1. Critical care Unit

2. Organization
Classification
Principles
Special equipments – ventilator, cardiac monitor & defibrillator
Infection control protocol
Monitoring
Ethical and legal aspects
Death and dying
Drugs used in icu

3. Meaning
) is a specialized facility in a hospital that provides intensive care medicine. Many hospitals also have designated intensive care areas for certain specialties of medicine, as dictated by the needs and available resources of each hospital.

4. The Critical care or intensive care unit is the term used to describe “the care of patients who are extremely ill and whose clinical condition is unstable or potentially unstable.”

5. Definition
Critical care unit is defined as the unit in which comprehensive care of a critically ill patient who is deemed recoverable is carried out.
Critical care unit is a specially designed and equipped facility staffed by skilled personnel to provide effective and safe care for dependent patients with life threatening or potentially life threatening problems.

6. Purpose Continuous Monitoring and treatment.
Required emergency interventions.
care for patients who are medically unstable or seriously ill.
Care for patients who do not have much chance for recovery due to the severity of their illness or traumatic injury.

7. History 1854 Crimean war – Florence Nightingale
Dr. W.E. Dandy – 3 bedded Neurosurgical unit in US
1927 first hospital for premature born infants in Chicago
II nd world war – shock wards
outbreak polio Epidemic – respiratory ICU
1950 peter safar anathetist ‘Advanced support of Life’ (sedated & ventilated)

8. History
7. Nurses practice – sick patients located near the nurses station receive more attention.
development of various specialty & ICU significantly reduced the mortality and hopital stay time
9. Major surgeries – liver transplant, kidney transplant and pancreatectomy

9. Organization of ICU Central unit with a back up services of
Sophisticated investigations
Imaging techniques
Physiotherapy
Super specialities
Beside Medical & surgical ICU
Trauma unit
Burns
Respiratory care
ICCU
cardiac surgery
Neurosurgery

10. Location Calm & Quiet environment Close relationship with
Imaging techniques
Physiotherapy
Trauma unit
Burns
Respiratory care
Laboratory

11. Size of the ICU Average 6-8 Less than 6 becomes uneconomical
> 12 becomes unwide
Precious yrs discharge X average length of stay
Size of the unit = X 2
365

12. Design of the unit

15. Should permit direct view of the unit – square, U shaped or rectangle.
Cubicles separated with walls/papers or opaque glasses
Doors should be wide enough
Provision for visitors and not to disturb the client/ Nursing team
Each cubicle should have window

16. 6. Calendar and clock in the unit/ cubicle
7. Rapid communication system
8. Centrally placed monitor

17. Ancillary area Nurses station Utility room Admission room
Room for specialized equipment
Conference or class room
Nurses waiting/resting room
Doctors waiting/resting room
Lab
Pantry
Visitors room
Store room & Changing room

18. Infrastructure

19. 1. Rails alongside the bed
2. Wall sockets for oxygen and pressurized air as well as for suction. At least 2 oxygen and pressurized air outlets are needed and 3 aspirators per patient.
3. A bell or intercom for calling the nurse should be at each bed.
4. A table and a telephone with an outside line should be at the bedside.
5. Armchairs should be on hand, preferably adjustable ones, to allow patients to sit up if they can.

20. Models Open ICU model Closed ICU model Mixed ICU model
Intensivist model
Intesivist co management model