SURGICAL SERVICES :

The hospital is well equipped to deliver the largest range of surgical services with the necessary personnel, equipment and infrastructure for over 2000 surgical procedures across multiple clinical specialties. The hospital has a vast panel of super specialist surgeons, anaesthetists, nursing and technical team to conduct complex surgeries with high quality outcomes.

The modular Operation Theatres are fitted with advanced OT tables and OT lights comparable with the best in the industry. The OTs are well equipped with sophisticated anaesthesia, laparscope and associated surgical equipments. The OTs are designed for centralized patient care with patient records, videos and intra-operative monitoring delivered in a single dashboard.

The hospital is led by leading physicians with extensive clinical and research experience to cater to all medical needs of a patient. Equipped with state of art diagnostics services, the physician team is capable to address all health needs of a patient. Super specialists across 30 different medical specialities work together, to deliver inter-disciplinary therapy to the patient.

The Medical Services includes outpatient and inpatient care including diagnostic, pharmaceutical, therapeutic and interventional procedures as prescribed by accepted international medical guidelines. In addition, the Medical team addresses multiple short stay services like dialysis, chemotherapy, infertility treatment in addition to ancilliary services like physiotherapy and nutritional counselling.

The Medical team leverages sophisticated IT driven clinical collaboration tools and well defined treatment protocols for delivering expert and standardized care to the patient.

The hospital has extensive facilities for delivering intensive care to its patients. All the intensive care beds are co-located to minimize cross movement of patient, relatives, medical staff, equipments and medical consumables, thereby significantly reducing hospital acquired infection.

The ICUs are well equipped with well qualified nurses with specific training for the specific nature of the ICU. Most ICUs have a 2:3 nursing ratio with round the clock coverage by dedicated critical care specialists.

All ICU beds are continuously monitored through state of art monitoring equipments which in turn are integrated to a single nursing dashboard which is further accessible to the doctor on mobile.

The ICUs are unique in maintaining individual air changes and physical barriers to minimize air borne/ contact infection growth. The ICUs are regularly audited by the hospital infection committee.

MICU (MEDICAL INTENSIVE CARE UNIT)

OVERVIEW

MICU is the Intensive care for patients with complex and multi-system medical illnesses. MICU treats severely ill patients using a collaborative, multidisciplinary approach to care include cardiopulmonary arrest, hepatic failure, respiratory diseases, sepsis, renal failure, severe gastrointestinal bleeding, multi-system organ failure and drug overdose. Having a loved one in the Medical Intensive Care Unit (MICU) can be overwhelming.

Our goals are to provide expert patient care in a comfortable and family-centered environment. The MICU is an ICU that offers specialized care for patients who have various medical problems. Patients are monitored on a continuous basis. Many patients in the MICU require life-support therapy.

Bristlecone Hospitals Standards of care established by the Critical Care Center help ensure that patients receive optimum, coordinated care regardless of which ICU they are assigned to.The unit is staffed by physicians who are experienced in treating internal medicine, pulmonary medicine and critical care. They provide 24/7 coverag along with the experienced nursing team, including a clinical nurse specialist, work in the MICU. Nurses have received advanced training in critical care nursing, and many have received additional degrees and certifications including as nurse anesthetists and nurse practitioners.

DIAGNOSIS

Diseases diagnosed and managed on this service include respiratory failure due to ARDS, pneumonia, COPD, asthma, neuromuscular diseases, shock, major pulmonary embolism, congestive heart failure, acute and chronic renal failure, upper and lower gastrointestinal haemorrhage, severe pancreatitis, liver failure, life-threatening infections, acute cerebral infarction, intracranial haemorrhage, and status epileptics. The MICU also provides critical care services for the UPMC Toxicology Program.

Joining the pulmonary intensivists and nurses on the multidisciplinary team are:

• Respiratory therapists
• Clinical pharmacists
• Clinical nutritionists
• Physical, occupational and speech therapists
• Case managers

What to Expect

The MICU is a Patient-Centred ICU and as such, families are always welcome at their loved one’s bedside. In emergencies a MICU nurse stays with the family to provide information and reassurance.

Patients, to the extent they are able, and their families participate in all discussions and decisions about their care. Because of the variety of conditions and illnesses in the MICU, length of stay varies from hours to months.

Attention to Quality and Safety

Bristlecone Hospitals maintains strict standards for quality and safety. The MICU regularly scores at or near 100% compliance with established procedures that are measured on a daily basis. Critical care standards have significantly reduced the number of bloodstream infections caused by central venous catheters and reduced the incidence of ventilator-associated pneumonia.

SICU (SURGICAL INTENSIVE CARE UNIT)

WHAT IS INTENSIVE CARE?

Sometimes a patient is transferred to the intensive care unit (ICU) for further, close monitoring. Intensive care is most often needed for patients on mechanical ventilation, for patients recovering from heart attacks or major surgery, for patients in shock, and for patients with acute renal failure, among other reasons. In intensive care, clinical staff closely watch the patient minute-by-minute.

Intensive and intermediate care for critically ill patients following gastrointestinal, oncology/endocrine, gynecologic, thoracic, plastic, otolaryngology/head and neck, orthopedic and renal transplantation surgical procedures. Once surgery has been completed, you are brought to the SICU, which also may be called the post-anaesthesia care unit (PACU). In the SICU, clinical staff will closely monitor you as you recover from anaesthesia. The length of time spent in recovery depends on the type of surgery performed and the condition of the individual patient.

While a patient is in SICU, the clinical staff may do the following:

• Monitor vital signs such as blood pressure, pulse, and breathing
• Monitor for any signs of complications
• Take the patient’s temperature
• Check for swallowing or gagging
• Monitor the patient’s level of consciousness
• Check any lines, tubes, or drains
• Check the wound
• Check intravenous infusions
• Monitor the patient’s urine output
• Maintain the patient’s comfort with pain medication and body positioning
• A patient can aid the speed of recovery by doing certain breathing and moving exercises in SICU. The clinical staff will instruct and assist you in trying the following:
• Deep breaths. Lying flat for an extended period of time can cause fluids to accumulate in the lungs. Taking deep breaths utilizing the entire diaphragm and abdomen can prevent pneumonia from developing.
• Coughing. Coughing helps remove chest secretions, which is another way to prevent pneumonia.
• Turning. Changing positions while in the recovery bed helps stimulate circulation and deeper breathing and relieves pressure areas.
• Foot and leg exercises. Moving the legs and feet stimulates circulation. Depending on the type of surgery, patients are encouraged to bend the knee and raise the foot several times, to “bicycle” and to draw circles with their great toes. You may be asked to wear special elastic stockings to stimulate circulation.

MOTHER-BABY UNIT

The Mother-Baby Unit in Bristlecone hospitals offers a unique environment for stable new-borns to “room-in” 24 hours per day with their mothers. A specialized nursing team provides post-partum care to mothers and regular newborn care to their infants.

