Lets Explore the ICULets Explore the ICU

What is the Purpose of the ICU?

To provide ___________________ intensive ________________ and treatment of patients seven days a week.

The ICU Health Care Team

• ____________________ • ____________________• Nurses• Physicians (IM, Pulmonary, etc.)• _____________________• Respiratory therapists • Other medical consultants from a broad range

of specialties including surgery, ____________, anesthesiology, and ________________

Where do the patients come from?

• The general hospital floors

• __________________

• _____________ from other hospitals & nursing homes

• _______________________

• _________________ bypassing the ER

Intensive Care Unit

What types of patients would you see?Post heart surgery MI’s

Renal and Liver failure _________________

Pulmonary embolism _________________

___________________________

Arrhythmias Suicidal

______________ coma ARDS

Intensive Care Unit

The monitors are your second major bedside assessment tool – the first is your ___________.

What is on the monitor screen?

•EKG•Heart rate•Blood pressure•Arterial pressure•O2 Saturation•Respirations

Equipment

EQUIPMENT cont….

• _______________: a machine designed to mechanically move breathable air into and out of the _____________.

CHEST TUBES:a flexible plastic tube that is inserted through the side of the ______________ into the _________ space to drain _________, body ___________ or ____________

LARYNGOSCOPE & ETT

•_________________: An instrument that helps in intubation for mechanical ventilation.

•________________ Tube: inserted into a patient's __________ in order to ensure that the airway is not closed off and that air is able to reach the _________. Regarded as the most reliable available method for ____________ a patient's airway.

CRASH CARTA set of trays/drawers/shelves on wheels used in hospitals for transportation and __________________ of emergency __________/equipment at the site of the emergency for ________ _________________.

Includes:•Defibrillator with pads•AMBU bag•Medications•IV equipment•Normal Saline•Procedure kits•Oxygen tank•And much more

Central IV LinesA catheter placed into a large vein in the __________ (internal jugular vein),__________ (subclavian vein) or ________ (femoral vein).

It is used to administer ____________ or fluids, obtain _________ tests and directly obtain cardiovascular _____________________ (central venous pressure).

LABS

• _______________ mostly draw the labs

• Similar labs to those drawn in the ER

• Common Labs Include:

• ABG’s (drawn by the _____________ usually)

• Evaluates the respiratory effort

• _______________ levels

• Chemistry

• _________________--Fibrinogen, Prothrombin

• __________________—proteins released into the bloodstream when heart muscle damage occurs

What are the routines of the ICU?

• Report, assessment, ____________________

• Record info: flow sheets, ______ sheets, _______________ totals, lab results, ________________

• ________________

• KARDEX

• Carrying out orders

• Documentation ______________

• Administering ________________

Intensive Care Unit

How does the ICU affect the family members?

• Feelings of __________________

• Scared and afraid

• ________________

• Inquisitive

• _________________

Intensive Care Unit

How to care for the family members?Practice _________________ Care!!!

• Be ___________________

• EDUCATE, EDUCATE, ________________

• ___________________ needs

• Keep them _____________

Intensive Care Unit

What’s next?

• Transfer to _____________

• Take to _________________

• Discharge (rare)

What are some important facts to consider before going into an ICU as a student?

There is more than one type of ICU? WHAT?

Intensive Care Unit

What’s a NICU?

• Neonatal Intensive Care Unit/Special Care Nursery• For _________________ and __________________ term

infants• Different levels of care for newborns…Levels I-III

– Level I: Lowest level of care (_____________________)

– Level II: ______________ care—IV fluids, __________, “feeder growers”, CPAP, ________ wks gestation or greater

– Level III: Highest level of care• __________ weeks gestation or greater (generally)• Ventilators• Surgeries (sometimes in the unit!)—______________________• Nitrous oxide therapy, Extra Corporeal Membrane Oxygenation

(ECMO)– __________________________

Who works there?

• Pediatricians• ____________________• NNPs, PNPs• Nurses• OT _______________• ________ (positioning,

massage)• ____________________• Respiratory Therapy

• Pharmacist• Pharmacy Technicians• ____________________• Chaplains• And more!

Why do we need a special ICU for infants?

• In premature infants, every body system is ___________________

• What problems do you think that a baby would have with each body system?– Nervous?– Cardiovascular?– GI?– Immune?– Endocrine?– Respiratory?– Musculoskeletal?– Reproductive?– Urinary?

What problems would you see?

• Chronic lung disease of prematurity (BPD)

• Necrotizing enterocolitis• __________________• Meconium aspiration• Congenital heart defects• _____________• Anemia• Intraventricular

Hemorrhage• ___________________

• Retinopathy of prematurity

• ___________________• _______________

Developmental care

• Simulate a _____________ environment– Warm, humid, dark, quiet

• Developmental positioning to aid with _____________ and ____________ development– Make the environment less ______________

• Poor _________________and growth• Abnormal ___________________

Stress signals

• May be different than in term babies, children and adults

• Crying– Less common in the very ill

or very premature babies

• ____________________• Wrinkled _____________• Averted gaze

• __________ arms and legs

• “stop” hands• “shut down”• Changes in vital signs

What stress cues are this baby displaying?

What is RIGHT with this picture?

The Goal…