St Vincent's Melbourne ICU through the ages
A rich history
Following the second world war, surgical procedures grew exponentially in number and complexity leading to a need for specialised postoperative care including mechanical ventilation which had simultaneously developed with the polio epidemics of the 1940s and 1950s. The Department of Anaesthesia was established in 1956 and a resuscitation area was established next to the operating theatres. Dr Bryan Galbally was appointed as the first “resuscitation officer” shortly after, and the intensive care unit was formally established in 1961.
Dr Galbally was joined by Dr John O’Donovan who had undertaken additional critical care training in Boston and later by Dr David Cade. Together, these specialists expanded the roles of intensive and respiratory care serves in the hospital. They opened a purpose built 14 bed ICU in 1969, an ICU at St Vincent’s Private Hospital in 1970, and were associated with ICUs in other Melbourne Hospitals. The Indonesian government commissioned them to design and build the first ICU in Jakarta in 1972.
In 1975, Dr Bernard Clarke was appointed as the first full time director. Having trained as a respiratory physician in USA and UK, he was also responsible for respiratory medicine at the hospital. Dr Clarke was appointed to run the Office of… which coordinated the movement of critically ill patients within Victoria and to head the Bioethics Centre at St Vincents. He moved into general medicine and private practice in 1985 when John Santamaria was appointed as Director in 1985.
Dr Santamaria graduated from University of Melbourne through the St Vincent’s Clinical School and had completed respiratory and critical care training at Royal Melbourne Hospital under Dr Michael Pain and Dr Jack Cade respectively. He was joined by Dr Bill Kelly in 1986 and by Dr Bob Lodge in 1988 who with Benno Ihle and Jonathan Burdon provided services within the Hospital.
The ICU became accredited for ICU training with both the RACP and the then Faculty of Anaesthesia (later Australian and NZ College of Anaesthetists).
By the 1990s, the ICU was becoming too small to accommodate the needs of the clinical services. A new hospital with 16 ICU beds was commissioned in 1995 and a further 4 beds in 2014.
St Vincent’s also established the first critical care nursing course in 1963 and has continued to train nurses and allied health professionals over the years.
In 1994, ICU implemented the Hewlett-Packard (now Philips) clinical information system. Now called ICCA, this system records all observations, medications and notes at bedside monitors as well as downloading relevant pathology results to assist patient care. This vast database is a valuable resource for clinical management, audit and research.
St Vincent’s participated in the MERIT study looking at the benefits of a medical emergency team. Since then, the emergency call database has provided valuable insights into the nature of calls, the impact various clinical practices, and been able to demonstrate reductions in mortality and cardiac arrest. In addition, the Unit has provided TPN services to the hospitals, continues with a tracheostomy review service and provides additional ward support through a nurse led liaison service. Find out more about these additional clinical services.
Today, the ICU/HDU is a busy 19 bed unit with over 1600 admissions per year. Find out more about the ICU.