Other services available include:

• Breastfeeding counselling
• Social work consultation
• Educational materials (pamphlets, hand-outs, videos)
• Interpreter services/TDY

The hospital OPD is uniquely grouped along clusters for inter-disciplinary care and streamlining patient flow. The OPDs cater to general specialities as well as specialty clinics. All the OPDs are available for patient care from 9 am to 9 pm and are manned by qualified specialists of the hospital. Each OPD cluster has dedicated procedure rooms relevant to the cluster and is closely attached to the lab, radiology and pharmacy services.

The Outpatient consultations services can be availed of through prior appointments. Most consultations require a hospital registration, which is done for free in the hospital. In addition, the hospital has three kiosks to allow patients avail of managing their own hospital services.

NEVER MISS YOUR HOME MORE THAN A DAY

Bristlecone Hospitals offers you a dedicated unit entirely for  Short stay care services/Day-care Services, where overnight admissions are not necessary. It includes a wide range of surgeries, consultation with Specialists, preventive health check-ups and lifestyle counselling. The Day-care Centre at Bristlecone Hospitals,Hyderabad offers all these and much more. We believe that ambience plays an important role in speeding up the recovery of the patients so we are providing excellent in that. Thus the Day-care Centre takes every care to provide a patient-friendly, functional and cheerful environment.

THERAPEUTIC & PALLIATIVE PROCEDURES

A number of therapeutic procedures like administration of Biologics for rheumatoid arthritis patients or chemotherapy for cancer patients, etc. where overnight admission is not needed are also carried out at the Day-care Centre. Here, the patients just walk in, have their treatments done and walk out.

DAYCARE SURGERIES

Patients availing of day care surgeries do not have to get admitted in the wards. They can come to the hospital on the day of the procedure in the morning and can be discharged on the same day. The advance in surgical techniques, anaesthesiology and pain relief are important contributing factors in increasing the popularity of day care surgeries. Fully-equipped Operation Theatres, latest gadgets and trained personnel ensure optimum patient safety and satisfaction. Latest technology such as key-hole surgery along with excellent post-operative care and effective pain relief enable the patients to recover in just few hours. Some of the Surgeries which include in Day care are as follows:

ENT PROCEDURES INCLUDES:

• Septorhinoplasty
• Myringoplasty
• Myringotomy and Insertion of Grommet
• Tympanotomy
• Direct laryngoscopy and biopsy
• Stone extraction from Submandibular Salivary gland
• Excision of Papilloma
• Ear lobe prick
• Excision biopsy
• Anterior nasal packing
• Nasal endoscopy
• Gland biopsy
• Posterior nasal packing
• Ear wax removal
• Examination under anaesthesia
• Suturing pinna
• Foreign body removal nose
• Punch biopsy
• Furuncle excision
• Antrostomy
• Myringotomy
• Incision and drainage
• Antral wash

GENERAL SURGERY INCLUDES

• Catheterisation
• Suturing
• Carbuncle excision
• Depomedrol injection
• Lymph node biopsy
• Circumcision
• Eversion of sac
• Gland biopsy
• Intercostal drainage
• Suprapubic cystostomy
• Cystoscopy
• Breast lump excision
• Incision and drainage
• Wart excision
• Sebaceous cyst excision
• C.V.P. line insertion

NEPHROLOGY PROCEDURES INCLUDE

• AV-fistula for Dialysis

OPHTHALMOLOGY PROCEDURES INCLUDE

• IOL +/- Phaco Surgeries
• Dacryocystectomy

RESPIRATORY PROCEDURES INCLUDE

• Fibre Optic Bronchoscopy

ORTHOPAEDIC PROCEDURES INCLUDE

• Fracture reduction with POP cast
• Dupuytrens Contracture release
• Simple Fasciotomy
• Arthroscopy Shoulder, Knee, Ankle
• ACL Reconstruction
• PCL Reconstruction
• Arthroscopic Loose Body Removal
• Arthroscopic Meniscal Repair- Menisectomy
• Implant Remaval
• ORIF Wrist, Elbow
• ORIF Forearm Fracture
• Carpal Tunnel Release
• De Querrains Release
• Trigger Finger Release
• Intraarticular injection
• Minor Amputation

VASCULAR SURGERY

• Varicose Veins
• AV Fistula

NEPHROLOGY

• Dialysis
• UROLOGY
• Bladder Stone Removal
• Cystoscopy URS with DJ Stenting (Unilateral)
• ESWL
• Hypospadias
• Circumcision

OBS/GYNACOLOGY:

• Dilatation and evacuation
• Suction & evacuation of uterus
• Gartner cyst excision
• Incision and drainage
• Colposcopy biopsy
• Fractional curettage
• Drainage of vulval hematoma
• Datation and curettage
• M.T.P with copper T
• Uterine inversion
• Cervical biopsy / Vulval/ Vaginal biopsy
• Episiotomy repair
• CPT repair

NURSING SERVICES :

The hospital has exclusive wards comprising multiple bed types. Each of the beds is uniquely designed for highest patient service and comfortable patient stay. The wards are adequately covered by nursing stations and necessary emergency equipments. The patient rooms are equipped with digital Television and Entertainment options to navigate and access their personal clinical/ billing data.
The nurses are assigned to a continuous training program to impart necessary clinical and patient service skills. The nurses are well equipped with clinical and IT tools to deliver integrated nursing services.

Economy Wards

The Economy Wards are cluster of eight beds with well-defined partitions for accommodating attendant couches. The wards are manned by wide nursing stations to allow coverage through sufficient staff. The patients in the economy wards are given access to sophisticated mobility solutions to manage their clinical and billing data.

Executive Wards

The Executive Wards are designed for providing adequate single room privacy while keeping an affordable pricing for rental and services. The wards are uniquely clustered to provide personalized nursing while the rooms are well furnished to give necessary space for patient care. The rooms are fitted with sophisticated mobility and entertainment solutions to deliver efficient patient care.

BRISTLECONE EMERGENCY CARE is a pioneer of modern day emergency care in India with a goal to treat each person as an unique individual. Our 24-hours emergency and trauma care is geared to meet all medical and surgical emergencies, including polytrauma cases.

Medical emergencies require a quick response and a highly trained staff. Bristlecone Hospitals has 24/7 coverage with highly skilled Emergency physicians along with Assistant physicians, EMTs and experienced nursing team. Bristlecone Hospitals has transport capability to shift patients in critical, life-threatening situations. This facility is equipped with state-of-the-art equipment for a wide spectrum of patients with acute emergencies for initial evaluation, resuscitation, treatment, investigation, stabilization, monitoring and disposition. Physicians in the ER access advanced diagnostic tests, high-resolution imagery, and a fully staffed laboratory.

