Acute Care + Preventive Care = Critical Care


The existing definition:

When searching for the existing definition of critical care, we see the ambiguity in the expression of the term critical care, alongside the lack of an actual definition but abundance of explanations of the term critical care itself.

  • • The specialized care of patients whose conditions are life-threatening and who require comprehensive care and constant monitoring, usually in intensive care units. Also known as intensive care.
  • • The care of seriously ill patients in a special hospital unit
  • • Intensive care is needed if someone is seriously ill and requires intensive treatment and close monitoring, or if they're having surgery and intensive care can help them recover. Intensive care units (ICUs) are specialist hospital wards that provide treatment and monitoring for people who are very ill. They're staffed with specially trained healthcare professionals and contain sophisticated monitoring equipment. ICUs are also sometimes called critical care units (CCUs) or intensive therapy units (ITUs).
  • • Continuous monitoring and treatment of seriously ill patients using special medical equipment and services

However, if we see the above definitions, it is very easy to see that critical care, at present, is being explained or defined on the basis of the location of provision of the health services, rather than on the nature of the illness or condition of the patient, or the kind of treatment provided.

In order to change the present outlook and to provide a definition of Critical Care that reflects the nature of the treatment that it provides, we express the term critical care as:

Acute care as a part of Critical Care:

A WHO study has defined Acute Care as:

  • a) Treatment of individuals with acute surgical needs, such as life-threatening injuries, acute appendicitis or strangulated hernias.
  • b) Treatment of individuals with acute life- or limb-threatening medical and potentially surgical needs, such as acute myocardial infarctions or acute cerebrovascular accidents, or evaluation of patients with abdominal pain.
  • c) Ambulatory care in a facility delivering medical care outside a hospital emergency department, usually on an unscheduled, walk-in basis. Examples include evaluation of an injured ankle or fever in a child.
  • d) Treatment of individuals with acute needs before delivery of definitive treatment. Examples include administering intravenous fluids to a critically injured patient before transfer to an operating room.
  • e) Care provided in the community until the patient arrives at a formal health-care facility capable of giving definitive care. Examples include delivery of care by ambulance personnel or evaluation of acute health problems by local health-care providers. The specialized care of patients whose conditions are life-threatening and who require comprehensive care and constant monitoring, usually in intensive care units. Examples are patients with severe respiratory problems requiring endotracheal intubation and patients with seizures caused by cerebral malaria.

Hence it is easy to see that acute care is very naturally a part of critical care, but the nature of care may vary depending on the basis of the kind of disease/disorder in question and the kind of care provided.

But while Acute Care is a part of Critical Care, it is evident that it is not limited to critical care only.

Preventive care as part of Critical Care:

For this, let us first understand the components of prevention in general:


It is obvious to see that the patients admitted in a critical care setup (i.e. those that fall in the group receiving critical care) are patients with either early onset or advanced diseases in most of the case, barring a few. Hence the components of preventive care we are taking into consideration here are

  • • Secondary prevention i.e. early detection and treatment (to prevent worsening or disease progression and recurrence)
  • • Tertiary Prevention i.e. prevention of complications and rehabilitation (to limit disability and improve lifestyle)

Hence the preventive component of Critical Care can be describes as:


And thus, we come to the statement we started with:

Acute Care + Preventive Care = Critical Care


Critical Care, Critical Time,Critical Decision Heal the World make it better place



The Advance Heath Care Foundation in association with Bellevue Clinic has been organizing an annual conference on Critical Care Medicine titled ‘Critical Care, Critical Time, Critical Decisions’. These three-day-long seminars include lectures, workshops and panel discussions by eminent doctors from all over the country as well as guest speaker and coordinators from the international medical fraternity. The aim: To bring together doctors and other medical personnel for various specializations under one roof for the purpose of integrated discussion on the subject of Critical Care. Since the first such seminar held on 2016, the organizers have gotten together to make this endeavor an annual one. The following are the highlights of the seminars held so far.

critical-care

2016 | DATE: June 18-19
LOCATION: Golden Park, Kolkata



After registration from 8AM to 9AM, the day’s activity started, initially with a Pleanery session,followed subsequently by workshop on various topics. The evening session included panel discussions and was concluded by the felicitation of the Senior doctors and a Cultural Program, thus ending by 7:30PM.

