Overview of ICN, BLS, Code Mngt. PDF

OVERVIEW OF CRITICAL CARE NURSING PROF. ARIS S. SANTOS, RN, RM Some photos that will be shown for this presentation are sensitive and maybe offensive to some attendees. It is used to give a better understanding of the topic. Some photos used in this presentation is not owned by the presenter. It is...

OVERVIEW OF CRITICAL CARE NURSING PROF. ARIS S. SANTOS, RN, RM Some photos that will be shown for this presentation are sensitive and maybe offensive to some attendees. It is used to give a better understanding of the topic. Some photos used in this presentation is not owned by the presenter. It is for “Fair Use” for education/academic purposes only. No copyright infringement intended on all references, materials and video clip links/sources used. The author(s)/owner(s)/producer(s) reserves all rights.  “Specialty within nursing which deals specifically to human responses with life- threatening illness” (American Nurses Association & American Association of Critical Care Nurses) CRITICAL It requires an ability to deal with crucial situations rapidly with precision, before it CARE was limited to traditional ICU within a hospital, however, Critical Care Nursing is NURSING no longer geographically defined. The primary reason is to provide care to critically ill patients and their families and promoting a patient-driven system of health care   HOLISM – refers to the combination of an individual’s physiological, psychological, spiritual and sociological being.  HOLISTIC NURSING Critical Care – involves in providing nursing care while keeping the totality of the patient. Nursing as a  Patient is admitted to an intensive care unit needs professional care directed not only at his Holistic pathophysiological problems, but also at the psychosocial, environmental, and family issues Framework intertwined with the physical illness.  Models of human and group behaviors are tools the critical care nurse uses, within the framework of the nursing process tto provide holistic nursing care. INTENSIVE CARE UNIT  An intensive care unit (ICU), also known as an intensive therapy unit or intensive treatment unit (ITU) or critical care unit (CCU), is a special department of a hospital or health care facility that provides intensive care medicine  Intensive care units cater to patients with severe or life threatening illnesses and injuries, which require constant care, close supervision from life support equipment and medication in order to ensure normal bodily functions.  They are staffed by highly trained doctors, nurses, and respiratory therapist, perfusionist and others who specialize in caring for critically ill patients. ICUs are also distinguished from general hospital wards by a higher staff-to-patient ratio and access to advanced medical resources and equipment that is not routinely available elsewhere. Common conditions that are treated within ICUs include ARDS, shock and other life-threatening conditions. TYPES OF ICU  CCU Critical Care Unit/ Regular ICU – ex: Medical ICU, Surgical ICU  PACU - Post Anesthesia Care Unit  PICU – Pediatric Intensive Care Unit  NICU – Neonatal Intensive Care Unit  CCU – Cardiac Care Unit/ Coronary Care Unit  CT ICU – Cardiothoracic Intensive Care Unit  Neuro ICU  Isolation Intensive Care Unit  Psychiatric Intensive Care Unit  Mobile Intensive Care Unit SAMPLE ICU SET-UP ICU NURSES A.K.A. critical care nurses are highly specialized and trained healthcare personnel who provide nursing care to patients with life-threatening illnesses or conditions. They provide specialized experience, knowledge, and skills that patients need to survive or de-escalate care. ICU nurses are trained to make split-second decisions and act quickly when a patient’s status changes. ICU nurses work in challenging and complex fields in their nursing profession. They have the primary duty to provide lifesaving care to patients fighting for their lives. They are highly trained to provide exceptional care for patients who depend on 24/7 nursing care. A patient in ICU is often ventilated, intubated, and can be on several life-saving machines and medications. ICU nurses are at the top of their game and well-versed with all aspects of specialized care to restore their patients’ health and wellness. Common Equipments, Systems and Instruments in ICU Mechanical Ventilator Emergency Cart Common Equipments, Systems and Instruments in ICU CARDIAC MONITOR Basic Cardiac Monitor Reading Common Equipments, Systems and Instruments in ICU MANUAL DEFIBRILLATOR AUTOMATED EXTERNAL DEFIBRILLATOR (AED) Common Equipments, Systems and Instruments in ICU BASIC ENDOTRACHEAL INTUBATION SET Common Equipments, Systems and Instruments in ICU BI-VALVE MASKS (AMBUBAG) SUCTION MACHINE Common Equipments, Systems and Instruments