KING EDWARD MEMORIAL HOSPITAL

Background History

The Department of Paediaric Anaesthesia was established on 8^th April 2018 with an intake capacity of two DM admissions and two Fellows per year.

Poster:

Sections Units Branches

1. Pediatric Surgery Anesthesia
2. Pediatric Acute & Chronic Pain Clinic
3. Pediatric Surgical ICU
4. Pediatric MRI/CT Scan/ GI Scopy/ Opthalmic services under GA

Staff

Faculty:

RESIDENTS

Fellows

HOUSE OFFICER

SR

Activities

Activities of the Department from August 2021

Academic Events/CME’s conducted

1. International – Asian Society of Pediatric Anesthesiologists (ASPA) 2021 in Singapore on 13^th November 2021 – Pediatric Trauma Track
2. Pediatric Airway Workshop- Emerging Trends, Techniques and Equipment- in association with IAPA Maharashtra State Chapter on 1^st May 2022
3. Patient Safety Workshop in Association with RSACP on 7^th July 2022
4. Pediatric Anesthesia National Academic Meet: Hybrid CME in association with IAPA on 9^th July 2022
5. Workshop on Advanced Hemodynamic Monitoring in children on 20^th August 2022 in association with IAPA Maharashtra
6. Pediatric Renal Transplant on RSACP on Foundation Day on 7^th July 2022
7. Pediatric Cardiac patient for Non Cardiac Surgery on 14^th October 2022 in IAPA National Fellowship Academic Programme
8. Workshop on Regional Anesthesia for Orthopedic Surgery in children organized by SRCC Children’s Hospital, Haji Ali, Mumbai on 15^th September 2022
9. PROACT 2022 Pune 9^th September 2022
10. NORA in children- Hybrid meet- 24^th Jan 2023

Prizes won

1. Dr Vishal Saxena (2^nd year DM Resident) won 1^st prize for poster presentation “Erector Spinae Block in paediatric VATS: A case series” at the IAPA mid–term conference conducted on 5^th September.

2. Dr Akhil Goel (fellow) poster “Neonatal Epignathus: small pill bug thrill” at the IAPA mid–term conference conducted on 5^th September.

Activities of the department from January 2019 to August 2019

Academic events/ CMEs conducted:

1. Low flow Anaesthesia and lung protective ventilation-Conference+ Workshop on 20^th January 2019.
2. Workshop on Midline insertion – 8^th April 2019
3. Paediatric Airway and Mechanical Ventilation- An Update –CME on 30^th June 2019

News paper mentions/ Media:

1. Dr Nandini Dave (Addl. Professor and Head in charge)was invited to speak on Paediatric Anaesthesia for the program “AROGYA SAMPADA” (health education program) which was live telecasted on national channel DD Sahyadri on 25^th April 2019

Prizes:

1. Dr Swarup Ray (2^nd year DM Resident) won 1^st prize for video presentation “A new paradigm in patient monitoring- Oxygen Reserve Index” at CME conducted by ISA Boriwalli on 25^th May 2019
2. Dr Karthika Rajan (2^nd year DM Resident) won 1^st prize for paper presentation “Perfusion index as a predictor for working paediatric caudal block under general anaesthesia- A Prospective Observational Study” in the superspeciality category at Staff Society Scientific meeting held on 19^th July 2019 at KEM
3. Dr Aarti Baghele (3^rd year DM Resident) won 1^st prize for poster presentation “Effect of pre-operative education on anxiety in children undergoing day-care surgery” in the superspeciality category at Staff Society Scientific meeting held on 19^th July 2019 at KEM

Publications:

