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This photo was taken in the early 80's in the old ICU which has now become a surgical ward. Left to right: Dr Fanny CHENG, Mr. Andrew YEUNG (who is now the General Manager (Nursing) of Caritas Medical Centre).

 

Set up

In the seventies, there were no intensive care beds in QEH. At that time, Medical C Consultant in-charge, Dr WI Pau, a cardiologist, had the vision that provision of intensive care to critically ill patients is a must in an acute hospital. He did a lot of work before final approval from the Medical & Health Department to develop ICU beds in QEH.

Click here for more photos and development history.

In 1981, after some renovation work in the medical ward C4, 4 beds were converted into intensive care beds in 4 isolated cubicles. The 4 beds were under the care of medical team C. These 4 beds were supposed to cater for the critically ill patients in the 3 medical teams which were operating independently without any integration at that time. Obviously, the limited capacity of the 4 beds could not satisfy the huge demand from the medical patients. Thus, Dr. EK Yeoh, Consultant in charge of Medical A team in the eighties successfully converted 3 medical beds to Special Care Beds in 1984 in ward C7. In 1998, 3 surgical special care beds were also established in surgical ward H6. In May 1992, with the new B Block extension, a newly designed ICU, located at 6/F, with a capacity of 14 beds were opened. With the support of the HCE, Dr. York Chow, a new operational model of the ICU was born: the special care beds in the medical and surgical wards were integrated into the new ICU with 8 beds and 2 critical care physicians, Dr KY Lai and Dr. KK Wong were responsible for the daily operation of the ICU. There were both surgical and medical trainees receiving training in ICU by rotation. By Jan 1993, the number of beds was increased to 12 beds.

Since April 1993, with the participation of Department of Anaesthesia, the intensivist with anaesthetic training background also joined the ICU team. This pioneer running model, which consists of 2 streams of intensivists, who are complementary to each other, was found to be a successful model adopted by most of the ICUs in HA nowadays.

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With the increasing demand for intensive care beds, 4 additional high dependency beds started functioning in 1996 in ward E4 as there was no more room for expansion in B6. The 2 separate locations, quite distant from each other, were not ideal in terms of manpower deployment and daily operation.

In 1999, the new D block extension project was completed and the 6th floor, which is in the vicinity of B6 was designed as an ICU according to the Guidelines set by the American College of Critical Care Medicine, Society of Critical Care Medicine in 1995. The deep contrast with the B6 ICU was the spacious floor area in D6 and also the separation of the ‘clean' and ‘dirty' work areas. There were also 2 isolated rooms with anteroom and reverse isolation facilities.

The SARS epidemic in 2003 posted a real challenge for all the ICU staff. At that time, D6 ward was totally occupied by SARS patients with some overflowed to ward B6 as well. The non - SARS critical patients had to be housed in the ‘borrowed' beds in CCU and isolation ward. All the staff had to wear full gear of protective clothing once they were in the ward. Resurgence of interest in infectious disease prevailed after the SARS epidemic. D6 ward was renovated after the epidemic to provide negative pressure in 4 isolation rooms and the common ward area. With this set up, nowadays, it is our policy to house all patients with pneumonia of unknown origin in the negative pressure isolated room until airborne disease is completely ruled out.

As at Jan 2009, we are operating with 18 ICU beds and 1 HDU bed. Another HDU bed will start functioning by Mar 2009.

 
Academic Accreditation

In 1993, QEH ICU was recognized as a full core (2 years) training centre for Critical Care Medicine by the HKCP and in 1996, same recognition was gained for the training in Intensive Care Medicine by the HKCA. In July 1998, our ICU, the only one, other than PWH, was also accredited as a full core, 24 month training centre by the Australian and New Zealand College of Anaesthetists, Faculty of Intensive Care (ANZCA-IC) after the joining of Dr. KG Hickling, an intensivist famous for his work in permissive hypercapnia in 1995. At the same time, a few anaesthetic colleagues were also accredited as Fellow of ANZCA - IC. Unfortunately, with the departure of Dr. Hickling at the end of 1999 and other ANZCA-IC fellows leaving our ICU for various reasons, ICU QEH was only able to secure a recognized core training of 12 months by the Joint Faculty of Intensive Care (JFICM) starting from 2005.

Our ICU is also a training centre for the Intensive Care Nursing Course organized by the IANS. In 2007, we also participated in the training program for China Nurses, organized by the HAHO.

 

Scope of Services
Our 20-bed ICU is admitting adult patients from all clinical departments of QEH except the Paediatric Department. Majority of our patients come from the Department of Medicine and Department of Surgery. Apart from admitting patients of QEH, we are also admitting patients of the KWC and KEC, who require ICU support for tertiary services, like cardiothoracic surgery and trauma services. Not uncommonly, we also receive patients from private hospitals because of financial reasons.

With the dedication of our senior staff, since 2004, we started our 24 hour senior on site call to give prompt support to the trainees.

 

Other services beyond ICU
- We are member of the ventilator panel of QEH to give advice and support to patients in the ventilator ward and general ward
- Regular senior staff support to patients in the ventilator ward
- Performing percutaneous tracheostomy for appropriate patients in the neurosurgery ward on consultation bases.
- Providing regular and systematic training for trainees on insertion of central lines

 

Future Development

With the installation of the Clinical Information System (CIS) completed in Dec 08, we will be evolving from the traditional hand-written paper record to a new era of possible ‘paperless' documentation.

In collaboration with the Radiology Diagnostic Department, the ‘filmless' digital image would likely to materialize in our ICU in the coming year.