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Intensive Care Unit (ICU) Overview

• ICU is a specialized area in hospitals
• ICU care focuses on critically ill patients
• Patients in the ICU require sophisticated support, careful monitoring, and complex decision-making to adjust therapy as needed.

ICU Purpose and Discussion Points

• The purpose of the discussion is to cover the introduction, critical care beds, critical care design, and ICU equipment.

Introduction to Critical Care

• Critical care refers to the care and management of critically ill patients.
• These patients require sophisticated support, meticulous monitoring, and complex decision-making.
• Therapy adjustments are crucial to meet the evolving needs of the patient.

ICU Setting, Environment, Structure, and Facilities

• Image/diagram of a hospital ICU ward is likely shown, featuring multiple beds, medical equipment, and dividers.
• Relevant diagrams/images of an ICU layout will be displayed, possibly with a floor plan or 3D modeling, to illustrate different areas within the ICU.

Critical Care Beds, Equipment, and Supplies

• Detailed information about ICU beds:
  • Types of beds available
  • Functionality (e.g., electric back rest, knee/trendelenburg tilting, adjustable height)
  • Dimensions
  • Features like side rails
  • Built-in control panels
  • Materials utilized

ICU Bed Features and Accessories

• Epoxy-coated mild steel bed frame
• Perforated top
• 125 mm diameter, noiseless castors with simultaneous braking system that locks/unlocks with a single pedal
• Provision for I.V. Rod on both sides of the bed
• Four easy lifting guardrails on each side with upward and downward fixation.
• Easily operated built-in Control Panel on both sides of guard rails.
• Removable and interchangeable ABS engineering plastic head panel and foot panel with safety lock and roller bumpers.
• Bed size: 2160 x 1100
• All functions are Power controlled.

ICU Bed Types

• "In Touch" beds; benefit patients and caregiver, with touch screen capability.
• Emphasis on features like lateral tilting (complication prevention and treatment assistance)
• Impatient fall protection with side rails.
• Recovery features like mobilization lifts and rails, optimizing heart and lung performance, treatment positions, and complication prevention.

ICU Setup

• ICU layout diagrams showcasing patient care areas, clinical support zones, and unit support zones.

ICU Classification of Patients

• Level 0: Normal ward care
• Level 1: At risk of deteriorating, requiring support from critical care team.
• Level 2: Observation or intervention for a single failing organ, or post-operative care.
• Level 3: Advanced or basic respiratory support, involving multiple organ failure.

Types of ICUs

• General: Medical, Surgical, and Medical-Surgical ICUs.
• Specialized: Neonatal, Special Care Nursery, Pediatric, Coronary Care Unit, Cardiac Surgery ICU, Neuro Surgery ICU, Burn Intensive Care Unit, and Trauma ICU.

ICU Design

• The ICU design focuses on providing a healing environment that optimizes patient, staff, and visitor comfort.
• Natural light
• Reduction of noise levels
• Reducing medical errors

ICU Design: Patient Care Zone

• Usually includes single-bed rooms with adequate space, natural light, and views
• In-room storage for supplies, clothing, and personal belongings.
• Necessary equipment like portable imaging, dialysis equipment, special procedures, and mechanical ventilators.

ICU Design: Clinical Support Zone

• Staff work areas
• Centralized monitoring stations
• Workspace for order entry and medical documentation.

ICU Design: Unit Support Zone

• Administrative and support functions
• Staff support functions
• Conference spaces, staff lounges, on-call rooms, change of shift reports, medical record documentation areas.
• Includes offices, conference spaces, staff lounges, and workrooms for sterile and non-sterile supplies

ICU Design: Family Support Zone

• Designed close to the ICU, or within it, to support families and visitors.
• Family lounge
• Consultation rooms
• Meditation spaces for families.

ICU Accessories

• 3 oxygen outlets
• 3 suction outlets (gastric, tracheal, and underwater seal)
• 2 compressed air outlets
• 16 power outlets per bed
• Storage facilities beside each bed.
• Hand-washing facilities.
• Equipment shelf at the head end
• Hooks for IV infusions, extended from the ceiling
• Infusion pumps on stands/poles
• Level II ICUs might require multichannel invasive monitors.

ICU Staff

• Medical Staff: Senior medical experts (ICU director/intensivist). Other specialists (anaesthesiology, medicine), are acceptable if clinically engaged in commitment elsewhere. Junior staff - intensive care trainees & trainers are on deputation from other disciplines.
• Nursing Staff: Trained nurses are crucial for patient care in tertiary care ICUs.

ICU Allied Services

• Specialized support staff, such as respiratory therapists, nutritionists, physiotherapists, biomedical engineers, technicians, clinical pharmacists, social workers, counsellors, security, and other staff.

ICU Design Summary

• Patients needs for critical care
• Key indicators for ICU bed strength: at least 8-12 beds
• Adequate space for each patient (125-150 sq ft desirable)
• Minimum 10% isolation beds in the ICU
• At least 2 barriers to the ICU entrance.

Environmental Requirements

• Single entry and exit points plus emergency exits
• Sufficient fire safety and extinguishing equipment.
• Central nursing station for visibility of all patients.
• HVAC system (Heating, Ventilation, Air Conditioning).
• Fully air-conditioned ICU at 16-25°C.
• Ensuring proper lighting (overhead at 20fc, floor at 10fc).
• Noise control under 45dBA during the day.
• Non-porous, stain-resistant furniture.

Water Disposal and Pollution Control

• Colour-coded buckets for waste disposal.
• Hand hygiene with foot-operated sinks and alcohol solutions.
• Adequate fire safety equipment.
• Multipurpose rooms, lockers, meeting rooms, and communication facilities for staff.

ICU Organization

• Geographically distinct area within the hospital with controlled access.
• A single entry/exit and separate emergency exits are vital.
• Goods and staff should not pass through the ICU area.
• Separate the visitor traffic.

ICU Design Considerations: Transport/Location

• Prioritize fast and easy transportation of critically ill patients.
• Proximate location to emergency, operating, and trauma rooms as convenient.