The OT Subcommittee expressed its anxiety over the fact that many surgeons were not ordering the investigations as required by the rules in the Medical Staff Rules & Regulations. The current ruling was that a Hb was required for all inpatients going for surgery and that a CXR and ECG were required for all those 40 years old and above.
Dr. Ngun was asked to discuss with the other anaesthetists with a view to reviewing the suitability of the current ruling and the necessity for changing it.
It was proposed by the anaesthetists that while Hb should be done for all surgical inpatients and while the ECG should be done for those 40 years and older, the CXR should be reserved for those 60 years and older as the use of radiological investigations carried certain risks.
Dr. Ngun was asked to check up on the various recommendations by national and other recognised anaesthetic associations and organisations.
At this meeting, Dr. Ngun suggested to follow the recommendations of the Chapter of Anaesthesiologists, Academy of Medicine, Malaysia, where ECG's were done for those 50 years and older and CXR, Renal Profile and Random Blood Sugar were reserved for those 60 years and older.
Based on the above, Dr. Ngun with the agreement of fellow anaesthetists proposed some amendments to the Rules and Regulations of the Medical Staff of SJMC.
The MAB agreed to the proposal and decided to table this at the November Quarterly Staff Meeting.
The above proposal was presented at this meeting but members decided against it and instead decided not to make any changes to the rules.
Most disappointingly, one of those who spoke out against the proposal was a fellow anaesthetist (see minutes of QMS). It is sad indeed, that we should speak out against a proposal that we ourselves have decided on. Once, we, as group, have made a decision, we should support it, or at least, not speak out against it. Unfortunately, Dr. Ngun was unable to attend the meeting and hence could not defend it against the marauders.
Hence, there will be no change.
A Hb will be required for all inpatients going for surgery, and
A CXR and ECG will be required for all those 40 years old and above.
