In­ten­sive care in good health 50 years on

Auckland City Harbour News - - News - By Scott Mor­gan

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.

Photo: JA­SON OX­EN­HAM

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.

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