Unplanned admission to Siriraj post-anesthetic intensive care unit

Notice of all surgical patients who need access to Siriraj post-anesthetic intensive care unit (ICU) must be given to the ICU in advance by the surgical team. However, there are some patients who present unexpectedly, and we would like to evaluate this unplanned ICU admission as a quality control.

We performed a self-reported study of the patients who were categorized as unplanned for ICU admission over a six-month period from June 1st to November 30th, 2001. We attempted to quantify these patients into small groups in order to learn what the reasons were, where they came from, and how big the anesthesia-related reasons can be.

There were 520 admissions to the ICU during study period, and of those 80 were unplanned patients. The major source of these patients is from the operating theaters, followed by the recovery rooms and surgical wards. There were 65 patients admitted because of the cardiopulmonary problems, while 13 patients were admitted for close observations; surgical complications made up another 8 patients. Overall there were 36 unplanned patients because of anesthesia-associated complications.

These results indicate that the patients who are admitted to the post-anesthetic ICU without prior planning can provide insights of ICU resource management, and the standards of perioperative management in the operating theatres. It definitely offers an opportunity to implement changes in our anesthetic practice. We will continue to monitor the impact of this important indicator.