JILID 17 BIL 4 DECEMBER 2013
Table of Contents
Message from the President of the MSA
Dear Colleagues and Friends,
Merry Christmas and a Happy New Year! Before I pen down all the exciting activities and news in the last quarter of the year and the forth upcoming events for 2014, I would like to draw your attention to subspecialty training.
Subspecialty Training …why?
The objective of the subspecialty training programme in anaesthesia is to provide a continuum education, training and experience in the various aspects at a sufficient level for the subspecialist trainees to acquire the competency to function as independent specialists in that field. The goal of subspecialty training is to teach the subspecialist trainees clinical practice complete with required and acquired skills and knowledge.
Holistic anaesthesia subspecialty training is vital for the development of clinical and academic excellence in anaesthesiology. There have been great advances in subspecialty training in the recent years and anaesthesia training programmes must continue to evolve. As subspecialty anaesthesia practices have matured, the quality of clinical care and our professional esteem have improved among the other medical specialties. The subspecialist provides leadership in his/her area of subspecialty and there is a need to keep abreast with the ‘new’ knowledge and advances in anesthesia and intensive care.
It is great to be a Jack of all trades but it is greater to be a Master of One…
Anaesthesia Day 2013 “Your Life… We Care!!!”
The last quarter began with the Anaesthesia Day celebration that was held in the month of October. Anaesthesia Day is officially celebrated on the 16th of October to commemorate the first successful demonstration of ether. Since it is the Society‘s 50th Golden Jubilee this year, we celebrated the National Anaesthesia Day by co-organising the event with the Department of Anaesthesia and Intensive Care, Hospital Kuala Lumpur. The event was graciously officiated by the Health Minister, YB Datuk Seri Dr S Subramaniam. It was not just a tremendous success but it was a very enjoyable event. For those of you who missed it, you definitely missed a great event!
On a personal note, I was also invited by Professor Dr Marzida Mansor and her team to attend the Anaesthesia Day celebration at the Universiti Malaya Medical Centre. I truly enjoyed the morning with an excellent montage media presentation that still brings a smile to my face as I write this message. I also had the opportunity to witness the opening ceremony of their “Pre Anaesthesia Clinic” and the first in the country ‘23-hour Daycare surgery unit’. Following that, we were treated to Professor Dato’ Dr Wang Chew Yin’s ‘Syarahan Perdana’ that took us down her path to becoming an anaesthesiologist.
Many hospitals celebrated the Anaethesia Day, and please enjoy reading their reports in this issue. On the media exposure, we had a wide multi-lingual media coverage with appearances on talk shows on radio and television and well-written articles in the newspapers.
I would like to take this opportunity to congratulate and thank all the hospitals that celebrated the Anaesthesia Day as it is a day that gets us out of the operating room for the public to see who we are. The doctor that is with the patient with every beat of the way when he/she comes for an operation!
18th ASEAN Congress of Anaesthesiologists, Building Bridges: Improving Outcome Through Collaboration. 31st October to 2nd November 2013
The conference was well received. It had a rich scientific programme that addressed the present issues in anaesthesia. We were well represented by 52 Malaysian participants at the conference.
CASA Board Meeting
I attended the CASA Board meeting with my fellow Presidents of the national societies in ASEAN. We had a fruitful meeting. We discussed and shared our challenges and concerns. Dr Grace Herbosa, the President of the Philippines Society of Anaesthesiologists, has volunteered to resuscitate the Asean Journal. She is looking forward to receiving papers for publication. Papers can be submitted online at the Asean Journal website. She is also looking into getting the journal indexed. This is a good opportunity for our medical officers and I urge all of you to partake in this. As for MSA, we will try to place the link on our website.
The host for the next ASEAN Congress is Indonesia and hence, the next President of CASA is the President of the Indonesian Society of Anaesthesiologists.
During the CASA Board meeting, a representative from the Asian Australasian Congress of Anaesthesiologists (AACA) 2014, spoke to us, encouraging greater participation from each of our countries. As you know, Malaysia is bidding for the Asian Australasian Congress of Anaesthesiologists (AACA 2022) and I urge all members to support this meeting and take the opportunity to enjoy New Zealand.
I could not stay for the whole conference as it coincided with Deepavali. Professor Dr Y K Chan was kind enough to take over my duties and represented me at the Presidents’ Forum which addressed ‘Teaching Anaesthesia to Medical Students’. The Gala Night, I was told, was simply outstanding. It is a tradition that all ASEAN countries present a performance at the Gala Night. Dato’ Dr Jahizah Hassan and Dr Ina Ismiarti led the Malaysian team for the presentation. I would like to especially thank Professor Dr Y K Chan, Dato’ Dr Jahizah Hassan and Dr Ina Ismiarti, members of our Executive Committee, and the other members of the Malaysian contingent for partaking in the performance at the Gala Night. I was told that Dr Noraini Sangit and Dr Rosliza Samsuddin from Hospital Tengku Ampuan Rahimah, Klang, were true songbirds!
I would like to clarify on some queries concerning the offer of updating your membership fees before 31st December in my message in the last issue of the Berita Anestesiologi.
At the second Executive Committee meeting, it was decided that there would be a one-off amenesty valid till end of this year for all members who have not paid their membership fees especially those who have not paid for more than three years. You can update your membership by just paying for three years and your membership would be current.
Annual Scientific Congress 2014 (ASC 2014)
Theme: BRIDGING THE GAP: EVIDENCE MEETS EXPERIENCE
The Executive Committee has agreed to change the name of the meeting to Annual Scientific Congress 2014. It is the one and the same meeting as our Annual Scientific Meeting / AGM of the Malaysian Society of Anaesthesiologists and the College of Anaesthesiologists. There are five exciting pre-congress workshops offering an obstetric anaesthesia simulation workshop, Paediatric difficult airway workshop entitled ‘No more fears’, a research workshop on how to start writing papers, point of care and critical ultrasound workshop and a neuromuscular blockade workshop. You will not be disappointed with the scientific programme that has been planned with numerous distinguished international and local speakers. There will also be a glitzy Gala Night!