Our Emergency care clinic is a scientifically developed protocol-driven emergency system. The system has several unique and innovative features

BRISTLECONE EMERGENCY CARE SERVICES INCLUDE:

• Ambulances that are well equipped and manned by trained personnel indeed a veritable ‘Hospital on Wheels’.
• Effective communication system between the central control room, ambulances and the emergency facilities in the hospitals.
• Fastest Response Time In Accidents, Heart Attacks and Paralytic Stroke.
• Easily accessible through a dedicated entrance, and has a ramp to facilitate the transfer of patients on stretchers and wheelchairs.
• Cardiac Monitors, Ventilators and portable X-ray, Sonography & 2 D Echo machines.
• Common functional and medical protocols across the system.
• Training of doctors and other personnel required for pre-hospital and in-hospital care.
• Well-equipped Surgical Cubicles to handle Surgical Emergencies.
• Our Medical Bay is equipped to handle Acute Stroke Unit and Chest pain units.
• A dedicated plaster room and an isolation room.

PHARMACY SERVICES :

The Bristlecone hospitals provide a good pharmacy  to  manage the procurement, storage, preservation, packaging, sterilization, compounding, preparation, dispensing or distribution of   medicine in the hospital.

QUALITY

Quality is the cornerstone of our existence. We have gained experience in pharmacy operations management and committed to delivering best services in the industry. We provide and believe in adhering to the highest quality standards, while serving our patients.

WELL STOCKED PHARMACY

We cater to an entire category of products in pharmacy, surgical, disposables, anti-cancer, lifesaving and general healthcare products.

Space for storage of common medicine, narcotic medicine, poisons inflammable materials, cold space & refrigerator for biological products & heat liable substance.

COMPETENT STAFF

Knowledgeable pharmacists will be available round the clock.

APPROVED MEDICINES

We assure delivery of only trusted medicines to our customers.

COLD CHAIN MAINTENANCE

We stock drugs according to prescribed temperature standards, thereby retaining their quality and effectiveness on consumption.

ELECTRONIC  SYSTEM

The entire supply chain mechanism is computerized; hence redundancies are managed effectively. The system also discloses expiry dates and batch numbers for medicines.

INPATIENT PHARMACY (WARD PHARMACY)

Bristlecone Hospitals Inpatient Pharmacies provide 24-hours pharmacy services to  the wards, clinics and other units in the hospital and to a majority of patients through the unit dose system supply. Our facilities specialize in accurate and efficient distribution of medications to a large population of inpatient services and patient care units. Our Department consists of full-time pharmacists and pharmacy residents.

The mission of the our Department is to provide safe, high quality, cost-effective pharmaceutical care for the purpose of helping to achieve positive patient outcomes. While services are provided to other departments that are directly or indirectly involved with patient care,and education, the primary focus of our services is the care of the patient.

To support the patient care and educational missions of the Hospital, our Department provides a number of pharmaceutical services, including:

• Drug Information Center
• Investigational Drug Service
• Adverse drug reaction (ADR) reporting – The Department reviews all adverse events reported through the Patient Safety Net
• Centralized chemotherapy preparation – Using sophisticated computerized information systems, Department personnel prepare chemotherapy in state-of-the-art facilities to maximize positive patient outcomes for both inpatients and outpatients.

WE ARE CREATING A PHARMACY DEPARTMENT THAT WILL:

• Ensure that all patients receive appropriate drug therapy that focuses on specific outcomes.
• Implement innovative drug delivery models that leverage staff resources.
• Be seen both internally and externally as providing quality service with a customer oriented focus.
• Work with State agencies and professional organizations to promote regulations compatible with the advancement of pharmacy practice.
• Promote pharmacy as a collaborative discipline which is an integral part of the health care team.
• Promote pharmacy as a collaborative discipline which is an integral contributor to the education of health care professionals.
• Proactively educate patients regarding their drug therapy and promote continuity of drug therapy in the ambulatory setting.
• For patients who have been discharged from hospitals, dispensing and counselling services will be provided. The Inpatient pharmacy also supplies the Psychotropic and Dangerous Drugs to the wards and units.

OUTPATIENT PHARMACY

CONVENIENTLY LOCATED NEAR THE HOSPITAL LOBBY

The Bristlecone Hospital Outpatient Pharmacy is centrally located on the first floor near the main lobby and The pharmacy provides an assortment of helpful services and supplies including:

• Prescription services
• Over-the-counter medications & products
• Health care products
• Tri-lingual medication counselling in English,Hindi and Telugu.

Our services are available to:

• Hospital patients who are being discharged
• Clinic patients
• Emergency Department patients
• Bristlecone Employees

SERVICES

• Prescriptions filled for patients prior to discharge
• Medication counselling
• On-line insurance billing for prescriptions
• Employee
• Discount for over the counter and non-covered prescriptions

FOR OUR PATIENTS

Discharge coordinators or social workers can fax prescriptions to the Outpatient Pharmacy along with the patient insurance information. The Pharmacy will have the prescription ready so the patient or family member can pick up the prescription at the Outpatient Pharmacy on their way out of the hospital.

RADIOLOGY SERVICES :

Bristlecone Hospitals provides state-of-the-art, high-quality diagnostic imaging services and patient-centered care. It is our goal to act as an imaging resource that serves as an extension of area medical practices. We strive to exceed your expectations by providing a comfortable environment that brings together the technology, imaging skills, expertise, responsiveness, and excellent care physicians require and patients deserve

Bristlecone Hospitals offers following Radiology services:

Digital X-ray vs Normal X-Ray

X – rays: X-rays are a form of radiation, like light or radio waves that can be focused into a beam, much like a flashlight beam. Unlike a beam of light, however, X –rays can pass through most objects, including the human body. When X-rays strike a piece of photographic film, they can produce a picture. Dense tissues in the body, such as bones, block (absorb) many of the X-rays and appear white on an X-ray picture. Less dense tissues, such as muscles and organs, block fewer of the X-rays (more of the X-rays pass through) and appear in shades of grey. X-rays that pass through air appear black.

X –ray is one of the fastest and easiest ways for a physician to view the internal organs and structures of the body. X-Ray is an excellent tool for assessing skeletal trauma (eg. Broken bones), for diagnosing the gastro-intestinal system (digestive tract) and for comprehensive imaging of the thoracic cavity including the lungs and heart.

Digital radiology may represent the greatest technological advancement in medical imaging over the last decade. The use of radiographic films in x ray imaging might become obsolete in a few years. An appropriate analogy that is easy to understand is the replacement of typical film cameras with digital cameras. Images can be immediately acquired, deleted, modified, and subsequently sent to a network of computers.

The benefits from digital radiology are enormous. It can make a radiological facility or department filmless. The referring physician can view the requested image on a desktop or a personal computer and often report in just a few minutes after the examination was performed. The images are no longer held in a single location; but can be seen simultaneously by physicians who are kilometres apart. In addition, the patient can have the x ray images on a compact disk to take to another physician or hospital.

