Intensive Care Units Overview

Intensive Care (ICU) Definition

• Intensive care is the highest level of patient care for critically ill patients.
• It involves a multidisciplinary and interprofessional approach for managing patients with established or at risk of life-threatening organ failure.
• ICU's provide temporary support and replacement for failing organ systems.

Intensive Care Aims

• Maintain vital functions of the body.
• Prevent further deterioration of the patient's condition.
• Reduce mortality rates.
• Prevent morbidity in critically ill patients.

Types of Intensive Care Units (ICUs)

• ICUs can be categorized by the specific conditions they treat, such as neurological, trauma, burns, medical, and surgical care.
• The age group of patients is another factor, including adult and pediatric ICUs.
• Specialized intensive care units include:
  • Medical Intensive Care Unit (MICU): Manages adult patients with medical illnesses needing frequent monitoring and treatments.
  • Surgical Intensive Care Unit (SICU): Focuses on managing postoperative patients requiring continuous monitoring or life support.
  • Pediatric Intensive Care Unit (PICU): Manages critically ill children, including those needing postoperative care.
  • Neonatal Intensive Care Unit (NICU): Manages premature, high-risk, and critically ill infants, including those with congenital disorders or birth complications.

Equipments Used in ICU

• The specific equipment used in ICUs varies based on patient needs, ranging from general to specialized.
• Common equipment in ICUs can be grouped into specific categories:

Respiratory Therapies

• High Flow Nasal Cannula: Delivers high oxygen concentrations comfortably, used for independent therapy or during breaks from tighter masks.
• Non-Invasive Ventilation (NIV): Supports breathing without tubes; uses a tight mask over the nose and mouth connected to a machine providing oxygen or assistance with each breath, improving oxygen levels and reducing carbon dioxide levels.
• Endotracheal Tube (ET): A tube inserted through the mouth into the windpipe, for patients with breathing difficulties due to lung problems or those unconscious. Connected to a ventilator.
• The Ventilator: Supports breathing with adjustable settings based on patient needs.
• Tracheostomy: A surgical procedure creating a hole in the neck and inserting a tube into the windpipe for long-term ventilation or specific patient requirements.
• Arterial line: A line inserted into an artery to allow continuous blood pressure monitoring and blood sampling. Connected to the cardiac monitor.
• Cardiac Monitor: Displays heart rate, blood pressure, and breathing; alerts should be reported immediately.
• Infusion Pumps: Control the amount and rate of medication or fluids administered to patients.
• Central Line: Inserted into a large blood vessel in the neck or groin, allowing multiple medications at once and stronger medications.
• Nasogastric Tube (NG): Inserts through the nose into the stomach, allowing for feeding when a patient is unable to eat or drink.
• Nasogastric (NG) Feed Pump: Delivers feed at a set rate per hour, typically for continuous feeding.

Other Therapies

• Total Parenteral Nutrition (TPN): Intravenous nutrition solution, administered by a pump, fulfilling a patient's nutritional needs.
• Thrombo-Embolic Deterrent Stockings (TEDS): Long green socks worn to prevent blood clots in the legs.
• Intermittent Pneumatic Compression Machine ('flowtrons'): Moves blood to prevent clots forming.
• Pressure Relieving Mattress ('Air mattress'): Helps prevent pressure injuries, also known as 'bed sores.'
• Urinary Catheter: Placed for monitoring hourly urine output, aiding in assessing fluid balance.