As the year draws to a close, I urge all members to register early for the ASC to take advantage of the early bird registration and not to miss out on the workshops. Please check our website and register online.
Travelling Fellowship Programme
We are proud to inform that Dr Gunalan Palari from the Executive Committee went to Vietnam to teach. It was an eye opener and an experience for him especially where English is not the medium of instruction. Further, Dr Lim Wee Leong is in the final stages of preparing for an educational trip to Laos. He hopes to run an educational programme of two to three days encompassing neuroanaesthesia, pain medicine, paediatric anaethesia and obstetric anaesthesia. He is asking for volunteers as speakers. Please feel free to contact him if anyone is interested to do some teaching.
At A Glance
Upcoming CPD Activities
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Ultrasound Guided Peripheral Nerve/Plexus Blocks Workshop August 2013
Reported by Dr Omar Sulaiman
The Johor State Anaesthesia Services (MOH), in collaboration with MSA and the Jebsen & Jessen company, organised a one-day hands-on workshop on ultrasound guided peripheral nerve blocks. The workshop was held on the 27th August 2013 in Hospital Sultanah Aminah, Johor Bahru, and catered for anaesthesiologists from both the government and private sectors in the southern region of Malaysia. The response from the participants was tremendously good. Because it was a hands-on workshop, it was only opened to 20 participants and we divided them into three groups in OT. It was conducted by two experts from Hospital Kuala Lumpur, Dr Azrin Mohd Azidin and Dr Amiruddin Nik Mohamed Kamil and was facilitated by Dr Omar Sulaiman from Hospital Sultanah Aminah, Johor Bahru. Nine orthopaedic patients were anaesthetised using peripheral nerve blocks of the upper and lower limbs for their surgical procedures.
The participants were taught the proper and correct techniques of doing peripheral nerve blocks for the upper and lower limbs. All of them enjoyed learning the different methods of performing the nerve blocks in a safe manner. In this era, all invasive procedures including setting of a central IV line and an intra arterial line, should be done under ultrasound guidance to minimise complications and to achieve zero error.
With good response and support, in future, similar workshops will be organised and will include invasive procedures under ultrasound guidance.
“Safe Surgery Saves Lives...Safe Anaesthesia Saves Lives”
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Passed Final MMed Anaes (UKM) Exams November 2013
Passed Final MMed Anaes (UM) Exams November 2013
Passed Final MMed Anaes (USM) Exams November 2013
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18th Asean Congress of Anaesthesiologists, Singapore
Reported by Dr Ina Ismiarti Shariffuddin
Every two years, anaesthetists from the ASEAN countries will gather in a regional meeting to share and exchange knowledge, experiences and expertise with regard to anaesthesiology. This year, the Singapore Society of Anaesthesiologists hosted this event. In this 2013 Congress, over 800 clinicians, nurses, medical students, residents and industry representatives from ASEAN, East Asia and Australasia were gathered.
The scientific programme were well organised to cater for the theme, “Building Bridges: Improving Outcome through Collaboration”, with variety of excellent international and local speakers. From Malaysia, we had Prof Dr Y K Chan, Dr Lim Wee Leong, Prof Dr Lee C Y and Prof Dr Lim T A as the invited speakers in this congress. In the ACA 2013 Best poster competition, Dr Azlina and colleagues represented Malaysia with their poster entitled “Comparison between Lignocaine and Ketorolac to reduce Rocuronium Injection pain”. This study was shortlisted as the top 10 best posters in the competition.
This is also the time of the year, that all anaesthetists showcased their singing and dancing talents in the ASEAN gala night. The traditional ASEAN gala night was held at the Flower Dome @ Flower Field Hall, Gardens by The Bay Singapore. Overlooking the changing Flower Field display on one side, and a spectacular view of the Marina Bay skyline on the other, this indoor space captivates with its picturesque backdrop of perpetual spring. It was a fantastic location for the gala night with a breath taking view. All the countries put up a wonderful performance. From Malaysia, we had our two songbirds, Dr Noraini Sangit and Dr Rosliza, supported by back up singers; Prof Dr Y K Chan, Dr Lim Wee Leong, Dato’ Dr Jaseemuddeen Abu Bakar and Dr Ina Ismiarti Shariffuddin, performed the famous “Bila Larut Malam” composed by the late Tan Sri P Ramlee.
In short, the 18th ACA was a successful meeting. I am sure everybody went home with good scientific updates and were able make new friends and renew old acquaintances. We shall meet again next in Thailand, in 2015.
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National Anaesthesia Day 2013
Malaysian Society of Anaesthesiologists & Hospital Kuala Lumpur, Kuala Lumpur
Reported by Dr Kok Meng Sum
Anaesthesiologist, a word so difficult to pronounce, a face so difficult to envision, a profession not understood by most, and a partner of healthcare so mysterious to all. Yet, no surgery is possible without anaesthesia.
“Are you a doctor?”, “What do you do actually?”, ‘Knocking out’ patients- How difficult can that be?”, “What do you do once the patient is asleep? Coffee? Newspaper? Leave the room? - Your job is accomplished anyway!” These questions are music to our ears – the same misconceptions that surround us.
We however, have specific questions running through our minds – questions pertaining to LIFE – Patients’ Life! “Will my patient be awake during anaesthesia?”, “Will my patient wake up from anaesthesia?”, “Will my patient be safe?”, “Is my patient in pain?”, “How do I plan safe anaesthesia to ensure that my patient makes it through uneventfully?”