MOBILE X-RAY MACHINES

 A rise in obesity rates and an increasing  demand for patient-centric medical care, there are times when healthcare professionals simply need a “radiology room on wheels.”

Mobile x-ray is designed to be just such a solution – specifically for use when it is not safe or practical to move a patient from his or her bed to the radiology department. And as mobile x-ray technology has evolved over time, users have continued to demand improved accessibility, reliability and flexibility to help address the increasingly specialized radiographic needs of patients.

ULTRASOUND

Diagnostic ultrasound, also called sonography or diagnostic medical sonography, is an imaging method that uses high-frequency sound waves to produce images of structures within your body. The images can provide valuable information for diagnosing and treating a variety of diseases and conditions.

Most ultrasound examinations are done using a sonar device outside your body, though some ultrasound examinations involve placing a device inside your body.

Ultrasound scan is a painless test that uses sound waves to create images of organs and structures inside your body. It is a very commonly used test. As it uses sound waves and not radiation, it is thought to be harmless. Doppler and duplex scans are used to visualise blood or fluids flowing through the body.

Ultrasounds are sound waves with frequencies higher than the upper audible limit of human hearing. Ultrasound is not different from ‘normal’ (audible) sound in its physical properties, only in that humans cannot hear it. This limit varies from person to person and is approximately 20 kilohertz (20,000 hertz) in healthy, young adults. Ultrasound devices operate with frequencies from 20 kHz up to several gigahertz.

Ultrasound is used in many different fields. Ultrasonic devices are used to detect objects and measure distances. Ultrasound imaging or sonography is often in medicine. In the non-destructive testing of products and structures, ultrasound is used to detect invisible flaws. Industrially, ultrasound is used for cleaning, mixing, and to accelerate chemical processes. Animals such as bats and porpoises use ultrasound for locating prey and obstacles. Scientist are also studying ultrasound using grapheme diaphragms as a method of communication.

Ultrasonography is an ultrasound-based diagnostic medical imaging technique used to visualize muscles, tendons, and many internal organs, to capture their size, structure and any pathological lesions with real time tomographic images. Ultrasound has been used by radiologists and sonographers to image the human body for at least 50 years and has become a widely used diagnostic tool. The technology is relatively inexpensive and portable, especially when compared with other techniques, such asmagnetic resonance imaging (MRI) and computed tomography (CT). Ultrasound is also used to visualize foetuses during routine and emergency prenatal care. Such diagnostic applications used during pregnancy are referred to as obstetric sonography. As currently applied in the medical field, properly performed ultrasound poses no known risks to the patient. Sonography does not use ionizing radiation, and the power levels used for imaging are too low to cause adverse heating or pressure effects in tissue. Although the long-term effects due to ultrasound exposure at diagnostic intensity are still unknown, currently most doctors feel that the benefits to patients outweigh the risks. The ALARA (As Low As Reasonably Achievable) principle has been advocated for an ultrasound examination – that is, keeping the scanning time and power settings as low as possible but consistent with diagnostic imaging – and that by that principle non-medical uses, which by definition are not necessary, are actively discouraged.

Ultrasound is also increasingly being used in trauma and first aid cases, with emergency ultrasound becoming a staple of most EMT response teams. Furthermore, ultrasound is used in remote diagnosis cases where tele-consultation is required, such as scientific experiments in space or mobile sports team diagnosis.

According to RadiologyInfo, ultrasounds are useful in the detection of pelvic abnormalities and can involve techniques known as abdominal (transabdominal) ultrasound,vaginal (transvaginal or endovaginal) ultrasound in women, and also rectal (transrectal) ultrasound in men

CARDIAC ECHOCARDIOGRAM

An echocardiogram (also called an echo) is a type of ultrasound test that uses high-pitched sound waves that are sent through a device called a transducer. The device picks up echoes of the sound waves as they bounce off the different parts of your heart. An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture is more detailed than a standard x-ray image. An echocardiogram does not expose you to radiation

• An echocardiogram can also be used to detect congenital heart defects in unborn babies.
• Look for the cause of abnormal heart sounds (murmurs or clicks), anenlarged heart, unexplained chest pain or pressure, shortness of breath, or irregular heartbeats.
• Check the thickness and movement of the heart wall.
• Look at the heart valves and check how well they work.
• See how well an artificial heart valve is working.
• Measure the size and shape of the heart’s chambers.
• Check the ability of your heart chambers to pump blood (cardiac performance). During an echocardiogram, your doctor can calculate how much blood your heart is pumping during each heartbeat (ejection fraction). You might have a low ejection fraction if you haveheart failure.
• Detect a disease that affects the heart muscle and the way it pumps, such as cardiomyopathy.
• Look for blood clots and tumours inside the heart

We have different types of echocardiograms are:

• Transthoracic  Echo Cardiogram(TTE). This is the most common type. Views of the heart are obtained by moving the transducer to different locations on your chest or abdominal wall.
• Stress echocardiogram. During this test, an echocardiogram is done both before and after your heart is stressed either by having youexercise or by injecting a medicine that makes your heart beat harder and faster. A stress echocardiogram is usually done to find out if you might have decreased blood flow to your heart (coronary artery disease).
• Doppler echocardiogram. This test is used to look at how bloodflows through the heart chambers, heart valves, and blood vessels. The movement of the blood reflects sound waves to a transducer. The ultrasound computer then measures the direction and speed of the blood flowing through your heart and blood vessels. Doppler measurements may be displayed in black and white or in color.
• Transesophageal echocardiogram (TEE). For this test, the probe is passed down the esophagus instead of being moved over the outside of the chest wall. TEE shows clearer pictures of your heart, because the probe is located closer to the heart and because thelungs and bones of the chest wall do not block the sound waves produced by the probe. A sedative and an anaesthetic applied to the throat are used to make
• Echocardiography

FETAL DOPPLER

Doppler fetal monitor or Doppler fetal heart rate monitor is a hand-held ultrasound transducer used to detect the fetal heartbeat for prenatal care. It uses the Doppler effect to provide an audible simulation of the heart beat. Some models also display the heart rate in beats per minute. Use of this monitor is sometimes known as Doppler auscultation. Doppler fetal monitors are commonly referred to simply as “Dopplers”.

