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ICU Team and Admission Criteria
40 Questions
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ICU Team and Admission Criteria

Created by
@TimeHonoredAlpenhorn

Questions and Answers

What score is assigned for a patient who opens their eyes spontaneously according to the GCS scale?

  • 4 (correct)
  • 1
  • 3
  • 2

    • The SOFA score assesses the degree of organ dysfunction in patients over time.

    True

    What is the highest score a patient can receive for the best motor response on the GCS scale?

    6

    The __________ score was developed in 1983 to predict outcomes in patients with traumatic injuries.

    <p>TRISS</p> Signup and view all the answers

    Match the following GCS responses with their corresponding scores:

    <p>Obeys commands = 6 Incomprehensive sounds = 2 Flexion = 3 No response (motor) = 1</p> Signup and view all the answers

    Which of the following criteria indicates adequate recovery for discharging a patient from ICU?

    <p>The patient has normal blood gases</p> Signup and view all the answers

    The GCS scale includes a category for assessing verbal response.

    <p>True</p> Signup and view all the answers

    What is considered adequate pain control for a patient in the ICU?

    <p>Adequate pain control means the patient experiences minimal to no pain, allowing recovery.</p> Signup and view all the answers

    Which of the following medical staff are included in the ICU team?

    <p>Intensivists and all Specialists</p> Signup and view all the answers

    Patients with a PaO2 of 80mmHg at 60% FIO2 are indicated for ICU admission.

    <p>False</p> Signup and view all the answers

    Name one reason for a patient to be admitted to the ICU.

    <p>Respiratory failure requiring ventilator support.</p> Signup and view all the answers

    Patients with a serum potassium level greater than ______ mEq/L may be indicated for ICU admission.

    <p>7.0</p> Signup and view all the answers

    Which of the following vital sign changes indicates potential ICU admission due to hemodynamic instability?

    <p>Diastolic arterial pressure &gt; 120 mm Hg</p> Signup and view all the answers

    Match the following medical conditions to their indications for ICU admission:

    <p>Acute myocardial infarction = Cardiac Pulmonary emboli = Pulmonary Eclampsia = Gynecological Sustained multiple trauma = Multiple organ system support</p> Signup and view all the answers

    What is one role of physiotherapy in the ICU?

    <p>Cardiopulmonary management</p> Signup and view all the answers

    A patient with a serum sodium level of 120 mEq/L requires ICU admission.

    <p>True</p> Signup and view all the answers

    Physiotherapy in the ICU always involves invasive procedures.

    <p>False</p> Signup and view all the answers

    What is one condition that can lead to a patient being ventilated in the ICU?

    <p>Acute congestive heart failure with respiratory failure.</p> Signup and view all the answers

    Name two benefits of early mobility in the ICU.

    <p>Improves blood sugar homeostasis and enhances cardiovascular function.</p> Signup and view all the answers

    The movement of air in and out of the lungs is known as __________.

    <p>ventilation</p> Signup and view all the answers

    Match the following gas laws with their main focus:

    <p>Boyle’s law = Inspiration Dalton’s law = Partial pressures of gases Henry’s law = Transport of gases</p> Signup and view all the answers

    Which of the following is NOT a technique used by physiotherapists in the ICU?

    <p>Surgical correction</p> Signup and view all the answers

    Knowledge of anatomy and physiology is not necessary for safe physiotherapy in the ICU.

    <p>False</p> Signup and view all the answers

    What indicates decreased ventilation in the V/Q ratio?

    <p>A V/Q less than 1</p> Signup and view all the answers

    What two components are essential for understanding the physiology of breathing?

    <p>Inspiration and expiration.</p> Signup and view all the answers

    An area with no perfusion is referred to as a shunt.

    <p>False</p> Signup and view all the answers

    What is the primary cause of hypoxaemia in a critical care setting?

    <p>Wasted perfusion</p> Signup and view all the answers

    An anatomical shunt is defined as __________ of the pulmonary arterial system.

    <p>2-5%</p> Signup and view all the answers

    Match the following conditions with their descriptions:

    <p>Atelectasis = Physiologic Shunt Pulmonary embolus = Dead Space Ventilation Bronchospasm = Physiologic Shunt Decreased pulmonary perfusion = Dead Space Ventilation</p> Signup and view all the answers

    What causes ventilation to be wasted in dead space ventilation?

    <p>Both A and C</p> Signup and view all the answers

    Perfusion is greater at the apex of the lungs due to gravitational forces.

    <p>False</p> Signup and view all the answers

    What should be the position of a patient for effective oxygenation?

    <p>Side lying</p> Signup and view all the answers

    What is an indicator of respiratory failure?

    <p>PaO2 less than 60 mmHg</p> Signup and view all the answers

    An increased deadspace will result in a decrease in carbon dioxide levels.

