDENCE OF CARDIAC ARREST – NIL
EXPIRED ON TABLE - NIL

15. PATIENT SHIFTING
SHIFTED TO WARD SHIFTED TO ICU
549 (42.89%)
731 (57.11%)

16. 2015 2016
TOTAL NO. OF NEUROSURGERY
CASES
1347 1280
EMERGENCY:ROUTINE 613:734 513:767
MALES:FEMALES 1105:242 1099:181
ADULT:PAEDIATRIC:GERIATRIC 1156:141:50 1105:124:51

17. 2015 2016
ANAESTHESIA MANAGEMENT
(GA:MAC)
1166:181 1231:49
INCIDENCE OF CARIDAC ARREST NIL NIL
DEATH ON TABLE NIL NIL
SHIFTED TO WARD:ICU 625:722 731:549

18. TC3 ICU Census 2016
1st JAN 2016 to 31st DEC 2016

19. ICU setup
1.Total no.of beds:- 20 ( with 5 cubicles of 4 beds each)
2.Faculty :- 2
3.Senior Residents :- 4

20. 2016 Admissions
• Total no.of pts :- 1407
• Split:-
1) OT:- 549
2) Ward:- 87
3) ED:- 771
55%
39%
6%
ED OT Ward

21. 771 755 770
549 561
467
87 105 96
0
100
200
300
400
500
600
700
800
900
2016 2015 2014
ED OT Ward
Comparisons with previous years

22. Male : Female = 1174 : 233
83%
17%
Male
Female

23. Cause of Admissions
• Head injury:- 1109
• Spine injury:- 250
• Both head and spine:- 48
78%
18%
4%
Head Injury
Spine Injury
Both

24. Comparisons with previous years
1109 1100
1023
250 266 269
48 55 41
0
200
400
600
800
1000
1200
2016 2015 2014
Head Injury
Spine Injury
Both

25. MORTALITY
• 96
6.8%
93.2%
Mortality
Transfer out

26. MORTALITY Comparisons with previous years
6.8% (2016)
8.3%(2015)
8.9% (2014)
0
1
2
3
4
5
6
7
8
9
10
1 2 3

27. CAUSES OF DEATH
• 1) Raised ICP/ Severe Head injury:- 57
(59.4%)
• 2) Shock(cardiogenic, spinal):- 17 (17.7%)
• 3) ARDS:- 10 (10.4%)
• 4) Sepsis:- 12 (12.5%)
59%
18%
10%
13%
Causes of Death
Raised ICP Shock ARDS Sepsis

28. Procedures
1) Bronchoscopy:- 92
2) Central venous line
insertion:- 203
3) Percutaneous
tracheostomy:- 328
92 90
41
203
171
159
328 328
317
0
50
100
150
200
250
300
350
2016 2015 2014
Fiberoptic
Bronchoscopy
CVP Line
Percutaneous
Tracheostomy

29. DEVICE RELATED INFECTIONS
1) VAP/1000 VENTILATOR DAYS:- 4.58 vs 8.56
2) CR-BSI/1000 CATHETER DAYS:- 4.3 vs 5
3) CA-UTI/1000 CATHETER DAYS:- 3.35 vs 1.45

30. Comparisons with previous years
4.58 4.3
3.35
8.56
5
1.45
8.8
3.6 3.56
0
1
2
3
4
5
6
7
8
9
10
VAP CLABSI CAUTI
2016
2015
2014

31. THANKYOU…