Doppler fetal monitors provide information about the fetus similar to that provided by a fetal stethoscope. One advantage of the Doppler fetal monitor over a (purely acoustic) fetal stethoscope is the electronic audio output, which allows people other than the user to hear the heartbeat. One disadvantage is the greater complexity and cost and the lower reliability of an electronic device]

Originally intended for use by health care professionals, this device is becoming popular for personal use. However, the FDA recommends against their home use, citing possible harm to a developing fetus and that these should only be used under the supervision of a healthcare professional when medically indicated for the benefit of the health of mother and child

Ultrasound image of a fetus in the womb, viewed at 12 weeks of pregnancy (bidimensional-scan)

TRANS ESOPHAGEAL ECHOCARDIOGRAM

Transesophageal echocardiography (TEE) is a test that produces pictures of your heart. TEE uses high-frequency sound waves (ultrasound) to make detailed pictures of your heart and the arteries that lead to and from it. Unlike a standard echocardiogram, the echo transducer that produces the sound waves for TEE is attached to a thin tube that passes through your mouth, down your throat and into your esophagus. Because the esophagus is so close to the upper chambers of the heart, very clear images of those heart structures and valves can be obtained.

• TEE is a test that uses sound waves to make pictures of your heart’s muscle and chambers, valves and outer lining (pericardium), as well as the blood vessels that connect to your heart.
• Doctors often use TEE when they need more detail than a standard echocardiogram can give them.
• The sound waves sent to your heart by the probe in your esophagus are translated into pictures on a video screen.
• After this test, you may have a mild sore throat for a day or two
• TEE can give clearer pictures of the upper chambers of the heart, and the valves between the upper and lower chambers of the heart, than standard echocardiograms.
• TEE is often used to provide information during surgery to repair heart valves, a tear in the aorta or congenital heart lesions. It’s also used during surgical treatment for endocarditis, a bacterial infection of the inner lining of the heart and valves.
• Look for the cause of abnormal heart sounds (murmurs or clicks), anenlarged heart, unexplained chest pain or pressure, shortness of breath, or irregular heartbeats.
• Check the thickness and movement of the heart wall.
• Look at the heart valves and check how well they work.
• See how well an artificial heart valve is working.
• Measure the size and shape of the heart’s chambers.
• Check the ability of your heart chambers to pump blood (cardiac performance). During an echocardiogram, your doctor can calculate how much blood your heart is pumping during each heartbeat (ejection fraction). You might have a low ejection fraction if you have heart failure.
• Detect a disease that affects the heart muscle and the way it pumps, such as cardiomyopathy.
• Look for blood clots and tumours inside the heart

B K ULTRASOUND

• Ultra High Resolution Ultrasound System
• Based on TriCore Technology developed by BK Ultrasound Scientists, the new bk is a powerful system that delivers exceptional speed and performance.

BK systems feature advanced transducers for general imaging, urology and emergency medicine, including the world’s only Triplane transducer. Every transducer has a unique Smart™ button that enables you to activate it, freeze, store and print images with a simple touch. Twin Cam Zero Insertion Force (ZIF) connectors reduce noise and are designed to be connected and removed with one hand. Up to four transducers can be connected to the bk3000 at once. Our advanced transducer technology offers superior access across a wide range of patient body types.

The bk3000 uses Multichannel Synthesis to deliver Ultra High Resolution Imaging and 2D Doppler. The technology fuses channel information to dramatically reduce noise and artifacts, while increasing detail and contrast resolution. With the bk3000, you’ll routinely see anatomy and micro-visualization not seen with conventional ultrasound. Visualize subtle tissue contrast, see real information at depth, and notice exceptional detail in moving structures with increased frame rates

Unparalleled performance in a sleek system that is designed for easy mobility in tight spaces, the bk3000 has a small footprint and five wheels for superb stability.

The system is completely adjustable to suit the preferences of clinicians, whether standing or sitting. Its monitor swivels and allows multiple adjustments for individual preferences. The bk3000’s intuitive user interface is designed for easy control with all major mode controls easily accessible. The keyboard is sealed, making it very easy to clean

ECG

Electrocardiography (ECG ) is the process of recording the electrical activity of the heart over a period of time usingelectrodes placed on a patient’s body. These electrodes detect the tiny electrical changes on the skin that arise from the heart muscle depolarizing during each heartbeat.

In a conventional 12 lead ECG, ten electrodes are placed on the patient’s limbs and on the surface of the chest. The overall magnitude of the heart’s electrical potential is then measured from twelve different angles (“leads”) and is recorded over a period of time (usually 10 seconds). In this way, the overall magnitude and direction of the heart’s electrical depolarization is captured at each moment throughout the cardiac cycle. The graph of voltage versus time produced by this non-invasive medical procedure is referred to as an electrocardiogram (abbreviated ECG).

During each heartbeat, a healthy heart will have an orderly progression of depolarization that starts with pacemaker cells in thesinoatrial node, spreads out through the atrium, passes through the atrioventricular node down into the bundle of His and into thePurkinje fibers spreading down and to the left throughout the ventricles. This orderly pattern of depolarization gives rise to the characteristic ECG tracing. To the trained clinician, an ECG conveys a large amount of information about the structure of the heart and the function of its electrical conduction system. Among other things, an ECG can be used to measure the rate and rhythm of heartbeats, the size and position of the heart chambers, the presence of any damage to the heart’s muscle cells or conduction system, the effects of cardiac drugs, and the function of implanted pacemakers.

• Electrocardiography
• Intervention
• ECG of a heart in normal sinus rhythm.

Reasons for performing electrocardiography include:

• Suspected heart attack
• Suspected pulmonary embolism
• A third heart sound, fourth heart sound, a cardiac murmur[5] or other findings to suggest structural heart disease
• Perceived cardiac dysrhythmias
• Fainting or collapse
• Seizures
• Monitoring the effects of a heart medication
• Assessing severity of electrolyte abnormalities

A typical ECG tracing is a repeating cycle of three electrical entities: a P wave (atrial depolarization), a QRS complex (ventricular depolarization) and a T wave (ventricular repolarization).

ECG Waves and Intervals:

What do they mean?

• P wave: the sequential activation (depolarization) of the right and left atria
• QRS complex: right and left ventricular depolarization (normally the ventricles are activated simultaneously)
• ST-T wave: ventricular repolarization
• U wave: origin for this wave is not clear – but probably represents “afterdepolarizations” in the ventricles
• PR interval: time interval from onset of atrial depolarization (P wave) to onset of ventricular depolarization (QRS complex)
• QRS duration: duration of ventricular muscle depolarization
• QT interval: duration of ventricular depolarization and repolarization
• RR interval: duration of ventricular cardiac cycle (an indicator of ventricular rate)
• PP interval: duration of atrial cycle (an indicator of atrial rate)
• 12 LEAD MOBILE ECG
• The portable device can be used to administer emergency care to cardiac patients , people can now monitor their condition at home if they do not have time to visit their doctor. “Just as people use the glucometer to monitor their blood sugar levels, soon they will be able to use the tele-ECG to monitor their heart
• The ECG graph can be transferred to the mobile phone using bluetooth and then sent as an MMS to an expert. This will help in administering emergency care at the patient’s bedside rather than move him to a hospital.
• The standard 12-lead mobile electrocardiogram is a representation of the heart’s electrical activity recorded from electrodes on the body surface. This section describes the basic components of the ECG and the lead system used to record the ECG tracings.

