Anaesthesiology and Intensive Care in Lithuania

Transcription

1 Anaesthesiology and Intensive Care in Lithuania Prof. J. Ivaškevičius President of Lithuanian Society of Anaesthesiology and Intensive Care 12 th of February, 1847, Vilnius Medical Society - A.ADOMAVIČIUS Presentation about ether anaesthesia. A.ADOMAVIČIUS and L.LECHAVIČIUS performed ether anaesthesia in Vilnius 23 rd of February, L.LECHAVIČIUS performed chloroform anaesthesia in Vilnius 21 st of December, the first endotracheal anaesthesias were performed 1960 the first department of anaesthesiology was opened in Vilnius Lithuanian Society of Anaesthesiology and Intensive Care was founded 1964 postgraduate training of anaesthesiologists was started 1991 Lithuanian Society of Anaesthesiology and Intensive care joined WFSA

2 Number anaesthesiologists in Lithuania Year Year (all licensed) Lithuanian society of anaesthesiology and intensive care Year members Year members Number of anaesthesiologists Country Poland Finland USA Italy Lithuania Croatia Czech respublic Uzbekistan Latvia Norway Switzerland WFSA recomends Number of anaesthesiologists pop. 0,8 1,0 1,0 1,6 1,7 1,1 1,5 1,3 1,4 1,1 1,3 1,0-1,6 Number anaesthesiologists in Lithuania Enough according to WFSA recommendations Shortage of anaesthesiologists in some district hospital Possible problem in future brain drain.

3 Training of anaesthesiologists Residency in anaesthesia and intensive care was started in 1991 Untill now 1 year of internship, 3 years of residency From year of internship, 4 years of residency Residency programme Based on Training Guidelines in Anaesthesiology of European Board of Anaesthesiology Reanimation and Intensive Care 1 year basics of anaesthesia and intensive care 3 years speciality anaesthesia and intensive care New programme more time to spend in intensive care, pain clinic. Anaesthesiologists in training Vilnius university Faculty of medicine - 32 residents 2003 graduated 10 residents Kaunas medical university 35 residents 2003 graduated 11 residents

4 Continuing medical education (CME) Recertification every 5 years. Controled by Ministry of Health. CME forms Formal CME 120 hours, training at Vilnius university Faculty of medicine Kaunas medical university Also publications in scientific journals, lectures, etc. Continuing medical education (CME) CME forms Nonformal CME 80 hours, Local conferences held by medical university or faculty together with scientific society Conferences abroad, etc. Continuing medical education (CME) Government should ensure 70 % of the finances for CME. The other part doctor himself, employer, company, etc. Financial difficulties to go to conferences abroad

5 Surgical operations in hospitals in 2001 Total Operations Digestive syst. Abs. Numb Per pop , ,5 % 100,0 16,8 Female genital org. Musculo-skeletal syst , ,0 14,9 14,3 Obstetrical op. Skin and subcutaneous tissue ,2 690,6 9,9 9,4 Ear, throat and nose ,3 7,9 Eye ,6 5,3 Surgical operations in hospitals in 2001 Operations Abs. Numb. Per pop. % Vessels ,4 4,9 Prostate Nervous syst. Heart ,1 183,8 162,6 2,7 2,5 2,2 Maxilla -facial Kidney and ureter ,6 139,7 2,1 1,9 Respiratory syst ,0 1,7 Breast ,4 1,2 Endocrine syst ,3 0,6 Financial situation in Lithuania There is no valuation for anaesthesia service in Lithuania Prices for anaesthesia is included in the price for surgery Prices for pain treatment are currently announced

6 Financial situation in Lithuania Introduction of realistic and proper valuation for anaesthesia requires additional funds from State patient fund Difficult to expand the range of modern anaesthesia techniques Consumption of inhalation anesthetics (in liters) in ,4 636,25 Sevoflurane Izoflurane Halotane Sevoflurane Izoflurane Halotane Valuation for ICU service in Lithuania: Level I - I (recovery room) I - II (primary ICU) II level Hours 24 hours 48 hours 3 days Cost EUR III level 4 days 695

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8 What we have today? Lithuanian Norm of Medicine Anaesthesiologist reanimatologist Resuscitation standarts based on international guidelines Anaesthesia safety standarts are being prepared Partnership with foreign organizations: CENSA, AHA (ACLS courses in Vilnius)

9 Our goals for the future Lithuanian society of anaesthesiology and intensive care should play active role in: Propagation and introduction of modern methods of anaesthesia and intensive care Training and CME of anaesthesiologists Creation of anaesthesia and intensive care guidelines and protocols Initiate and insist on renovation of equipment Our goals for the future International partnership Exchange of visiting doctors Joined conferences and meetings Scientific research work Creation of anaesthesia and intensive care guidelines Thank you for your attention