2021

1. Goel A, Dave N, Shah H, Muneshwar P. The troublesome triumvirate: Temporomandibular joint ankylosis, Pierre Robin syndrome and severe obstructive sleep apnoea. Indian J Anaesth 2020;64:800-3.
2. Jain D, Ray S, Yaddanapudi S, Bhardwaj N. Effect of different fraction of inspired oxygen on development of atelectasis in mechanically ventilated children: A randomized controlled trial-A Comment. Paediatr Anaesth. 2020 May;30(5):628
3. Rajan K, Dave N, Dias R, Muneshwar P, Kesarkar N, Saxena V. Perfusion index as a predictor of working pediatric caudal block under general anaesthesia‐A prospective observational study- Journal of Anaesthesiology Clinical Pharmacology. DOI: 10.4103/joacp.JOACP_34_21
4. Agrawal B, Dave N, Dias R, Kulkarni K, Shah H. Comparison of airtraq™ versus C-MAC® videolaryngoscope for tracheal intubation in children with normal airways. Medical Journal of Dr. DY Patil Vidyapeeth. 2022 Mar 1;15(2):197
5. Saxena V, Kaur A, Ray S, Dias RJ, Parmar U. Epinephrine is the drug of choice in anaphylaxis. Paediatr Anaesth. 2022 Aug;32(8):977. doi: 10.1111/pan.14476. Epub 2022 May 12. PMID: 35557026.

2019

1. Parekh A, Dias R, Dave N. Correlation between skin-epidural space diatance with weight, age, and height in paediatric patients. Indian J Anaesth. 2019;63(2):143–146. doi:10.4103/ija.IJA_310_18
2. Dias R, Dave N, Agrawal B, Baghele A. Correlation between bispectral index, end-tidal anaesthetic gas concentration and difference in inspired–end-tidal oxygen concentration as measures of anaesthetic depth in paediatric patients posted for short surgical procedures. Indian J Anaesth 2019;63:277-83
3. Karnik PP, Dave NM, Shah HB, Kulkarni K. Comparison of ultrasound-guided transversus abdominis plane (TAP) block versus local infiltration during paediatric laparoscopic surgeries. Indian J Anaesth 2019;63:356-60
4. Kesarkar, N. , Kulkarni, K. and Dave, N. (2019), Cascade sign: A guide to sonographic confirmation of central venous catheter position. Pediatr Anaesth, 29: 772-773. doi:1111/pan.13674
5. Dennis PB, Dave N, Shah H, Dias R. A novel use of ultrasound for the extraction of a fractured umbilical arterial catheter. Indian J Anaesth 2019;63:660-2
6. Baghele A, Dave N, Dias R, Shah H. Effect of preoperative education on anxiety in children undergoing day-care surgery. Indian J Anaesth. 2019;63(7):565–570. doi:10.4103/ija.IJA_37_19
7. Efficacy and Safety of videolaryngoscopy guided verbal feedback to teach neonatal and infant intubation. A Prospective Randomised Cross over Study-Saran A, Dave NM, Karnik PP- Accepted for publication in Indian journal of Anaesthesia
8. “Lock Jaw – An Airway Nightmare” –Rajan K,Dave NM,Dias R,Shah H- Accepted for publication in Medical Journal of Dr. D.Y. Patil Vidyapeeth
9. “Accuracy of ECG Guidance for Depth of Insertion of Central Venous Catheters in Children: A prospective observational study.” Shah H, Dave NM- Accepted for publication in Medical Journal of Dr. D.Y. Patil Vidyapeeth

Ongoing projects

First Anniversary celebrations:

• The department of Paediatric Anaesthesia celebrated its 1^st Anniversary on 8^th April 2019 followed by short focused workshop on midline insertion.

New Machine/ technology/ New endeavor:

