Intensive care in good health 50 years on
Huge changes have taken place in intensive care at Auckland Hospital since it began 50 years ago.
The profession’s half century will be marked at a conference day later this month attended by current and former staff, including James Judson.
Dr Judson, based in the hospital’s critical care medicine department, has seen more than his fair share of advances during 33 years in the field.
When he was child, Dr Judson says there wasn’t a lot that could be done for patients who contracted diseases like polio, which restricts breathing because of muscle spasms.
“When I was nine years old I heard that people were dying of polio in Copenhagen. I remember thinking: ‘I hope I don’t get that’.”
But the Herne Bay resident says diseases such as polio were the trigger that led to the development of artificial breathing machines.
“The ability to support people’s breathing really got intensive care started.”
The use of respirators has expanded over the years to include patients such as those who have suffered chest injuries in a car crash and patients who overdosed on barbiturates.
Dr Judson admits the job can be difficult because intensive care has created some contentious issues for the medical profession.
“Ventilators have changed the way we look at life and death,” he says. “We didn’t have brain death. Now artifi breathing keeps the heart going.”
And he says dealing with very sick patients and upset families is tough.
“If they die at least you know you did everything that you could.
“Sometimes you were dealing with children the same age as your own.”
Technology has improved to the point where it’s more likely people will survive.
Over the years rubber tubes have been replaced by plastic ones, meaning patients’ airways are now less likely to be damaged. And newer respirators adjust to a patient’s breathing patterns, rather than going at one standard rate.
He says improvements in diagnosis equipment such as CT scans have made it easier to get patients the correct treatment more quickly.
Critical care medicine department clinical director Dr Colin McArthur says having Dr Judson around is invaluable because there’s no substitute for time in the job.
“You’ve got to have a length of experience to pick up things that are a little unusual.”
Auckland’s critical care department deals with around 1100 patients a year. Many of these patients only stay overnight as a precaution after surgery. In more serious cases patients stay longer if they’re having trouble breathing because of nerve or muscle damage or if they have internal injuries. The department has 14 beds, but can be increased if needed.
Fifty years young: Dr James Judson has seen many changes in his 33 years as an intensive care doctor at Auckland Hospital. The hospital celebrates 50 years of intensive care later this month.