Agenda Item Discussion lead by:
Physiology of Venrilation Dr. Partha Goswami
Optimizing Renal Replacement Therapy in Critically ill Patients Dr. Pratim Sengupta
Hemodynamic Monitoring in Critical Care Dr. Subhendu Sarkar
Pleanery Session Chairperson: Dr. Roop Kishen
Discussion Topic Coordinators
Basic Modes of Ventilation:
  • • Maintaining Ventilation
  • • Liberation from Mechanical Ventilation
  • • Tracheotomy
  • • Difficult situation during Mechanical Ventilation
  • Dr. Pradipta Mukherjee
  • Dr. H. Christine
  • Dr. Partha Goswami
  • Dr. Ahsan Ahmed
  • Dr. Ashif
  • Dr. Sudhakshina Mallick
Renal Replacement Therapy
  • Dr. Pratim Sengupta
  • Dr. Lalit Agarwal
  • Dr. Roop Kishen
Hemodynamic Monitoring
  • Dr. Subhendu Sarkar
  • Dr. Suddhadeb Roy

The evening Session started from 5pm and the following are the highlights


  • • Panel Discussion on Organ Transplantation and How West Bengal can go Ahead
  • • Lecture on Evolution of Critical Care by Dr. Sagarmay Basu
  • • Lecture on Ethics in Intensive Care by Dr. Roop Kishen
critical-care

Day 2

The sessions of Day 2 began from 9:30AM and consisted of general discussions, Pleanary sessions and mainly lectures by eminent specialist Doctors on varied topics.

Topic Chairperson: Dr. Rahul Jain
Organization and Delivery of ICU Care Dr. Subir Saha
Management of Acute Decompensated Heart Failure Dr. Swapan Kr. Pal
Hyponatremia in ITU Dr. Abhigayan Majhi
Diabetes in Critical Care Chairperson: Dr. S.K. Gopalka, Dr. Rita Pal
Peri Operative Consideration in Longstanding Diabetic Patients Dr. Subhendu Sarkar
Diabetic Emergencies in ITU Dr. Sauren Panja
Glycemic Control in Critical Care Setting Dr. Subhankar Chowdhury
Lectures of Morning Session Chairperson: Dr. Sarbari Sawika
Cardiac Arrest: Prognosis and Outcome Dr. Lilabati Thakur
Rural Critical Care Dr. Ashutosh Ghosh
Ventilatory Management in ARDS Dr. Pawan Agarwal
Antimicrobial Use in PKPD Dr. Bhaskar Chowdhury
Pre Operative Intensive Care in Surgical Oncology Dr. Sudakshina Mallick
Ultrasonography in the ICU Dr. Sati Sikta
Pleanery Session
Role of Neurointervention in Acute Cerebrovascular Emergency Dr. Sukalyan Purakastha
Sepsis on the Cups of Cure Dr. Yash Javeri
Fluid Therapy in ITU Dr. Roop KIshen
Lectures of the Afternoon Session
Nutrition in Critical Care Dr. Tapan Sarkar
Management of Acute Kidney Injury Dr. Lalit Agarwal
Management of Acute Pulmonary Embolism Dr. Anirban Neogi
Pain Management in ITU Dr. Subrata Goswami
Sedation in ITU Dr. Krishna Poddar
Biomarkers in Acute Lung Injury Dr. Partha Goswami
ABG and its Clinical Implications Dr. Roop Kishen
Catherter Related Blood Stream Infection in ITU Dr. Anuradha Agarwal
Disaster Management Dr. Sumit Poddar
Use of Blood and Blood Related Products in ITU Dr. Biplab Talukdar
Panel discussion on recent updates on sepsis
Moderated by Dr. Yash Javeri Panelists:→
  • Dr. Prasun Mitra
  • Dr. Sibabrata Banerjee
  • Dr. Sujoy Mukherjee
  • Dr. Rajat Chowdhury
  • Dr. Dip Narayan Mukherjee
  • Dr. Amitava Saha