in ICU INFUSION PUMP SYRINGE PUMP Common Equipments, Systems and Instruments in ICU INTRA-AORTIC BALOON ABG MACHINE PUMP MACHINE Common Equipments, Systems and Instruments in ICU EXTRACORPOREAL MEMBRANE OXYGENATION MACHINE (ECMO) HEMOPERFUSION MACHINE Common Equipments, Systems and Instruments in ICU ECG MACHINE ICP MONITORING DEVICE Common Equipments, Systems and Instruments in ICU PERIPHERAL ARTERIAL LINE INTRAOSSEOUS KIT Video Presentation EMERGENCY CART, DEFIBRILLATOR, CARDIAC MONITOR AND INTUBATION Basic life support SUDDEN CARDIAC ARREST It is the sudden, unexpected death caused by loss of heart function, most common cause is a heart attack. ASSESSMENT: No palpable pulse, no breathing, the victim is unconscious Cerebro-Cardio-Pulmonary and Renal Resuscitation (CCPRR / CPR)  A technique of basic life support for the purpose of promoting circulation and oxygenating the brain, heart, lungs, kidneys, until a more advance definitive medical treatment can restore normal heart and ventilatory function  Primary Indication: Cardiac Arrest  Secondary Indication: Pulseless Electrical Activity (PEA), Ventricular Fibrillation (VF), and Pulseless Ventricular Tachycardia (pulseless Vtach)  QUALITY MATTERS: improves chance of survival  2 key elements:  High Quality CPR Skills (Chest Compression and Rescue Breaths)  More efficient team approach HIGH QUALITY CPR SKILLS  Begin CPR Compressions within 10 seconds of determining cardiac arrest  Compress fast, at a rate of 100 to 120 beats per minute  Compress hard, at least 2 inches or more for adult, and at least 1/3 depth of chest for children/infants  Allow for complete chest recoil at top of each compression  Minimize interruptions to compressions  Give effective rescue breaths that create a visible chest rise (10-12 breaths per minute via BVM if in hospital setting via head tilt-chin lift maneuver/jaw thrust/or if advance airway is available)  Avoid excessive air on rescue breaths  External Chest Compressions  Increases pressure inside chest and directly compresses heart, forcing blood to move from chest to lungs, heart, brain, kindney and the rest of the body ADULT CHILD INFANT Compression Area Lower half of the sternum not hitting the xiphoid process Depth More than 2 inches 1/3 of the depth of the chest, 1/3 depth of chest or about or about 2 inches 1 ½ inches How to Compress Heel of 1 hand, non Small children, heel of 1 hand Encircle sides of chest with dominant over Large children, can use both hands, and use thumb tips dominant hand hands to compress lower third of breatbone Compression rate 100-120 times per minute: 10 -12 rescue breaths (observe switching and pulse check every 2 mins ; for infants may increase to 12-20 breaths CRITERIA FOR NOT STARTING CPR All patients in cardiac arrest receive resuscitation efforts unless: The patient has signs of irreversible death (visible brain matter,) Rigor mortis (stiffening of the body) decapitation dependent lividity WHEN TO STOP CPR S – cene is not safe/ Spontaneous signs of circulation is restored T – urn over to medical services or other health care member O – perator/nurse is already exhausted and cannot continue CPR P – hysician assumes responsibility (declares death, take over) Ethico-Legal Considerations In a hospital set-up, once a patient is for resuscitation, you must know if he has ADVANCE DIRECTIVE. If the patient or the relative (next of kin) already signed a DNI and DNR waiver, we must respect that. If a patient does not have an advance directive, and the relatives are still in the process of deciding whether to signed DNR, you are still to perform resuscitative efforts as long as there is no signed from/waiver. ANY QUESTIONS? Teamwork isn’t really teamwork unless the Team actually works. Seems simple enough, But in practice, EFFECTIVE TEAMWORK IS HARD! SKILLS LAB ACTIVITY: Video Journal Video Journal on Dream Specialization in ICU: Make a 1 to 1.5 minute video journal and answer this question, If you are given the opportunity someday to specialized in critical care nursing, what specific ICU set up would you like to work and why? Grading System: Content of the Journal (Depth of answer, reflection of thoughts) 50% Construct of Journal (Ability to communicate, English Speaking Skills) 20% Creativity (effects, editing, organization of presentation) 20% Over-all Impact (includes time bounded presentation) 10% TOTAL 100% Submission: Next Week before the start of the class REFERENCES Hudak,et al. Critical Care Nursing: A Holistic Approach Schumacher & Chernecky. Critical Care and Emergency Nursing Lippincott. Manual of Nursing Practice Emergency Nurses Association of the Philippines. BLS & ACLS Handbook https://www.incrediblehealth.com/nurse-types/icu-nurse/ https://en.wikipedia.org/wiki/Intensive_care_unit