Mais conteúdo relacionado


Preparation of patients before arrival to icu guidelines.pptx

  2. MEANING OF ICU • Intensive care refers to the specialised treatment given to patients who are acutely unwell and require critical medical care. • An intensive care unit (ICU) provides the critical care and life support for acutely ill and injured patients. • Unless you are an emergency admission, you will need a referral from your doctor or specialist to be admitted to ICU.
  3. WHO IS CARED FOR IN ICU? • Patients may have a planned admission following surgery, an unexpected admission after an accident or be admitted because of a sudden and critical deterioration to their health. • ICU teams are multi-disciplinary, made up of highly skilled intensive care nurses, doctors and specialists trained in providing critical care for patients with a variety of medical, surgical and trauma conditions.
  4. WHAT ARE THE TWO TYPES OF ICU? • Medical intensive care units (MICUs) which provide care for patients with medical conditions who do not require surgery. • Long term intensive care units (LTAC ICUs) which provide care for prolonged critical care needs patients.
  5. TYPE OF PATIENT TO BE ADMITTED ICU • Some hospital ICUs specialise in providing care for particular health conditions or injuries including: • major trauma • severe burns • respiratory failure • organ transplants • complex spinal surgery • cardiothoracic surgery.
  6. PREPARATION OF PATIENT BEFORE ARRIVAL OF ICU • Area to be check the patient arrival to ICU • From emergency • From out patient services • From referral of various of health Centre through emergency Dept/direct admission • From operation theatre • From various of ward /department of hospital internal
  7. PREPARATION OF PATIENT • Checking of patient condition followed by doctor order and patient family /relative consent for admission of patient to icu • Informed and written consent as per policy of hospital • Preparation of patient personal hygiene/removing of patient belongingness /dress code for ICU • Preparation of equipment /devices/instruments accessories need to give life support for the patient while entry to ICU • Preparation of health team capable to transfer patient to ICU with support of mobile/movable full equipped bed with accessories/ transporter ventilator /monitorwith accessorie etc.
  8. ICU LOCATION • LOCATION • The CCU has to be ideally located in a separate area with easy accessibility to the emergency department, operation Room, radiology department, catheterization lab and blood bank • The unit must have sufficient big lift, ramps and a wide corridor that can be facilitate smooth transfer in and out of the patients • The ICU should have a single entry and exit with an anteroom • There should be provision for emergency exits in case of disasters
  9. FLOOR SPACE • The recommendation varies from country to country • Floor space: 125 to 150 sq ft per patient is recommended. It may vary up to 250 per sq ft • The floor space for a separate room should be much higher at least 300 ft2 per patient • The bed space between two beds should be 4 – 4.5 sq ft • The beds are separated with a removable partition • The head end should have enough space for easy patient access for intubation or resuscitation • Two bigger rooms or two separate rooms should be available for patients requiring isolation precaution or for the immuno compromised patients • The room should be big beside procedures such as ECMO and renal transplant therapy and for those who have a large number of gadgets attached to them • 100 % to 150% extra space is recommended for other than patient care area
  10. OTHER FACILITIES • An ICU should have storage space for ventilators, monitors, infusion pumps, room for doctors office, nurses office, toilets. • Facility should be provided for medical storage (gloves, medicines, airways, suction tips, catheters, Ryles tubes) • Other facility to be provided are : medicine preparation area, equipment storage area, secretarial and computation facility, clean linen storage, seminar room with a small library and dirty utility room • An ideal ICU should have a clear cut zoning with patient care areas, support areas, dirty utility, and toilet in other areas • For movement of dirty utility there should be a separate pathway • There may be provision of RO purified water access within ICU • There should be a minimum of two to three oxygen outlets, two to three vacuum outlets and one to three compressed air outlets • 16-18 electric outlets are recommended • There should be sufficient natural lighting available. Wall mounted or ceiling mounted pendent type lights are preferable to save space and for good illumination • Hand washing facility should be easily accessible. Isolation ICU should have
  12. PREPARATION OF ICU CUBIC/PATIENT UNIT • Equipment that may be used on an ICU includes: • a ventilator – a machine that helps with breathing; a tube is placed in the mouth, nose or through a small cut in the throat (tracheostomy) • monitoring equipment – used to measure important bodily functions, such as heart rate, blood pressure and the level of oxygen in the blood
  13. PATIENT ICU ROOM EQUIPMENT/DEVICE/INSTRUMENTS • ICU ROOM • Bedside trolleys, drug cart and emergency cart • Patient Lifting devices • Portable X Ray machine • Picture archiving & communication system is preferable • Bedside ultra sound and echo machines • Renal replacement therpay • IABP or Ventricular Assist Device • Bedside bronchoscopy machines For every patient the following monitors should be available: • ECG Monitor • Pressure Monitor • Temperature Monitor • End Tidal CO2 monitor • Pulse Oximeter • Non Invasive arterial pressure monitoring • Pulse Oximeter • Bedside (ABG) lab and ECMO are optional and may be available
  14. CONTINUED • For safe handling and maintenance of equipment the medical, nursing and other allied health personnel have to be trained periodically • The various sizes of endotracheal tubes, tracheostomy tips, nasogastric tubes, airways, suction tips & ICD tubes should be available • Catheters, ECG leads, gloves, gowns, masks, goggles, drugs, IV fluids and refrigerator should be available to store medications • Adequate amount of medications should be stored at the bedside as well as in the central stores
  16. CONTINUED • IV lines and pumps – tubes inserted into a vein (intravenously) to provide fluids, nutrition and medication • feeding tubes – tubes placed in the nose, through a small cut made in the tummy or into a vein if a person is unable to eat normally • drains and catheters – drains are tubes used to remove any build-up of blood or fluid from the body; catheters are thin tubes inserted into the bladder to drain pee
  17. PATIENT AND FAMILY SUPPORT SERVICES COUNSELLING • Counselling • Admission to ICU because of critical illness or accident can have a huge physical and emotional impact on your life and your family. • Some ICUs have a dedicated counsellor to provide support for patients and their families. These counsellors are highly experienced and have a thorough knowledge of ICU procedures.
  18. PASTORAL CARE • For many people, emotional and spiritual thoughts tend to surface when someone they care about is in a critical condition in hospital. • Many hospitals provide chaplaincy and pastoral counselling services for patients, families and staff who need compassionate, professional and spiritual guidance and support
  19. INTERPRETER SERVICE • An interpreter service is available for patients and families if English is not your first language. • These interpreters are specifically trained to interpret medical terms into other languages. It is important that you use this service if you are having problems understanding doctors explaining information or are being asked to provide consent for medical procedures.
  20. REMEMBER OF ICU • Visiting ICU can be a confronting experience. • Patients are monitored 24 hours a day. • Doctors, nurses and specialists are highly trained in delivering critical care.