    <p>False</p> Signup and view all the answers

    What does hypoxaemia refer to in the context of respiratory failure?

    <p>Failure of oxygenation</p> Signup and view all the answers

    The purpose of airway maintenance is to ensure adequate __________.

    <p>ventilation</p> Signup and view all the answers

    Which of the following is NOT a clue to the presence of respiratory failure?

    <p>High oxygen saturation</p> Signup and view all the answers

    Match the terms to their meanings:

    <p>Hypoxaemia = Failure of oxygenation Hypercapnia = Excess carbon dioxide in the blood Tidal volume = Volume of air per breath Work of breathing = Effort needed to ventilate lungs</p> Signup and view all the answers

    Paradoxical breathing is a sign of increased work of breathing.

    <p>True</p> Signup and view all the answers

    What can necessitate airway maintenance?

    <p>Partial or complete airway obstruction, oedema, secretion removal, or mechanical ventilation.</p> Signup and view all the answers

    Study Notes

    ICU Staffing

    • Medical staff includes intensivists and various specialists.
    • Nursing staff consists of critical care nurses.
    • Pharmacists play a vital role in medication management.
    • Physiotherapy staff include critical care trained physiotherapists and respiratory therapists.
    • Other allied health professionals in ICU: dietitians, occupational therapists, speech therapists.

    Indications for ICU Admission

    • Patients with respiratory failure needing ventilator support: PaO2 < 60mmHg at 60% FIO2, severe respiratory distress, or PaCO2 > 45mmHg.
    • Patients with acute severe medical/surgical illness and two or more organ failures requiring close monitoring.
    • Hemodynamically unstable patients needing invasive monitoring: vital signs such as pulse < 40 or > 150 bpm, systolic BP < 80 mmHg.
    • Abnormal lab test results indicating critical conditions: serum sodium < 110 or > 170 mEq/L, potassium < 2.0 or > 7.0 mEq/L, glucose > 800 mg/dL.
    • Acute conditions requiring monitoring: acute myocardial infarction, pulmonary edema, severe eclampsia.

    Glasgow Coma Scale (GCS)

    • Eye opening responses: spontaneous (4), to speech (3), to pain (2), no response (1).
    • Best motor responses: obeys commands (6), localizes pain (5), withdraws (4), flexion (3), extension (2), no response (1).
    • Best verbal responses: oriented (5), confused speech (4), inappropriate words (3), incomprehensible sounds (2), no response (1).

    Severity of Illness Scoring Systems

    • Anatomic and physiological scores predict outcomes for trauma patients.
    • TRISS (Trauma and Injury Severity Score) considers blunt versus penetrating injuries.
    • SOFA (Sequential Organ Failure Assessment) developed to assess organ dysfunction over time; scores range from 0 to 4.

    Discharge Criteria from ICU

    • Patient must have a clear airway and strong cough reflex.
    • Normal blood gas levels and respiratory effort required.
    • Hemodynamically stable patients not on inotropes.
    • Adequate neurological status and renal function must be confirmed.

    Role of Physiotherapy in ICU

    • Integral for patient management involving manual airway clearance, suctioning, positioning, and interference with ventilators.
    • Focuses on cardiopulmonary management and early mobilization to prevent complications, improve oxygenation, and enhance lung function.

    Benefits of Early Mobility

    • Improves blood sugar control and cardiovascular function.
    • Enhances endothelial function and hormone regulation.
    • Preserves musculoskeletal integrity and reduces depression.

    Respiratory Physiology

    • Breathing consists of inspiration and expiration, allowing ventilation (air movement) and respiration (gas exchange).
    • Key gas laws: Boyle’s law governs inspiration, Dalton’s law pertains to gas pressures, and Henry’s law involves gas transport.

    Ventilation/Perfusion (V/Q) Relationships

    • Normal V/Q ratio is 1; any deviation indicates ventilation/perfusion mismatch.
    • Conditions like chronic bronchitis or pulmonary embolism impact efficiency significantly.

    Respiratory Failure

    • Defined by a PaO2 < 60mmHg on high FiO2 or PaCO2 > 50mmHg with acidosis.
    • Symptoms include increased respiratory rate, decreased tidal volume, and increased work of breathing.

    Airway Maintenance

    • Involves ensuring adequate ventilation; artificial airways may be necessary for patency.
    • Required during airway obstructions, edema, or when facilitating secretion removal.

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    Quiz Team

    Description

    Explore the roles of the various medical and nursing staff within the Intensive Care Unit (ICU), including intensivists, critical care nurses, and physiotherapists. This quiz also covers the indications for patient admission into the ICU, specifically focusing on respiratory failure and ventilator support. Test your knowledge on these crucial aspects of critical care.

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