This led to this year’s National Anaesthesia Day theme – “Your LIFE… We CARE!!!” creating awareness of our role and dedication in ensuring the care of patient’s life.
Hospital Kuala Lumpur (HKL), under the umbrella of the Malaysian Society of Anaesthesiologists (MSA), has taken another step forward to commemorate the birth of Anaesthesia – on the Golden Jubilee Year of the Malaysian Society of Anaesthesiologists.
The Walk Hunt
12th October 2013 - The sun smiled upon us on a beautiful Saturday morning, the blast of music brought life to Taman Tasik Titiwangsa, the smiles of organisers greeting eager participants and the glances from passersby on our event, all setting the stage for the perfect scene - first of its kind for the National Anaesthesia Day celebration – A Walk Treasure Hunt. The voice of Dr Ismail Tan Mohd Ali Tan, the Organising Chairperson and the emcee of this outdoor activity echoed through the field.
This event kicked off with Zumba – a blend of dance cum aerobics and before anyone could realised it, we were all soaked in sweat; panting, energised and warmed up for the main event. Present were the President of the Malaysian Society of Anaesthesiologists, Dr Sushila Sivasubramaniam, the President of the College of Anaesthesiologists and Head of Anaesthetic and Intensive Care Services of Malaysia, Datin Dr V Sivasakthi and the Chief National Transplant Coordinator of the National Transplant Resource Centre, Datin Dr Lela Yasmin Mansor, and even they could not resist the temptation. Over 500 attendees joined in the fun.
The wave of the Malaysian Society of Anaesthesiologists flag high above the ground by Dr Sushila Sivasubramaniam, the President of the Malaysian Society of Anaesthesiologists, marked the commencement of the Walk Treasure Hunt. The glows on the faces of over 240 eager Treasure Hunters, four to a group, each with unique names, spiced up the Hunt. The Hunt proved no easy task - the frown on the hunters’ foreheads at the sight of the clues, thinking caps popping out one by one and the serious discussions while pursuing their target meant only one thing – this was serious business! No play-play! This was definitely the spark of the day.
As the hunters eyed the prizes, the rest of the attendees were having fun too. Children were entertained with games and the rest with magic, playing tricks to the eyes. Those who yearned to know more about resuscitation and basic life support flooded the mannequins for hands-on sessions on “How to Save a Life”. The Organ Donation Pledge headed by Transplant Coordinator of the National Transplant Resource Centre, Datin Dr Lela Yasmin Mansor, the Blood Donation campaign and the free health check too were popular. Participants who were keen to learn about anaesthesia and the scope of services offered, were wooed to the exhibition booths. Some of our patients who were happy with our services also attended as a sign of support for the event and to spread the good word about anaesthesia to others.
The National Anaesthesia Day celebration was graced with the presence of our Minister of Health, YB Datuk Seri Dr Subramaniam who launched this year’s National Anaesthesia Day and the Malaysian Society of Anaesthesiologists Year Book 2012/2013. He was accompanied by the President of the Malaysian Society of Anaesthesiologists, Dr Sushila Sivasubramaniam; President of the College of Anaesthesiologists and Head of Anaesthetic and Intensive Care Services for Malaysia, Datin Dr V Sivasakthi, as well as the Deputy Director of Hospital Kuala Lumpur, Dr Ruzita Othman.
The Guest of Honor was entertained with a song “While You Sleep”, composed by an anaesthesiologist for all anaesthesiologists. It was done from scratch to melody and from melody to lyrics by Dr Azrin Mohd Azidin. This sweet melodious beautiful song and an exceptional performance was brought together by hidden talents unveiled this day from the Department of Anaesthesia and Intensive Care, Hospital Kuala Lumpur - Dr Azrin and his team. This was followed by dance performances by the department staff.
A total of 20 cash prizes were given away, with the power puff team, oops apologies - it’s “The Power Puffing Girls” – the team of intensivists who comprised Dr Tai Li Ling, Dr Shanti Rudra Deva and Dr Louisa Chan Yuk Li bagging the consolation prize.
The Guest of Honor was presented with the book “History of Anaesthesia in Malaysia” as a token of appreciation before he proceeded to the booths, took part in booth activities, and concluded the day with a press conference and lunch.
This was a successful and enjoyable day. We felt that our aim of portraying an anaesthetist as a doctor who manages patients in a holistic manner with care was achieved and we were proud to see the many happy and satisfied faces of our participants. This made our day as the organisers!
We felt that one of the reasons for the high turnout during our event was the encouragement of the media to run stories about anaesthesia and interviews with anaesthesiologists to publicise our events which included:
TV Talk Show
Selamat Pagi Malaysia live interview with Dr Sheliza Jamil.
Astro TV Vizhuthugal Channel 201 live interview with Datuk Dr V Kathiresan.
Radio Talk Show
Minnal FM 92.3 with Dr Gunalan Palari Arumugam.
Business FM (BFM) 89.9 with Dr Sushila Sivasubramaniam.
Interview with Datin Dr V Sivasakthi in Makkal Osai Newspaper.
A series of articles in The Star Fit4Life section by Datin Dr V Sivasakthi and team:
Prologue: Not Just Sleep Doctors: Dr Kok Meng Sum / Datin Dr V Sivasakthi
Episode 2: Let’s Operate: Dr Lee Yan Wei / Datin Dr V Sivasakthi
Episode 3: Pain Control: Dr Mary Suma Cardosa / Datin Dr V Sivasakthi
Finale: Intensive Care at the Hospital : Dr Tai Li Ling / Dr Ismail Tan Mohd Ali Tan / Dr Teoh Sim Chuah / Datin Dr V Sivasakthi.