Orientation of the 12 Lead ECG

It is important to remember that the 12-lead ECG provides spatial information about the heart’s electrical activity in 3 approximately orthogonal directions:

• Right ⇔ Left
• Superior ⇔ Inferior
• Anterior ⇔ Posterior
• Each of the 12 leads represents a particular orientation in space, as indicated below (RA = right arm; LA = left arm, LL = left foot):
• Bipolar limb leads (frontal plane):
• Lead I: RA (-) to LA (+) (Right Left, or lateral)
• Lead II: RA (-) to LL (+) (Superior Inferior)
• Lead III: LA (-) to LL (+) (Superior Inferior)
• Augmented unipolar limb leads (frontal plane):
• Lead aVR: RA (+) to [LA & LL] (-) (Rightward)
• Lead aVL: LA (+) to [RA & LL] (-) (Leftward)
• Lead aVF: LL (+) to [RA & LA] (-) (Inferior)
• Unipolar (+) chest leads (horizontal plane):
• Leads V1, V2, V3: (Posterior Anterior)
• Leads V4, V5, V6:(Right Left, or lateral)
• Lead Placement Diagrams.

TREAD MILL TEST (CARDIAC STRESS TEST)

The cardiac stress test is done with heart stimulation, either by exercise on a treadmill, pedalling a stationary exercise bicycle ergometer, or with intravenous pharmacological stimulation, with the patient connected to an electrocardiogram (ECG).

The patient is brought to the exercise laboratory where the heart rate and blood pressure are recorded at rest. Sticky electrodes are attached to the chest, shoulders and hips and connected to the ECG portion of the Stress test machine. A 12-lead EKG is recorded on paper. Each lead of the ECG represents a different portion of the heart, with adjacent leads representing a single wall. For example:

• Leads 2, 3, and aVF = bottom or inferior portion of the heart.
• Leads V1 and V2 = septum or partition of the heart.
• Leads V3, V4, V5 and V6 = anterior or front portion of the heart.
• Leads 1 and aVL = superior or top and outer left portion of the heart.
• Lead aVR looks at the cavity of the heart and has almost no clinical value in identifying coronary disease.

Three of the EKG leads are also constantly displayed on the treadmill monitor. Each lead representing a different wall. The physician has the option of selecting different combinations of three.

The treadmill is then started at a relatively slow “warm-up” speed. The treadmill speed and it’s slope or inclination are increased every three minutes according to protocols are perfectly acceptable). The protocol dictates the precise speed and slope. Each three minute interval is known as a Stage (Stage 1, Stage 2, Stage 3, etc. Thus a patient completing Stage 3 has exercised for 3 x 3 = 9 minutes). The patient’s blood pressure is usually recorded during the second minute of each Stage. However, it may be recorded more frequently if the readings are too high or too low.

As noted earlier, the ECG is constantly displayed on the monitor. It is also recorded on paper at one minute intervals. The physician pays particular attention to the heart rate, blood pressure, changes in the ECG pattern, irregular heart rhythm, and the patient’s appearance and symptoms. The treadmill is stopped when the patient achieves a target heart rate (this is 85% of the maximal heart rate predicted for the patient’s age). However, if the patient is doing extremely well at peak exercise, the treadmill test may be continued further. The test may be stopped prior to achievement of the target heart rate if the patient develops significant chest discomfort, shortness of breath, dizziness, unsteady gait, etc., or if the ECG shows alarming changes or serious irregular heartbeats. It may also be stopped if the blood pressure (BP) rises or falls beyond acceptable limits. Please note that the systolic BP (upper number) may normally rise to 200 at peak exercise. At the same time, the diastolic BP (lower number) remains unchanged or falls to a slight degree. In contrast, the BP of patients with hypertension or high BP will show a rise of both systolic and diastolic readings. The latter may rise above 90 – 100

C-ARM

Experience the difference of using a C-arm designed for the specific needs in Orthopedics. The power to penetrate  dense anatomy in lumbar and hip regions in small or large patients. The precision to   accentuate boney anatomy for clear spine and ortho images. The performance to get the image you need in less time and with fewer exposures.

• Move it easily into place, set it up fast and get exceptional images. With easy steering, customized one-button pre-sets and clear dynamic imaging
• 37 % more information per image may be crucial for an optimal workflow. You can see all the surrounding structures at a glance and can accurately plan and perform your intervention.
• Save valuable OR time. The larger field of view minimizes the number of required images
• Minimize dose. Less exposures result in an even more gentle intervention for both you and the patient
• Modern imaging systems will use the image intensifier as the source of images supplied to a storage system.
• It will be used either as a fixed piece of equipment in a dedicated screening room or as mobile equipment for use in an operating theatre.
• C-arm (encompasses the actual X-ray source and image intensifier)
• Table
• Fluoroscopic exposure and program controls
• Post processing software
• Viewing monitors
• The C-arm systems are commonly used for studies requiring the maximum positional flexibility such as:
• Angiography studies (peripheral, central and cerebral)
• Therapeutic studies (Line placements i.e. Permacath/Hickman, transjugular biopsies, TIPS stent, embolisations)
• Cardiac studies (PTCA)
• Orthopedic procedures (ORIF, DHS, MUA, spinal work) – again generally using a portable C-arm maximum flexibility in positional use. There are very few permanently installed C-arms in an O.R. setting.The workflow seldom justifies this sort of dedication of one O.R. or Permanent C-arm
• The Imaging system must be compact and lightweight to allow easy positioning with adequate space to work around and a wide range of motion while remaining inflexible enough so as to avoid misalignment due to flexion caused by the mass of the X-ray tube or Image system assemblies.
• The images can be manipulated in many ways on the computer screen. Examples of this are:
• Cine loop replay- Allows review of a dynamic scene without extra dose
• Cine Loop editing- Shorter loops can be made over review of a dynamic scene
• 16 Picture overview- For quick overview.
• Zoom- Fast magnification.
• Relative stenosis measurement- Can measure the distance of two vessels for vasuclar procedures.
• Test Annotation- To label all images

DEPARTMENT OF CLINICAL BIOCHEMISTRY :

The Department of Clinical Biochemistry at Bristlecone Hospital is internationally renowned and highly specialised in the measurement of circulating biomarkers.

The department is dynamic, innovative and dedicated to excellence within the field of clinical biochemistry, haematology and coagulation disorders.

Focused on providing laboratory tests to benefit patient care, we perform analyses requested both from general practitioners and hospital-based doctors. We support patient-near analyses (POCT) performed both at the hospital and by general practitioners. In addition, we run a clinic for patients with thrombosis and haemophilia and a number of specialised tests on national and international request.

