Posts

LEGAL AND ETHICAL ASPECTS OF ICU

Informed consent Informed consent is an agreement by a client to accept a course of treatment or a procedure after providing complete information includes the benefits and risks of treatment alternatives to the treatments and prognosis, if not treated by a health care provider. For the consent, usually the client sign a form provided by the agency, that form is the record of the informed consent. Delegation " The delegation is defined as transferring to a competent individual the authority to perform a selected nursing task in a selected situation." "Delegation is defined as transferring responsibility for the performance of an activity or task while retaining accountability for the outcomes." "five right of delegation" Right task – the task is delegate for a specific client such as tasks that are repetitive, require little supervision and are relatively noninvasive. Right circumstances – appropriate client setting, available resources and other relevan...

ORGANIZATION OF ICU

Image
(According To IPHS Standards) PHYSICAL SETUP General Principle - 2 to 5 percent total medical and surgical beds in a hospital should be Critical Care beds. Minimum 4, maximum 12 bed per Critical Care unit. Number of beds -5% of the total hospital bed strength. ICUs having 24 are difficult to manage. Location In close proximity of emergency and accident department, Operating rooms, trauma ward, diagnostic facilities, blood bank, pharmacy etc. (for Safe, easy, fast transport of a critically sick patient). Equipped with central suction and medical gases, uninterrupted electric supply, heating, ventilation, central air conditioning and efficient life services. Corridors, lifts & ramps spacious enough to provide easy movement of bed/ trolley. There should be single entry/exit point. It is required to have emergency exit points in case of emergencies and disaster. Designing and Space 125 to 150 sq ft area per bed in the patient care area or the room of the pati...

NURSING PROTOCOLS FOR CRITICAL CARE

(BY SIHFW RAJASTHAN) No critical care patient will be left without a nurse in attendance. Each nurse will be responsible for the entire care of his/her patient, and acts to coordinate care with other health team professionals. Breaks will be arranged according to unit need/safe coverage by mutual agreement between each nurse and his/her coworkers. The nurse must give a full report to another staff nurse prior to leaving for a break.  The staff nurse will report any changes in his/her patient's condition directly to the physician. All critical care patients will have continual ECG monitoring. Alarms must be left on the ECG and arterial lines at all times. Appropriate limits will be selected at the nurse's discretion according to institutional policy. For a stable, non-acute patient without invasive monitoring equipment, vital signs are measured at least every hour. The turning of all critically ill patients every two hours around the clock is done unless contrain...

EQUIPMENT'S & SUPPLIES IN ICU

Patient monitoring equipment Patient monitoring equipment includes the following: Cardiac Monitors: to monitor the electrical activity of the heart. Cardiac monitors continuously measures and displays data on vital signs, such as heart rate, blood pressure, cardiac output, and blood oxygen levels. Pulse Oximeter: to monitor the saturation of oxygen in the blood. Swan-Ganz catheter or pulmonary artery catheter: is used to measure the amount of fluid filling the heart as well as to determine how the heart is functioning. Intracranial pressure monitor— Measures the pressure of fluid in the brain in patients with head trauma or other conditions affecting the brain (such as tumors, edema, or hemorrhaging). Apnea monitor —continuously monitors breathing to detect cessation in infants and adults at risk of respiratory failure. Arterial Line: A very thin tube (catheter) is inserted into one of the patient's arteries (usually in the arm) to allow direct measurement of the blood pressur...

INTENSIVE CARE UNITS (ICU)

"A Critical Care Unit (CCU) or Intensive Care units (ICU) is defined as a specially staffed, specialty equipped, separate section of a hospital dedicated to the observation, care, and treatment of patients with life threatening illnesses, injuries, or a complication from which recovery is possible. It provides special expertise and facilities for the support of vital function and utilizes the skill of medical nursing and other staff experienced in the management of these problems." Critical Care Unit (CCU) or Intensive Care units (ICU) are specialized units that is designed and staffed to deliver the highest level of medical and nursing comprehensive and continuous care to the critically ill patients who are deemed recoverable but who need supervision and need or likely to need specialized techniques by skilled personnel. The Units have the following major characteristics like space, equipment and working staff and continuous service and care all around the clock 24 hours x 7...

INTRODUCTION TO CRITICAL CARE

Critical care nursing is the field of nursing with a focus on the utmost care of the critically ill or unstable patients following extensive injury, surgery or life threatening diseases. The aims of Intensive and Critical Care Nursing are to promote excellence of care of critically ill patients by specialist nurses and their professional colleagues. Critical Care Critical care (medicine) is the multidisciplinary healthcare specialty that cares for patients with acute, life-threatening illness or injury. Critical care (Intensive Care) is a healthcare specialty that cares for patients with acute, life-threatening illness or injury and involves multiple skills and specialties. Critical Illness Critical illness is a condition where life cannot be sustained without invasive therapeutic interventions. Critically Ill Patient Critically ill patient is defined as those patients who are at high risk for actual or potential life-threatening health problems and they are highly vulnerable, unsta...

COMMONLY USED DRUGS IN ICU

ATROPINE SULFATE Isopto Atropine Classification Anticholinergics Dosage Bradycardia: 0.5 mg IV every 3-5 mins, max of 0.04 mg/kg Cardiac Arrest: 1 mg every 3-5 mins Nerve and Organophosphate symptoms: may repeat in 2 mg increments q 3 mins titrated to relief symptoms Indication Pre-op meds/pre-aesthetic meds To restore cardiac rate and arterial pressure during anaesthesia when vagal To lessen the degree of A-V heart block To overcome severe carotid sinus reflex Antidote for cholinergic toxicity Side effects CNS: restlessness, ataxia, disorientation, hallucinations, delirium, coma, insomnia, agitation, confusion. CV: tachycardia, angina, arrhythmias, flushing. EENT: photophobia, blurred vision, mydriasis. GI: dry mouth, constipation, vomiting. GU: urine retention. Hematologic: leucocytosis Other: anaphylaxis Adverse effects CNS: headache, excitement. CV: palpitations GI: thirst, nausea Contraindications Hypersensitivity With acute angle closure glaucoma, obstructive uropathy, ob...