Interview with Dr Lim Ern Ming in Sin Chew Daily
The Hospital Kuala Lumpur Event
Exhibitions were held at the Foyer of Hospital Kuala Lumpur from 21st to 25th October 2013, and was very well received and drew the curious public to learn more about anaesthesia and our scope of services. National Anaesthesia Day celebrations this year concluded with a half-day event on 25th October 2013, which was held at the Main Auditorium in Hospital Kuala Lumpur.
The auditorium celebration was headed by Dr Sheliza Jamil and Dr Noorulhana S Hadzarami and was overseen by Datin Dr V Sivasakthi.
Dr Abraham Philips and I were privileged and thrilled being given this opportunity to be the hosts of this prestigious celebration. The Department of Anaesthesiology and Intensive Care was honored to have invited YB Dato’ Dr Haji Azmi Shapie, Director of Medical Development Division, Ministry of Health Malaysia, as the Guest of Honor to grace this occasion.
The celebration began with the signature anaesthesiologists’ song by Dr Azrin and his team, followed by a short multimedia presentation depicting the scope of our anaesthetic services, and cultural performances by the staff of the department. The height of this occasion was a talk by Dr Loo Su Yin, taking us down the road less travelled “While You Were Sleeping”. As one of the investigators in the National Audit on Awareness, she shed light on one of the grey areas of anaesthesia – Awareness Under Anaesthesia.
As our distinguished guests retreated to the exhibition booths and tea, the celebration in the auditorium continued. No celebration is complete without gifts and everyone love gifts! Gifts it is – and quizzes it will be! Everyone took part actively exploring into different parts of anaesthesia; patients and staff alike, and we had a gala time!
It has indeed been a pleasant afternoon celebrating with our patients and the staff from all departments in the hospital. This event had brought us closer, with deeper understanding among the attendees on the role and importance of an anaesthesiologist.
All in all, the chosen theme “Your LIFE... We CARE” was successfully depicted in both the field as well as auditorium activities. This is definitely a major milestone in the Malaysian Society of Anaesthesiologists’ and the Department of Anaesthesiology and Intensive Care, Hospital Kuala Lumpur’s history.
Let’s reminisce and enjoy the excerpts from the lyrics “While You Sleep” by Dr Azrin Mohd Azidin:
Behind the mask we smile and cry it’s true, We hide your pain, we wait and care for you, Makes those times worthwhile from years ago, Through all the sweat and tears… The feelings that we hide inside so deep, We tell it while you sleep…
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National Anaesthesia Day 2013
Hospital Banting, Selangor
Reported by Dr Masturah
World Anaesthesia Day is celebrated on the 16th of October every year to celebrate the vast changes and progress made in the field over the years. It is also celebrated to commemorate the first successful demonstration of ether anaesthesia which took place at the Massachusetts General Hospital. The theme chosen by the Malaysian Society of Anaesthesiologists for this year’s event was “Your Life... We Care”.
For the first time in the history of Banting Hospital, we celebrated World Anaesthesia Day successfully on 11th November 2013. A bit of history regarding our hospital, Hospital Banting is a district hospital founded in 1975. The Anaesthesia Department is a new department and officially started its services in January 2012.
Since our department is still new in this hospital, we formed a committee and came up with a few events in conjunction with World Anaesthesia Day as a day for us to introduce the services provided by the Anaesthesia Department to the community.
The event was held in the space between the Emergency Department and Pharmacy Department. We had posters featuring different types of anaesthesia as well as procedures done by the anaesthesia team in the ICU and OT. We also had skills station with an intubating mannequin and airway adjuncts, where we taught and demonstrated the skills of intubation to the public and health care students. We also explained some of the problems faced during intubation. Some members of the public had a go at attempting to intubate the mannequin and we were amazed to see the reaction on their faces when they were successful.
We also organised a quiz to test the public’s understanding about our anaesthesia services and for those who gave the correct answers, we rewarded them with prizes.
All in all, it was a day well spent and we are proud to be part of the Anaesthesia team in Banting Hospital.
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National Anaesthesia Day 2013
Hospital Tengku Ampuan Rahimah, Klang, Selangor
Reported by Dr Devendran
In conjunction with the National Anaesthesia Day 2013, Department of Anaesthesia & Intensive Care, Hospital Tengku Ampuan Rahimah, Klang, held its own celebration at Hotel Sri Permaisuri, Port Dickson, Negeri Sembilan.
Unlike the previous years, it was more of a fun filled approach as we had our Family Day as well. It was conducted away from our home-ground and also an overnight stay at Port Dickson. Participation was from our hospital staff with their respective families along with the hotel staff.
The theme for this year was “Your Life... We Care”
We took this opportunity to interact and teach BLS course to about 20 hotels staff. It was conducted with mannequins along with hands-on practical sessions. There were full participation, excitement and enthusiasm from them.
The day started with an opening speech by our specialist, Dr Rosliza Samsuddin, Head of the Organising Committee, who welcomed the participants, followed by theoretical and hands-on sessions. Questions from the participants were overwhelming. Later in the evening, the excitement peaked with activities such as telematch conducted by the hotel staff by the beach.
The following night we had our ‘Malam Mesra Family Day’. It started with an Opening Speech by our Head of Department, Dr Haji Mohd Rohisham Zainah Abidin, followed by karaoke sessions and lucky draw contest, and buffet dinner by the beach. A surprise hit song, sang by our HOD, sent a wave of excitement among the crowd.
The next day, everyone had their own activities. Some swam by the beach and others in the hotel poolside. The extra excitement was the banana boat ride, jet ski and beach buggies.
Later in the afternoon, lunch was served and everyone dispersed to their respective ways back home.
We were very grateful to our HOD, Committee Members and the hotel staff for their unparalled full support to make this a combined successful event. In future, we hope to conduct the Anaesthesia Day annually in a different and unique way.