2017 | DATE: August 4-6
LOCATION: ICCR, Kolkata



Day 1 started from 10AM onwards with the Workshop:


The topics for the scientific discussion and lectures included:


  • • Telemedicine and E-Critical Care
  • • Intensive Care in the next 20 years
  • • A Critical Role for Echocardiography
  • • Diabetes in Critical Care
  • • Bronchoscopy in ITU
  • • ECMO in ARDS and Heart Failure
  • • Assessment of Fluid Response
  • • Severe Dengue Fever- Role of Intensivist
  • • Intensive Candidiasis-Current Therapy
  • • ABG and its Clinical Implications
  • • Catheter Related Infections
  • • Antimicrobial use and PKPD
  • • Peri Operative Intensive Care
  • • Optimization of Nutrition Practices
  • • ALI and ARDS: Experimental Studies
  • • Transfusion and Hemostasis
  • • Multi-Drug Resistant Bacteria
  • • Surviving Sepsis Guideline
  • • Practical Use of Vasopressors and Ionotrops in Shock
  • • A new Look on Lactate
  • • Cardiac Shock, Septic Shock and Hemorrhagic Shock
  • • Cardiac Arrest: Management and Complications
  • • Hospital Acquired Infections
  • • Renal Replacement Therapy
  • • Peri Operative Hemodynamics
  • • Acute Coronary Syndrome and Heart Failure
  • • From Rapid Response Team to ICU Triage
  • • Stroke
  • • Traumatic Brain Injury
  • • Sedation in Critically Ill
  • • Hematological Malignancies and Oncology in The ICU
  • • Benefits of World Research Network
  • • Organ Transplantation: Role of Intensivists
  • • Withdrawal of Life Sustaining Therapy
  • • Medico-Legal Issues in Critical Care

Workshop || Coordinator: Dr. Saurabh Kole

Topic Convener
Ventilation
  • Dr. Partha Goswami
  • Dr. Pradipta Mukherjee
  • Dr. H. Christine
Imaging and Critical Care
  • Dr. Nandita Chakraborty
  • Dr. Abhik Bhatterjee
  • Dr. Debalina Roy

The topics of discussion and Conveners on the Days 2 and 3 are as follows:

Topic Convener
Rural Critical Care
  • Prof. Ashutosh Ghosh
  • Dr. Rajat Chowdhury
Pulmonary Medicine and Critical Care
  • Dr. Anirban Neogi
  • Dr. Pawan Agarwal
Cardiac Critical Care
  • Dr. Tapan Sarkar
  • Dr. Eshan Ahmed
Neuro Critical Care
  • Prof. S.N. Ghosh
  • Dr. S.K. Biswas
  • Dr. Sukalyan Purakayastha

2018 | DATE: August 3-5
LOCATION: ICCR, Kolkata



    Topics of Scientific Discussion:

  • 1. GOLDEN HOUR IN CRITICAL CARE
  • 2. RURAL CRITICAL CARE
  • 3. TELEMEDICINE & E-CRITICAL CARE
  • 4. A CRITICAL ROLE FOR ECHOCARDIOGRAPHY
  • 5. DIABETES IN CRITICAL CARE
  • 6. ANAPHYLAXIS
  • 7. TROPICAL FEVER IN ITU
  • 8. ASSESSMENT OF FLUID RESPONSE
  • 9. INTENSIVE CANDIDIASIS – CURRENT THERAPY
  • 10. ABG AND ITS CLINICAL IMPLICATIONS
  • 11. CATHETER-RELATED INFECTIONS
  • 12. ANTIMICROBIAL USE AND PKPD
  • 13. ALI &ARDS: EXPERIMENTAL STUDIES
  • 14. TRANSFUSION & HAEMOSTASIS
  • 15. MULTI-DRUG RESISTANT BACTERIA
  • 16. SURVIVING SEPSIS GUIDELINE
  • 17. A NEW LOOK ON LACTATE.
  • 18. CARDIAC ARREST: MANAGEMENT & COMPLICATIONS
  • 19. HOSPITAL-ACQUIRED INFECTIONS
  • 20. RENAL REPLACEMENT THERAPY
  • 21. SEDATION IN CRITICALLY ILL
  • 22. HAEMATOLOGICAL MALIGNANCIES & ONCOLOGY IN THE ICU
  • 23. BENEFITS OF WORLD RESEARCH NETWORK
  • 24. ORGAN TRANSPLANTATION – ROLE OF INTENSIVIST
  • 25. WITHDRAWAL OF LIFE SUSTAINING THERAPY
  • 26. MEDICO LEGAL ISSUES IN CRITICALCARE.
  • 27. HEART FAILURE
  • 28. NUTRITION IN CRITICAL CARE
  • 29. PULMONARY EMBOLISM
  • 30. QUALITY AND SAFETY IN CRITICAL CARE
  • 31. PATIENT PARTY CONSENT AND CONSULTATION…..TO WHAT EXTENT(IN ITU)