The biochemistry department offers a broad spectrum of tests for the diagnosis and monitoring of disease, and response to therapy. These will measure levels of specific chemical components of body fluids required to assess or monitor the function/dysfunction of organs such as the heart, kidney, liver, thyroid etc.

Tests include blood glucose, electrolytes, enzymes, hormones, lipids (fats), other metabolic substances, and proteins. These tests are performed using fully automated and sophisticated equipment, able to handle high volumes, and make results available within a very short turnaround time.

AUTOMATION

This section performs the high volume of routine and urgent tests required from clinical chemistry in a large NHS Trust. It is staffed 24 hours a day, but with minimum staffing levels outside core hours.

ENDOCRINOLOGY

This section offers a comprehensive range of endocrine tests including tumour markers, hormone assays and markers of cardiac damage.

SPECIAL CHEMISTRY

This section performs a range of assays, which require the use of specialist analytical techniques such as mass spectrometry and HPLC.

The biochemistry section is a new generation laboratory, fully equipped with the latest state of the art technology. Analytes of serum and other body fluids are measured like routine and specific assays of proteins in serum, urine and cerebrospinal fluid, including specialized tests like oligoclonal protein banding. The laboratory accepts stat requests and aims for a rapid turn-around time on all samples.

This laboratory also applies mass spectroscopy for rapid detection of a broader array of toxic agents and drugs than possible with less advanced technology. The monitoring of immunosuppressant drugs such as cyclosporine and immunoglobulins is also done. Mass Spectrophometry also permits analysis of renal calculi within 30 minutes. Immunology section performs hormonal and other non-infectious assays using Chemiluminiscent Immunoassay (CLIA) Fluorescence intensity Luminescence, Fluorescence polarisation, and Enzyme-linked Immunosorbent(ELISA) assays. Of special note are the fetal lung reactivity profiles and alpha fetoprotein assays in serum and amniotic fluid for neural tube defect screening and tumour marker studies.

HAEMOTOLOGY

The Department of Haematology treats malignant and benign hematologic diseases. Malignant diseases include acute and chronic leukemia, various lymphomas, myeloma and “pre – malignant” diseases like myelodysplastic syndrome (MDS) . Amniotic diseases include congenital anemias, especially thalassemia, various coagulation diseases and other benign diseases of the blood cells.

OUR DEPARTMENT OFFERS:

• Medical services – These services are provided by three separate units – the inpatient department, day care unit, and outpatient clinics.
• Laboratories – Service laboratories that perform many diagnostic tests – some routine and some unique
• Apheresis Unit – provides treatments for a wide range of diseases.

Another important area is the study of abnormalities of blood coagulation. Coagulation (blood clotting) measures the ability of the blood to clot, either as a check before surgery, patients who have unexplained bleeds, or monitoring patients on anticoagulants like warfarin & heparin.

DEPARTMENT OF IMMUNOLOGY

The Immunology Department provides a wide-ranging service for the investigation, diagnosis and treatment of conditions which result from dysfunction of the immune system. The integration of laboratory and clinical services allow us to provide a cutting edge laboratory testing service which is essential in the diagnosis and monitoring of complex immune diseases. Clinically, there are two main areas in which we specialise: Allergy and Primary Immunodeficiency.

ALLERGY

Allergy results from an immune reaction to a substance which would otherwise be harmless. We offer outpatient clinics for the diagnosis and management of allergies, including desensitisation immunotherapy where appropriate. Anaphylaxis represents the most severe end of the spectrum of allergic disease, and the Resuscitation Council UK guidelines advise that all patients who have suffered an episode of anaphylaxis are referred to a specialist allergy clinic to allow the identification of any triggers, reduce the risk of future episodes and to prepare the patient to manage any future episodes.

Summary of services:

• Anaphylaxis
• Urticaria
• Food allergies
• Aeroallergens (eg animal dander, pollens)
• Investigation and diagnosis
• Management
• Desensitisation immunotherapy

MEDICAL MICROBIOLOGY – SEROLOGY

The Serology Laboratory performs tests for chlamydia and gonorrhea using Transcription-Mediated Amplification (TMA) methodology.

Acceptable sources include:

• Endocervical
• Male Urethral
• Serologic tests are available for Syphilis, Hepatitis A, Hepatitis B, Hepatitis C,
• HIV 1/2 + O Ab/Ag, Rubella (IgG and IgM), Tularemia and Brucella.
• The mission of serology department is to provide state of art services in:
• Screening all donated blood units for transfusion transmitted infections (TTIs).
• ABO/Rh typing of all donated blood units.
• Antibody Screening of all donated blood units.
• NAT testing of all donated blood units.

The Serology Department consists of 3 main Laboratories:

• The Microbiology Screening Laboratory.
• The Red Cell Serology Laboratory.
• The Nucleic Acid Amplification Technology (NAT) Laboratory.
• Other Responsibilities

Training Programs:

The Serology Department develops Training Programs to all new staff, as well as on job trainings for all staff working in screening laboratories within the National Blood Transfusion Services.

The Quality Implementation:

The quality assurance program of the Serology Department encompasses: the development and maintenance of written procedures; training, continuing education and competency evaluation of staff; participation in proficiency testing programs; validation of software, hardware, equipment and procedures; and the analysis of errors and outcomes of routine audits and practices.

MICROBIOLOGY

WHAT WE DO

• The Microbiology Department is part of the Laboratory Medicine.
• The three main sections of the laboratory are:
• Bacteriology is concerned with
• Culture of a range of biological material (e.g. swabs, urine, blood, sputum) from human sources.
• Isolation and identification of potentially pathogenic bacteria.
• Determination of antibiotic susceptibilities.

Serology involves the diagnostic identification of antibodies in serum. Such antibodies are typically formed in response to an infection (against a given microorganism). Serological tests for antibodies to HIV, Hepatitis B & C and Syphilis are, among others, available in the Clinical Microbiology department.

Molecular Microbiology employs a highly sensitive technique known as Polymerase chain reaction (PCR) to amplify (replicate many times) a specific target DNA sequence in order to detect a particular pathogen.  Molecular Microbiology, like Serology, is employed when the suspected microbial agent either cannot be isolated in culture by any known method or can be isolated in culture only with great difficulty (e.g. Chlamydia).

