1. Trauma ICU Audit-2013

2. 2013
• Total no. of patients admitted to TC2 - 698

3. Breakup of Admissions
12%
88%
0%
Orthopedic
Surgery
others

4. Comparison with previous years
0
100
200
300
400
500
600
700
2011 2012 2013
538
634
698
admissions
admissions

5. Fall in absolute mortality over
the years
22.67
20.34
17.7
0
5
10
15
20
25
2011 2012 2013
mortality % of admissions
mortality % of
admissions

6. Causes of mortality
47%
51%
2%
Septic shock
Hemorrhagic shock
others

7. Icu Admissions : Sex Ratio
86%
14%
Sex Ratio
Male
Female

8. Adult : Peadiatric ratio
92%
8%
Sex Ratio
ADULT
PEDIATRICS

9. Shifted From
Ward; 16%
OT; 56%
ED; 28%
Ward
OT
ED

10. Indications of Admissions
30%
16%
54%
Indications
monitoring
shock
ventilation

11. ICU Stay
• Total no. of patients : 698
• Mean length of ICU stay : 7.7 days
• Mean ventilator days : 5.02 days
• Mean urinary catheter days : 6.9 days
• Mean central line days : 4.64 days

12. Comparision with last year
5.93
6.29 6.5 6.56
7.7
5.02
4.64
6.9
0
1
2
3
4
5
6
7
8
9
ICU Stay Ventilator days CVP days Foleys days
2012
2013

13. Infection - CLABSI
1
2 2
0
2
3
2
3 3
2
0 0
1 1 1
0
4
0
3
2 2
1
0
1
0
1 1 1
0
2
0 0
3
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
2011
2012
2013

14. Infection-CAUTI
2
4
2
5
6
3 3
4 4
1 1
2
4
0
1
0
2
0
3
0
1
2
0
1
0
1
0 0
2
0
1
0 00
1
2
3
4
5
6
7
2011
2012
2013

15. Infection-VAP
0
2
5
2
4 4
2 2
3
1
2
1
2
0
1
2
0 0
1
2 2
1 1 1
3 3
4 4
3
4
5 5
4
0
1
2
3
4
5
6
2011
2012
2013

16. Procedures
• Fiberoptic bronchoscopy - 42
• Percutaneous Tracheostomy - 15
• Central line placement - 125
• Arterial Line Placement - 118
• Ultrasound usage - 383
• Intrabdominal pressure measurement - 07
• Hemodialysis - 15 patients
Total sessions-62

17. Innovation
• Weekly morbidity and mortality meet in
multidisciplinary model
• Weekly radio conference meet
• Weekly Infection control meet
• Care bundle checklist for every patient made
compulsory filled by nurse observing doctor’s
functioning
• Started ICU registry

18. Future Directions
• Plan to have a real time monitoring for
checking hand hygiene compliance in
collaboration with Hospital infection control
• Working on protocolised approach in ICU
management
• Working on antibiotic protocol for the hospital
along with infection control

19. Severity Index at Admission
0
2
4
6
8
10
12
14
16
18
20
Apache2 SAPS SOFA
7.12
18.11
6.56
severity of illness

20. VAP Rate/1000 Ventilator Days
8.5
0 0
3.7
8.9
7.3
10.5
19
17.7
12
8.7
12.2
16.7
10.5
17.8 17.2
25
17.8
0
5
10
15
20
25
30
Jul Aug Sep Oct Nov Dec
2012
2011
2013

21. CLABSI Rate/1000 CVC Days
0
14.6
0
11.4
7.6 7.9
0
13.4 14
11.6
16
15.3
4.1
0
7.9
0 0
11.7
0
2
4
6
8
10
12
14
16
18
Jul Aug Sep Oct Nov Dec
2012
2011
2013

22. CAUTI Rate/1000 Catheter Days
0
5.8
0
8.2
0
2.7
16.4
20.7
8.7 9.1
14.3
12.2
0
5.5
0
3
0 00
5
10
15
20
25
Jul Aug Sep Oct Nov Dec
2012
2011
2013