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National Anaesthesia Day 2013
Penang Hospital, Penang
Reported by Dr Chin Im Im & Dr Sheshendrasurian Visvalingam
The day was set, the time constraints were obvious, but the goals were high and the expectation feverish.
Hospital Pulau Pinang started the ball rolling by being the first in its fraternity to celebrate the National Anaesthesia Day on 1st October 2013.
“Your Life... We Care!!!” The theme set pace for the tempo of the celebration and the events planned. Our objectives were not only to create greater awareness of operative care but to provide improved understanding of various aspects involved in acute and chronic pain control, intensive care (ICU) and resuscitative management.
Cyclethon? Walkathon? The ideas were in abundance and chatter was high. Aerobics was finally decided upon with professional aerobic instructors leading the way.
Participation from various disciplines added to the air of festivity and camaraderie. Booths on healthy food, blood donation, pain management and a Well-being Clinic to provide free preliminarily medical check-up and referrals to relevant clinics were planned. Ideas were plentiful and the list was set to expand. A colouring contest for the Paediatric patients were in cards of plans.
The Committee Members were a diverse group of doctors, nurses, assistant medical officers and the support staff. Dr Luah Lean Wah, Consultant Anaesthesiologist, headed the team as the Organising Chairperson. She had behind her, a team of enthusiastic members. Meetings were regular in number as time was fast approaching.
The day finally dawned. The moment arrived for us to showcase ourselves as anaesthesiologists. In a sea of dignified blue clad T-shirts, we emerged strong and unified in effort. Nothing could go wrong. The smiles we wore were bright and cheerful.
A crisp loud rumble brought on worried faces, inquisitive onlookers and questions “What on earth was that? Gunfire? Relax! The level headed ones exclaimed... That’s thunder! Nothing can go wrong...”
Tick tock, the clock ticked by; dignitaries, heads of departments and guests arrived with enthusiasm to participate in the much anticipated aerobic session.
What ensued was a scene from a theatrical production gone disarray. The foyer was filled with arriving guests and lo and behold! The aerobic instructors were nowhere in sight. The downpour that occurred earlier had derailed many roads. In essence, there were no aerobic instructors and a sea of eager audience waited to participate in what was meant to be the highlight of the event!
One cannot express the array of emotions felt… and it was with immense pride that we report within moments, a team from the Organising Committee was formed. While far from professional instructors, their enthusiasm and spontaneity kept the momentum high and formed the backdrop of high spirits that continued throughout the celebration.
The Opening Ceremony ensued and was graced by the presence of the State Health Director, Dato’ Dr Hj Lailanor b Hj Ibrahim; Hospital Director, Dato’ Dr Yasmin bt Sulaiman and Dato’ Dr Jahizah Hj Hassan, Head of the Department of Anaesthesia and Intensive Care. Adding cheer and support, were heads and staff from other departments, nurses, allied health staff and members of the public.
The young and enthusiastic emcees provided a backdrop of subtle humour with an air of pomp and pageantry. Dr Luah delivered an arousing speech followed by welcoming speeches by Dato’ Dr Jahizah and our State Health Director. The latter then officially launched the National Anaesthesia Day 2013 celebration.
This was followed by a reading of a poem entitled “While You Sleep” by our emcee Dr Mazlilah. The serenity of her voice carried the strength of the words with such precision behind an ambience of slow subtle music and balanced against a backdrop of pictures of our personnel at work. It is with gratitude that we thank Dr Azrin Mohd Azidin, Consultant Anaesthesiologist from Hospital Kuala Lumpur, for allowing us to use his work of genius at our event.
The highlight of the event was an educational multimedia video presentation on various services carried out in the department. Again, it is with pride that we report this directorial debut by Dr Terrence Teow which certainly was a production of class and showcased the various strengths of anaesthesia with such poignancy.
A prize-giving ceremony was held for the winners of a colouring contest. Participants involved 40 children from the Paediatric oncology day-care and in-patients. This was a poignant moment shared between us, the recipients and their parents.
The exhibition site resembled a tapestry of colours, ages and professions. The area was converted to showcase posters on anaesthetic services, a mock operating theatre, a heart-lung machine and booths on pain management, dietary advice, blood donation and a well-being clinic offering simple medical checks of body-mass index, blood pressure and blood sugar. A total of 231 members of the public participated in the well-being clinic. The Blood Donation Awareness Booth brought forth 31 donors, much to our amazement.
A meet-the-media session was organised to further disseminate information for the general public. Some of the print media invited included The Star, Berita Harian, Kwong Wah and Sin Chew Daily.
The day ended on a high note. It was a day that showcased the many hidden talents within our department. It was a day that we stood together as anaesthesiologists and portrayed our profession with such merriment, cheer and dignity. It was a day that we took the time and trouble to answer ever so patiently the many questions that the public directed towards us. A day where no questions were left unanswered. From “Who is Anaesthesia?” to “Ini penyakit apa?”
We stood together in solidarity to answer and disseminate the presence and the importance of anaesthesia.
We conclude by thanking the Education Resource Unit of Penang Hospital, the Malaysian Society of Anaesthesiologists and the pharmaceutical industry for their unwavering support in making this event a success.
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National Anaesthesia Day 2013
Hospital Sultanah Aminah, Johor Bahru, Johor
Reported by Dr Seethal Padmanathan & Dr Ismawati Sukawi
In conjunction with the World Anaesthesia Day on 16th October 2013, the Department of Anaesthesia, Hospital Sultanah Aminah, Johor Bahru, organised activities over a week to commemorate this day. The activities were organised by Dr Seethal Padmanathan and Dr Ismawati Sukawi and with Yg Bhg Dato’ Dr Subrahmanyam Balan as the Advisor. Dr Faizal Zuhri was in charge of organising the Total Intravenous Anaesthesia (TIVA) workshop on 17th October 2013. All other Organising Committee members were indispensable in running the show.