• We provide a routine clinical microbiology service for investigation of infectious disease.
• We test a variety of specimens (including; urine, faeces, blood, tissue, fluids and swabs from different bodily sites, hair, skin and nail) for evidence of infection.
• We look for infection caused by bacteria, viruses, fungi and parasites.
• We process screening samples for the identification of MRSA and Clostridium difficile toxin detection in both community and hospital patients.
• We determine which antibiotics are most useful to treat a particular infection using antibiotic sensitivity testing methods.
• We test blood samples for viruses (including HIV, Hepatitis A, B and C, Rubella, syphilis, Chicken pox, measles, mumps) using automated analysers.
• We screen specimens from  GP family planning and hospital clinics for sexually transmitted infections (STIs).
• We work closely with the hospital and community infection control teams to help prevent the spread of infection within the hospital and other healthcare settings.
• Tests and investigations are performed by Biomedical Scientists who are supported by Medical Laboratory Assistants.
• We report results of investigations to other healthcare professionals.
• We do not give results to patients, relatives or friends.  They will only be given to the requesting doctor (Data Protection Act and patient confidentiality legislation).
• Turnaround times for microbiology samples vary due to the length of time taken for micro-organisms to grow.  Most micro-organisms will take 24 to 48 hours to grow and identify but some may take up to 6 weeks to grow.
• The majority of investigations are performed on site, but some samples are sent to reference laboratories and may take longer to be completed.

HISTOPATHOLOGY

WHAT WE DO

Histopathology is the study of diseased tissues and organs through the examination of the microscopical architecture of tissues and the relationship between the different types of cells and tissue types found within tissues and organs.

The histopathology department receives tissue specimens from patients, taken at either surgical operation, outpatient or GP clinics, or at post-mortem examination. Specific pieces of tissue or cells or fluids removed from patients are taken that are associated with the condition under investigation and sent to the laboratory.

By examining the tissues or cells or fluids removed from patients the histopathologist can determine whether disease is present and, if so, what affect the disease will have on the patient. The report is then sent to the treating clinician who explains this diagnosis and its implications to the patient.

WHOM WILL YOU MEET

If you are a patient there should be no circumstances under which you would need visit the histopathology department as all specimens are sent to the department by the clinical team managing your care. However, if you are a healthcare professional, you can visit our department but please contact us before hand to arrange this.

The service includes:

• Paediatric pathology
• Neuropathology
• Muscle pathology
• Metabolic disease
• Autopsy (including perinatal post mortem)

Our scientific team offer a range of specialist investigations including:

• Immunohistochemistry
• Electron microscopy

Molecular diagnostics is a technique used to analyse biological markers in the genome and proteome—the individual’s genetic codeand how their cells express their genes as proteins—by applying molecular biology to medical testing. The technique is used to diagnose and monitor disease, detect risk, and decide which therapies will work best for individual patients.

By analysing the specifics of the patient and their disease, molecular diagnostics offers the prospect of personalised medicine.

These tests are useful in a range of medical specialisms, including infectious disease, oncology, human leukocyte antigen typing (which investigates and predicts immune function), coagulation, and pharmacogenomics—the genetic prediction of which drugs will work best. They overlap with clinical chemistry (medical tests on bodily fluids).

The rise of molecular biology has revolutionized the diagnosis and treatment of diseases. Modern test methods, based on the detection of DNA and RNA, offer many advantages over traditional methods for the detection of diseases. The new procedures can detect viruses, bacteria and genetic variations faster and much more accurately. Treatments can be tailored better to individual patients.

REHABILITATION & PHYSIOTHERAPY:

The field of Physical Medicine and Rehabilitation has entered an exciting time of growth and development. In the clinical realm, Physiotherapists have increasingly incorporated the use of spine injections to complement traditional rehabilitation techniques, musculoskeletal ultrasound is being introduced into the office setting as an aid to the diagnosis and treatment of musculoskeletal conditions, and public awareness of the issues of traumatic brain injury has been expanded.

Moreover, the team-oriented approach that is at the core of rehabilitation medicine has resulted in enhanced collaboration with multiple other specialties within the hospital. The Department of Rehabilitation Medicine at Bristlecone Hospitals is active in these areas of clinical care, and is helping lead the way in advancing our specialty.The physical, occupational, speech and recreation therapists within our department provide critical services to patients as both outpatient and inpatients. We offer a wide array of outpatient specialty programs for patients with neurologic, orthopedic, cardiopulmonary, vestibular, pediatric and other disorders.

Facilities available at Bristlecone Hospitals:

• Occupational Therapy
• Physical Therapy
• Speech-Language Pathology
• Recreation Therapy
• Acute Inpatient Rehabilitation
• Burn Rehabilitation
• Cardiac and Pulmonary Rehabilitation
• Musculoskeletal and Orthopedic Rehabilitation
• Neuromuscular Rehabilitation & The Center for Stroke Rehabilitation
• Pediatric Physical Medicine and Rehabilitation
• Seating and Mobility Program
• Women’s Health Rehabilitation Program

DIETARY SERVICES:

Hospitals are not particularly known for the food they serve. But that isn’t true when we talk about Bristlecone Hospitals. The hospital has taken special steps to create a system which meets the special dietary demands of overseas clients while not compromising with tase.

Strict Quality Control is a deeply imbibed quality at Bristlecone Hospital. The food is prepared in a hygienic environment and complies with high quality standards. Personalizing food to meet the both the nutritional and taste needs of overseas patients is a challenge that the F&B Services Dept. at Bristlecone Hospital overcomes day after day

The F&B Services Dept. is one of the most important departments because it is their responsibility to make certain the food served meets the prescribed nutritional level. Our specialist doctors along with skilled and experienced dieticians chart out personalized diet plans to ensure that patients receive their daily intake of nutrition and enjoy what they eat too.

The Hospital Dietary Department provides meal services and clinical support for in-patients.A full-time, registered dietician delivers dietary counselling, assessment, and education to both inpatients and outpatients. Meals are prepared using fresh, high-quality ingredients and are individualized to the patient’s needs.

PATIENT MEALS

Patients can order meals by calling Room Service. Patients on any diet may order a meal from  his room,24/7.,however the duty nurse along with dietician will make a diet chart suggested by your physician.There is no additional charge for this service. A menu is available in every room.

GUEST TRAYS

Guest trays for visitors who wish to dine with patients are sometimes available for an additional charge. Please call Room Service for more information.

GOURMET MENU

This menu offers a variety of gourmet selections, specially prepared and delivered to your room. Please contact Room Service for menu information. Modifications can be made to accommodate special diets.

The Department of Food and Nutrition is leading the way in researching and providing information and services to meet the nutritional needs of patients during their hospital stay and their recovery. Working collaboratively with the Ambulatory Care Network Nutrition Services, the Department offers outpatient consultations and medical nutrition therapy.

Every day, we serve meals to patients and also provide food services to visitors, staff and ambulatory patients. We also offer vital nutrition education programs that empower patients and their families to make appropriate dietary choices that promote good health.

Our mission is to be the market leader in the provision of food and nutrition services by exceeding the expectations of our patients and customers.

Our vision is to go beyond the expectations of our patients and customers with the clinical expertise, service, compassion, education, and caring that one expects from a premier clinical nutrition and food service department. Networking, our team focuses on best practices in the spirit of unity where each team member autographs their work with pride and quality.