Understanding Intensive Care Units (ICUs), Exams of General Surgery

Download Understanding Intensive Care Units (ICUs) and more Exams General Surgery in PDF only on Docsity! ICN: Intensive Care Unit Intensive care unit (ICU) - Also known as an intensive therapy unit or intensive treatment unit (ITU) or critical care unit (CCU). Intensive care unit (ICU) - A special department of a hospital or health care facility that provides intensive care medicine. Intensive care unit (ICU) - Caters 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. Intensive care unit (ICU) - Staffed by highly trained doctors, nurses, and respiratory therapists, perfusionists and others who specialize in caring for critically ill patients. Intensive care unit (ICU) - 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 this unit include ARDS, shock and other life-threatening conditions. Critical care unit - Type of ICU Ex: Medical ICU, Surgical ICU Post anesthesia care unit - Type of ICU After receiving anesthesia for a surgery or procedure, a patient is sent here to recover and wake up. This is a critical care unit where the patient's vital signs are closely observed, pain management begins, and fluids are given. Pediatric intensive care unit - Type of ICU The section of the hospital that provides sick children with the highest level of medical care. Neonatal intensive care unit - Type of ICU Newborn babies who need intensive medical care are often put in a special area of the hospital called the __________. Cardiac care unit / coronary care unit - Type of ICU: CCU This is a specialized hospital ward designed to treat people with serious or acute heart problems such as patients with MI, patients who underwent angioplasty, pericardiocentesis, and other cardio problems. Cardiothoracic intensive care unit - Type of ICU This area is designed specifically for the care of postoperative cardiac and thoracic surgery patients. Neurological intensive care unit - Type of ICU The intensive care unit for patients with life-threatening neurological (nervous system) diseases. Isolation intensive care unit - Type of ICU Patients admitted here are isolated because of highly infectious patients. Thus, room is in negative pressure. Psychiatric intensive care unit - Type of ICU A closed environment that provides care to individuals who are experiencing a severe episode of mental illness and whose condition and behaviours cannot be safely managed in a hospital mental health unit. Mobile intensive care unit - Type of ICU Designed to provide on-site trauma and surgical services both at a medical facility or free-standing on location at a disaster location. Ambulances with complete equipment that transport patient from one place to hospitals; have access in advanced airway (intubation) + drugs. Common ICU setup - Includes bed, syringe pumps, mechanical ventilator, IAVP machine (waveforms w/ ECG). ICU nurses - These nurses, also known as critical care nurses, highly specialized and trained healthcare personnel who provide nursing care to patients with life-threatening illnesses or conditions. at least 4 cm - It is suggested that the tip of ET should be ________ from the carina, or the proximal part of the cuff should be 1.5 to 2.5 cm from the vocal cords. Bi-valve masks (ambu bag) - These bags are used to inflate the lungs during procedures including intubation. Suction machine - Also known as an aspirator, is a type of medical device that is primarily used for removing obstructions — like mucus, saliva, blood, or secretions — from a person's airway. Infusion pump - The medication is put into a syringe which is connected to the patient via specialized IV tubing. This device is then programmed by a clinician, usually the patient's nurse, to deliver the medication and fluids. 500-1000 mL Syringe pump - The medication is put into a syringe which is connected to the patient via specialized IV tubing. The pump is then programmed by a clinician, usually the patient's nurse, to deliver the medication and fluids. < 500-1000 mL Intra-aortic balloon pump machine - Allows blood to flow more easily into the coronary arteries. Helps the heart pump more blood with each contraction. Intra-aortic balloon pump machine - Consists of a thin, flexible tube called a catheter. Attached to the tip of the catheter, is a long balloon. This is called an intra- aortic balloon or IAB. The other end of the catheter is attached to a machine (computer console). This machine has a mechanism for inflating and deflating the balloon at the proper time when the heart beats. Intra-aortic balloon pump machine - he device deflates when the heart pumps, so blood can flow to the rest of the body. It inflates when the heart relaxes to keep more blood in the heart. ABG machine - For ABG analysis every 6 or 8 hours. * Blood is obtained arterially (1-3 cc, depending on machine). Usually patients with ABG monitoring have an arterial line, a catheter that is inserted into an artery. Common arteries used are radial or brachial arteries. * Values appear on the machine, the ICU nurse interprets the results. Hemoperfusion device - A device that perfuses blood. Shown to be capable of removing harmful substances. Found to be an effective means for removing cytokines and reducing their inflammatory effects in other diseases. Extracorporeal membrane oxygenation machine (ECMO) - A device that perfuses blood. It is a temporary life support machine that pumps blood from the patient's body to an artificial lung (oxygenator) that adds oxygen and removes carbon dioxide before returning it (the blood) to the pt via a pump with the same force as the heart while the healthcare team works on treating the underlying disease or injury. ECG machine - Analyzes the conduction of the heart. ICP monitoring device - Measures the pressure inside the skull. Used in patients with elevated ICP, traumatic brain injury, stroke, or patients who had brain surgery (e.g., ventriculostomy). Peripheral arterial line - This device allows continuous monitoring of blood pressure and, when necessary, allows frequent blood samples to be drawn for testing. Intraosseous kit - Consists of IO needle and IO gun. The most common site used for this device is the tibia. * Used for patients na mahirap sweruhan; walang veins, nagshock na talaga, constricted na yung mga ugat, pumuputok na, the next best option is to give medications through IO. * Performed by doctors, nurses assist. * Pag walang IO needle and baril, ginagamit usually gauge 19 needle. After mascrew, may mag babackflow indicating that you have reached the bone marrow. * Connect the IV line/tubing then you can infuse fluids and medications. Defibrillator functions - 1. Defibrillator mode 2. Cardioversion mode 3. Basic mode Indications for the use of defibrillator - 1. Shockable rhythm (Pulseless Vtach, Afib) 2. For cardioversion setups, used for restarting the heart to the proper rhythm 3. Pacing mode for bradycardia Instructions for the use of defibrillator - 1. Turn on 2. Set up the specific joules (Basic defib max is 200 J) 3. Press charge and prepare the paddles with KY Jelly 4. Hear intermittent beepings 5. After the long beep is heard, shout clear and deliver shock 20 pounds - The paddles are placed on the Apex and the Sternum with _________ of force applied for each in order to ensure that no air is trapped between the paddles and the patient skin First drawer of emergency cart - Which emergency cart drawer contains the following? * Drugs commonly found inside the ECart * Left side contains high alert drugs used in emergencies (cardio) such as: 1. Epinephrine (for cardiac arrest; 1mg q3-5 mins) 2. Atropine (0.5mL for symptomatic bradycardia) 3. Amiodarone (antiarrhythmic drug for pt. with vtach, pulseless, vfib; 300mg as loading dose) 4. Inotropes (to increase cardiac output and bp in esp. In cases of cardiogenic shock; given via IV drip) 5. Antiarrhythmic drugs (digoxin, adenosine, verapamil) 6. Dexamethasone (steroid, given also to COVID-19 pt.)Citicoline (neurotonic for stroke pt.) 7. Isosorbide Dinitrate (nitroglycerine, for chest pain ACS or angina pt; given via IV drip) * For respi: 1. Aminophylline, hydrocortisone (for opening of the airways) 2. Nicardipine (during hypertensive emergency; given via IV drip, 10mg usually mixed with 90 cc NSS then hooked on a drip, start from 5 cc to 10 cc per hr) Second drawer of emergency cart - Which emergency cart drawer contains the following? * Concentrated electrolytes