It started with a talk show on Radio Johor on 14th and 15th October 2013, by our Consultant Anaesthesiologist, Dr Omar Sulaiman. Dr Omar spoke on the Anaesthesia Day celebrations and highlighted services provided by the anaesthesia team.
A TIVA awareness workshop was conducted on 17th October 2013. It included a talk on the subject by Medical Officer, Dr Azzma, followed by a demonstration on how to use the TCI pumps. Suitable patients from the elective lists had their procedures done under TIVA. Medical companies Schmidt, B Braun and Abbvie were on hand to help with the smooth running of the workshop.
A free blood pressure and body-mass index check was conducted from 14th to 18th October 2013, from 8 am to 12 noon at Foyer 1, Hospital Sultanah Aminah, Johor Bahru. The response from the public was encouraging. At the same foyer, an exhibition was held with posters highlighting the history of Anaesthesia and conduct of anaesthesia. Airway equipment and adjuncts were also put on display. Huge banners and buntings displaying the theme “Your Life... We Care” were placed at strategic places in the hospital which ensured all staff and visitors to the hospital, were fully aware of the event. There was a separate booth for organ donation awareness and for the public to make their pledges.
The Malaysian Society of Anaesthesiologists (MSA) badges were distributed to all Specialists, Medical Officers and staff of Anaesthesia department to commemorate 50 years of MSA. To wrap up the week-long celebrations, a colouring competition was organised for children below 12 years of age. A total of thirty children participated in two categories: below 12 years and below 7 years of age. Goodie bags and certificates were handed to all participants by Yg Bhg Dato’ Dr Balan and attractive prizes were given away to the top three participants in each category.
Overall, the Anaesthesia Day celebrations were a resounding success with much awareness created among the general public.
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National Anaesthesia Day 2013
Universiti Malaya Medical Centre, Kuala Lumpur
Reported by Dr Ina Ismiarti Shariffuddin
Universiti Malaya Medical Centre celebrated World Anaesthesia Day on Tuesday, 16th October 2013, to commemorate the beginning of modern day anaesthesia in 1846. The opening ceremony was held at the “Dewan Sekapur Sirih” and was graced by the attendance of Hospital Director, Prof Dato’ Dr Ikram Shah Ismail, the President of MSA, Dr Sushila Sivasubramaniam, and the Head of the Department of Anaesthesia and Intensive Care, Prof Dr Marzida Mansor, as well as the heads of other departments, doctors, nurses, allied health staff and members of the public.
The theme for this year’s celebration was “Your Life… We Care!!!”. The aim of this celebration was to highlight our role in caring for our patient’s life when they cannot care for themselves. We also aim to create awareness that anaesthesiologists provide anaesthetic services beyond the operating theatre. Following the launch, we presented our in-house production of a video entitled “Trust your life to nobody else… but the Anaesthesiologist”.
In conjunction with this event, Prof Dato’ Dr Ikram Shah Ismail, Director of UMMC, had officiated the opening of UMMC’s Pre-Anaesthetic Clinic and 23-hour Day Surgery Unit. The 23-hour Day Surgery Unit is the first of its kind in a public hospital in Malaysia. The benefits of 23-hour day surgery include minimizing delays and cancellations on day of surgery and maximizing the use of theatre time and hospital beds. This ensures increased efficiency in utilization of operating theatre sessions and postoperative beds. It will also help to reduce waiting time for surgery and length of hospital stay.
We also held a three-day exhibition on services provided by anaesthesiogist in the hospital concourse area. Our main objective was to create public awareness on how anaesthesiologists cared for the life of our patients. We had simulation stations representing the setting in the Operation Theatre and a video presentation on what we do while they are asleep under our care. Visitors were also given brochures on Anaesthesia and children were given a button badge carrying our motto in Paediatric Anaesthesia, “You are safe with me”. The exhibition was well attended by the public.
The highlight of our celebration was the inaugural lecture by our very own Prof Dato’ Dr Wang Chew Yin. She delivered a very inspiring talk on her journey for the last 35 years in advancing anaesthesia, as an anaesthetist and a researcher in Universiti Malaya.
Overall, we had a successful celebration. The public went home with a better picture on the role of an anaesthesiologist, young doctors went home feeling inspired in advancing anaesthesia and as a department, we are motivated to improve our services with the latest additions to our portfolio: the pre-Anaesthetic clinic and 23-hour Day Surgery Unit.
The department would like to thank UMMC’s public relation bureau, our support staff and the Malaysian Society of Anaesthesiologists for their support in organising this event.
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Education and Training: A Malaysian Perspective Presentation at the Vietnam Society of Anaesthesiologists Meeting
Reported by Dr Gunalan Palari Arumugam
On the 8th of November this year, I represented the Malaysian Society of Anaesthesiologists at this meeting which was organised by our counterparts in Vietnam. The meeting was held at the Ninh Binh General Hospital which was about 100 km south of Hanoi. Ninh Binh is famous for its natural limestone formations and grottoes, and famously described as Ha Long Bay on land.
The meeting was attended by about 300 delegates and there were also the participation by the industry vendors as well. Although the event in itself, was held in a simple manner, the opening ceremony was very colourful and showcased a lot of the history of the Vietnamese people which they are very proud of.
The theme of this year’s meeting was on training and education. Apparently, from what I understood during the interactions with our Vietnamese colleagues, there has been a push from the Vietnamese Ministry of Health to train more anaesthesiologists to cope with the current demand of the services required of them. Apparently, there are close to 1000 anaesthesiologists in Vietnam (for a population of 90 million people). In order to cope with the demand, there was a proposal that the training period for anaesthesiologists to be shortened and possibly more allied health personnel to be trained to deliver anaesthesia services as well. This was central to the theme of the meeting where various training programmes from all over the world were discussed and the merits of each were presented in detail.