WORKSHOP: NEURO CRITICAL CARE including topics like:

  • • Management of Acutely raised Intra Cranial Pressure
  • • Medical Management of Acute Sub Arachnoid Hemorrhage
  • • Acute Management of Intra Cranial Hemorrhage
  • • Nutrition in Neuro Critical Care
  • • Diagnosis of Brain Death
  • • Stroke Intervention Trials
  • • Traumatic Brain Injury: Latest Guidelines
  • • Ventilation in Neuro Critical Care Unit
  • • Ultrasound in Neuro Critical Care Unit
  • • Basic Neuro Radiology
  • • Convulsions in Neuro Critical Care Unit
  • • Neuromuscular Weakness in ICU

    FACULTY:

  • • Dr. Asutosh Ghosh
  • • Dr. Amita Acharjee (Pahari)
  • • Dr. Amitabha Chakrabarti
  • • Dr. Amitava Das
  • • Dr. Amitayu Nandi
  • • Dr. Animesh Deb
  • • Dr. Anirban Neogi
  • • Dr. Anup Sadhu
  • • Dr. Arabinda Ray
  • • Dr. Arindam Maitra
  • • Dr. Arun Manglik
  • • Dr. Asif Iqbal
  • • Dr. Asitendu Datta
  • • Dr. Balram Prasad
  • • Dr. Buddha Mukherjee
  • • Dr. Chandrashis Chakrabarty
  • • Dr. Dalia Chatterjee
  • • Dr. Debkishore Gupta
  • • Dr. Dip Mukherjee
  • • Dr. Ehsan Ahmed
  • • Dr. Herbert Chistin
  • • Dr. Indrajit Kr. Tiwari
  • • Dr. Jayanta Sharma
  • • Dr. Krishnendu Mukherjee
  • • Dr. Lalit Agarwal
  • • Dr. Mahesh Goenka
  • • Dr. Manatosh Panja
  • • Dr. Partha Karmakar
  • • Dr. Parthasarathi Goswami
  • • Dr. P.K. Harzra
  • • Dr. Prabir Kar
  • • Dr. Pradipta Narayan Mukherjee
  • • Dr. Pratim Sengupta
  • • Dr. Pravin Jadav
  • • Dr. Prosenjit Sarkar
  • • Dr. Radheyshyam Joshi
  • • Dr. Rahul Jain
  • • Dr. Rita Pal
  • • Dr. Sadhan Ray
  • • Dr. Sagar Basu
  • • Dr. Saptarshi Basu
  • • Dr. Samarendra Ghosh
  • • Dr. Sauren Panja
  • • Dr. Saurendra Mitra
  • • Dr. Saibal Chakraborty
  • • Dr. Sandeep Chaterjee
  • • Dr. Santanu Das
  • • Dr. Sarbari Swaika
  • • Dr. Sasanka Saha
  • • Dr. S.K.Biswas
  • • Dr. Sreya Chatterjee
  • • Dr. Subir Saha
  • • Dr. Subrata Goswami
  • • Dr. Subrata Ray
  • • Dr. Sudakshina Mullick
  • • Dr. Sumit Poddar
  • • Dr. Sushrata Bandyopadhyay
  • • Dr. Sukalyan Purokayasta
  • • Dr. Tapan Sarkar
  • • Dr. Udas Ghosh
  • • Dr. Vijay Kejariwal
  • • Dr. Yash Javeri(New Delhi)