1. Oxygen Reserve Index (ORi ^TM )-Masimo monitor: a new equipmentto detect impending desaturation during apnoeic ventilation for retrieval of foreign body in the airway for children under anaesthesia
2. Real time intra-operative Ultrasound is performed by us in various situations of surgical diagnostic dilemmas and to aid in better patient care
3. Target Controlled Infusion pump was bought by the department for the administration of Total Intravenous Anaesthesia in children
4. Started Paediatric anaesthesia services for MRI since January 2019 on all Saturdays and Mondays from 9am to 4 pm
5. Started Paediatric Anaesthesia OPD services since March 2019 on all Tuesdays and Thursdays from 2pm to 4pm.
6. Recently acquired MR compatible laryngoscopes by Donation from Ratanchand Hirachand Foundation
7. In addition the Department is equipped with State of the act Drager Perseus Anesthesia Machines, GE Logiq E USG machine including pediatric Transthoracic Echo probes, Sonosite  USG machine,Pentax Fibreoptic bronchoscopes 2.2 and 3mm for difficult airway and bronchoscopies, CMAC Karl Storz Video Endoscope, MOST CARE pediatric cardiac output monitor etc.
8. NIRS/ Cerebral/Somatic Oximeter monitor donated by Smt. Pramila Shantilal Shah Charity Foundation, Mumbai.

Announcements for any future event:

• Intrathecal injection of the drug Spinraza in children with Spinal muscular atrophy – a part of National project in conjunction with the Department of Paediatrics,KEM is under discussion.

For Student

• Teaching Schedule

DM Pediatric Anesthesia Programme

Admission Requirement

For admission to DM (Paediatric Anaesthesiology), a candidate is required to possess MD or an equivalent qualification in anaesthesia of an Institute/University recognized by the Medical Council of India.

Duration of Course

Three full academic years

No. of Candidates

As per sanctioned Intake- 2 seats

Aims and Objectives of the Course

The aim of the course is to impart thorough and comprehensive training to the candidate in the various aspects of this specialty to enable him/her:

(a) To function as a faculty/consultant in the specialty

(b) To carry out and help in conducting applied research in the field of paediatric anaesthesia

(c) To plan and set-up independent paediatric anaesthesia unit catering to paediatric surgery and intensive care.

Method of Selection

The selection of candidate for admission of DM in Paediatric Anaesthesia is to be made through nationwide Common Entrance Test (NEET) The selection is based on merit only.

Periodic rotations in the following Operation Theatres and Intensive Care Units would be made.Paediatric Surgery, Plastic Surgery, Neurosurgery, Cardiovascular and Thoracic Surgery, Cardiac catheterization laboratory, Interventional radiological procedure laboratory, Otorhinolaryngology Surgery, Ophthalmology Surgery, Gastrointestinal Surgery (GI scopy, Liver Transplantation), Paediatric ICU, Neonatal ICU.

The following teaching programme is prescribed for the course:

DM seminar/Case discussion/Tutorial once a week

Journal Club once a week

Teaching of MD Anaesthesia students by the DM student is part of the training.

Period of Posting in Various Units

The trainee will be posted in different specialties and duration of these postings will be as following:

Paediatric surgery OR 16 months

CVTS 2 months, Cardiac catheterization lab 2 months

Neurosurgery 1 months, Plastic Surgery 1 month, ENT 2 months

Pediatric Pain Clinic- 1 month

Paediatric ICU 3 months, Paediatric Surgery ICU 1month, Neonatal ICU 2 months

Posting at Speciality Centre 2 months

Exam preparation 3 months

Fellowship Programme

Course is designed to train candidates in the principles and practice of Paediatric Anaesthesia to enable them to conduct anaesthesia and intensive care for paediatric patients and to function as faculty/consultant in Paediatric Anaesthesia and paediatric preoperative and postoperative intensive care.

The trainee will be posted in different specialties and duration of these postings will be as following:

Pediatric General Surgery OT- including Urology, Oncology, Thoracic Surgery- 5 months

NICU- 1 month

Pain Clinic- 1 month

Cardiac OT & Cath Lab- 1 month

Plastic Surgery- 1 month

Orthopedic Surgery- 1 month

ENT- 1 month

Neurosurgery- 1 month

For Patient

OPD includes- Pediatric Surgery OPD, CT/MRI/GI Scopy PAC

Chronic Pediatric Pain Clinic

OPD days- Tue/Thu 2-4 pm

1^st Floor, OPD Building- MSB

Opp Clinical Pharmacology Dept

Other