It was a privilege to have been able to represent the Society and present what we have achieved locally over the years. The dilemma for the anaesthesiology fraternity in Vietnam right now, would probably be similar to where we were about 40 to 50 years ago when we were starting to establish our own training programmes. My presentation focused on how our training programme evolved over the last few decades. This was also the first time I was involved in a conference where the main language used was other than English. My slides and content of the talk were ably translated by Dr Nguyen Ngoc Tho to Vietnamese on the spot (including the jokes and I noticed the delegates laughing so I guess they got the punchline). The planned 20 minutes talk lasted 40 minutes as each slide was translated and there were no simultaneous audio translation via headphones.
Among the questions asked during the Q&A session was whether we train our nurses and paramedics to deliver anaesthesia for our patients. I replied that this was the case some time ago but the practice has been reduced as we began to train more doctors to provide the services. This was also in recognition of the increased complexities of the care that is needed to be provided to the patient which necessitated the proper knowledge and training. This is not in any way diminishing the role of our allied health colleagues but we are focused on training them to be our assistants and not the model in USA where nurse anaesthesiologists are being trained and licensed to provide anaesthesia services under supervision of a consultant.
Another interesting question asked was whether medicolegal issues are being addressed as part of the syllabus at a postgraduate level. My reply was, we did not specifically do so at this moment in time; although we do have a lot of presentations and CME programmes where talks are given by medico-legal experts in order to expose ourselves to this challenging issue. It was agreed that this may be an important issue that would probably be included in postgraduate syllabus in the future.
All in all, the Vietnam Society of Anaesthesiologists was appreciative of our efforts to attend and present at the meeting. I would like to thank the Malaysian Society of Anaesthesiologists and Prof Dr Quyet Thang Cong, President of the Vietnam Society of Anaesthesiologists for the opportunity given to attend the meeting.
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Anaesthesiologists Outside The OT
by Dr Gunalan Palari Arumugam
In continuing with our series of articles on anaesthesiologists and their interest outside the OT, this month, we literally zoom in our lenses on Dr Loy Yuong Siang, Consultant Anaesthesiologist at the Columbia Asia Hospital in Puchong. We spoke to him in detail on his love for photography and how it all began.
Dr Loy or Loy, as he prefers to be called, confesses to us that he has been bitten by the shutterbug since 1984. “At first, I was exploring the interest on my own. There wasn’t really any photography clubs in my school then because photography was not something popular. Just to keep my interest going, I joined some competitions organised by schools in other districts in Klang and Petaling Jaya. I even won some prizes in these competitions. Nowadays, to pursue my interest further, I decided to look for a club and am now a member of the Negeri Sembilan Photography Club.”
When asked about joining photography classes, he said he never had the chance to attend any classes. “I was learning from books and selfexperimenting. A properly conducted class will be very beneficial for most people as it can minimize the time spent in the lower part of the learning curve and can help one to start enjoying better photographs earlier, hence, increasing the interest to pursue the hobby further,” he adds.
One of the things that I am sure we all realise, is the ease in which technology had made it easy for the novice photographers like most of us, to begin shooting pictures like professionals. Loy says, “Starting from the development of digital photography, the price of cameras initially was steep but subsequently, decreased to become affordable. The cost of the initial investments by manufacturers for the research and development that went into the design of these cameras was high initially, and that needed to be recouped. But the advantage was that, it was counter balanced by the marked reduction in the cost of maintenance of the hobby. For example, the cost of a professional Single Lens Reflex camera (SLR) in those days was around RM20,000 compared to RM10,000- 20,000 nowadays. The emergence of lower end Digital Single Lens Reflex camera (DSLR) costing around RM1,000-2,000 has also been popular since the last decade. The cost of maintaining the hobby is also markedly reduced. In the film/slide era, every press of the shutter release button will cost money due to the use of negatives, development of the films and printing, regardless of the quality of the photo taken. Nowadays, one gets to experiment endlessly without any significant cost incurred.”
I am sure every budding photographer out there dreams of having his favourite shots on the cover of National Geography or Time. Loy jokingly says, “I have thought of that but I realised those dreams will require a more full-time involvement. For now, I will keep that dream aside until I go into retirement from my current job. Of course, who knows one day I may come up with some spectacular shots and be remembered just as how some of my idols are remembered such as Joe McNally, Dave Black and Ansel Easton Adams, to name a few. In terms of places, I would love to have the opportunity of travelling to and taking photos, top on the list, would be the Yellow Stone National Park in the United States and Inner Mongolia, among many others.”
I asked Loy how does he prepare for a session and what difficulties does he encounter during these sessions. He replied by saying, “Every other shot is as easy and as difficult as the other ones. Personally, the most difficult shots I have taken so far are the macro shots of insects and plants in their natural habitats. It involves a lot of patience, steady hands and crawling through bushes. A detailed study of the characteristic of the subject will help a lot in most kind of photography. Any good photo session will always begin with a detailed study of the subject. Let’s say I want to do photography for a trip, which is more relevant to most people, I will start from searching through the Internet for information on the particular area I am visiting. Any particular beautiful sceneries, any particularly interesting human activities, browse through the photographs taken by others on-line, taking note of the sunrise and sunset time, the expected weather and geographical location and sun position that correlates with my time of visit. This is to avoid missing some critical landmarks or activities. Twilight will enhance a lot of scenes and the time should be noted. The position of the sun and satellite images from Google will tell us the best positions to shoot certain landscapes by enhancing the shadow and light distribution.”
