Plans for 2019

Whenever one has to formulate one’s procurement, one has to work up the basics. Are we going to set up the annual requirement of a running hospital, or is it altogether for a new hospital? Is it a primary health center/district hospital/medical college/service establishment/specialty-based/commercial hospital?

Till 1970, medical college hospitals, advised and controlled by various medical bodies, used to decide the norms of the nation. Today, we have distinct advice from World Federation (WFSA) on the protocol and governance. In 1988, at Prague WFSA Conference, a task force was created to work mandatory minimum needs of anesthesia equipment as well as monitors. 1992 WFSA Conference in Washington finalized and circulated among the member nations these mandatory needs. ISA as a member country for WFSA took the challenge and listed the requirements at all levels with minimum practical changes that included the basic need to most advanced of them. To emphasize the development, I take the privilege and analyze the last six decades of anesthesia practice. We started monitoring with clinical evaluation, sphygnomanometry and ECG. Subsequently we compounded further with central venous pressure, arterial pressure, pulmonary wedge pressure, continuous hemogram, blood biochemistry, blood gas analysis, and cardiac output monitoring. Cardiac output monitoring is done by pulmonary artery catheter, which is nearly replaced by pulse pressure analysis by Pico, Lidco, volume view, and cardiac output status from a combination of trans pulmonary thermodilution and arterial pressure waveform analysis. Esophageal Doppler with a transducer at the tip demonstrates constant cardiac function along with thoracic aortic blood flow and cardiac changes.

Anesthesiology, critical care, and dorology equipment procurement plan involves a modern, extensively used over the globe, locally available equipment with service guarantee. High pressure and unscrupulous marketing must not influence our minds. Procurement of instruments needs square knowledge about the available international market. It needs an instantaneous service facility along with intelligent budgeting with a group of highly skilled professionals.