And all this while, I really thought you just focus and press the button…
So, how does Loy juggle his busy working schedule with this interest? It seems to take some time to do all this research. “I mainly shoot landscapes during my holidays and the rest of time, I shoot insects and plants which are abundant in our country. I have these sessions of what I call ‘one hour, one lens’ where I bring my macro lens with me to work and go out to take some shots in the nearby park when I have about an hour or so in between cases. These sessions are useful to help me practice keeping my hand steady when shooting and the eyes sharp when looking for subjects to shoot.” It sounds like Loy has managed to find the perfect balance between his work life and his interest.
When I asked him what he considers his biggest achievement to date, “I did win some prizes over the years but the biggest achievement for most photographers and especially for me, is the thrill of seeing a shot turn out just as we have imagined. And when I asked him about ever giving up this passion, he replied with honesty, “I thought I would give up photography just at the end of last year when I sold off and gave away all my equipment. At that time, I thought that was the best thing to do and I will not come back to photography. Well, I was just too wrong, after ten months of abstinence, I bought back most of my gear and came back with an even bigger appetite to photography.”
Loy’s parting advice to budding photographers out there, “Photography is just like anaesthesia. Anyone with a decent camera can produce a decent photograph under optimal condition just like any trained medical assistant can give a spinal for an ASA 1 case going for a k-wiring of the toe. It is the knowledge and the detailed planning before and during the performance of anaesthesia that elevates ones work to the level of art. That’s how I see photography as well. There are a lot of photography books out there and do join in some forums to exchange knowledge. With the right knowledge, the photos will get better. A very famous quote among the photographers is ‘f/8 and be there’. This emphasizes the importance of a strong and healthy body. You can never take the breathtaking view from the top of a mountain if you are not able to get up there in the first place.”
We wish Loy all the best in his passion, who knows he will be the first anaesthesiologist to have a Pulitzer Prize winning shot and make us all proud. We would also like to thank Loy for sharing with us two of his favourite photographs that accompany this article.
Till the next article, cheers!
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Message from the President of the College of Anaesthesiologists, AMM
Merry Christmas and a very Happy New Year to you all!
It seems so fast that 2013 is coming to an end and we are on the brink of yet another wonderful year.
Many events have transpired since I last penned a few lines to you.
Continuing from where we left off, we were honored by yet another visit from the President of the College of Anaesthetists, Ireland, Dr Ellen O Sullivan and the CEO, Mr Fintan Foy, in October 2013. They gave us a talk in Hospital Kuala Lumpur, and it was very well attended and overwhelmed with many questions and answers. This talk was followed by a business meeting with the University heads, The President of MSA and HKL, and senior MOH representatives.
Interested doctors can check the website for information on the MCQ:
The examinations are held at the Perdana University. Further details can be obtained at the following links:
Eligibility for OSCE/SOE:
They have said that they may consider the OSCE/SOE exams to be held in Malaysia if there are a reasonable number of candidates. The Intensive courses could also then be held here prior to the exam.
If you have any queries on the above matter, please e-mail me.
(L-R) Dr Sivasakthi, Dr Ellen O’Sullivan, Mr Fintan Foy and Dr Anthony Cunningham
10th MOH-AMM SCIENTIFIC MEETING 2013
(Incorporating the 16th Scientific Meeting of the National Institutes of Health)
This meeting was held on 29th - 30th September 2013, at the Dewan T J Danaraj, Medical Academies of Malaysia, Kuala Lumpur. It was a function that was well-attended and filled with pomp and ceremony. The Opening Ceremony and other official events were held on 29th September 2013. It started with the academic procession line up, opening speeches, conferment of Honorary Fellowship on Datuk Seri Dr S Subramaniam, Minister of Health Malaysia, and induction of new members into the various colleges. Congratulations to our new inductees!
2ND AMM-AMS-HKAM TRIPARTITE CONGRESS &
47TH SINGAPORE-MALAYSIA CONGRESS OF MEDICINE
It was held on the 23rd - 24th August 2013, at the Grand Copthorne Waterfront Hotel Singapore.
It was a huge success and the scientific content of the congress was current and of great interest. There was a conferment of Honorary Fellowship to the President of the College of Anaesthesiologists, Malaysia.
MRA MEETING 14th – 15th SEPTEMBER 2013
Grand Melia Hotel, Jakarta, Indonesia
This was a meeting attended by the Presidents of the Anaesthesia Societies in the ASEAN region. The discussion was centred on the presentation of the education programme in the various countries and the areas or opportunities where we can interface between the various countries, whether it was possible and the way we are going to evolve over the next few years. There was also a healthy exchange of new and innovative ideas to improve medical education and finally a discussion on MRA and the regulations.
Workshops on Duration of Postgraduate Experiences
There have been two meetings by the Academy of Medicine in
trying to define the ideal period of supervised training a specialist
in anaesthesia should have once he passes the final examination
till he can be registered in the NSR (post qualification experience).
The College has come to a consensus and has suggested a period
of one year. However, we need to await the final reply from the
Academy of Medicine.
The College is updating / revising the following practice guidelines:
Consent for Operation
A meeting was held on the 18th July 2013, in Putrajaya, to discuss issues on consent for operation after the document on consent was loaded on the Malaysian Medical Council website in January 2013. This meeting was organised by the Ministry of Health and had representatives from College, the MSA, the Universities, the Legal Division of the Ministry of Health, Medico-legal Society and MMC. The anaesthetic issues and queries were put forth to MMC for clarification and there was an ensuing healthy discussion. We are still awaiting a reply from MMC and we will highlight the replies to our queries as soon as possible.
Well, friends, please visit our website and become a member of the College of Anaesthesiologists. Together, we can pave our future and evolve to even greater heights!
See you next year!
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