Lets 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? Intensive Care Unit Where do the patients come from? The general hospital floors __________________ _____________ from other hospitals & nursing homes _______________________ _________________ bypassing the ER

What types of patients would you see? 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

What is on the monitor screen? Equipment 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 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 CART A 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 Lines A 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 Common Labs Include: _______________ 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? Intensive Care Unit 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 Feelings of __________________ Scared and afraid How does the ICU affect the family members? Feelings of __________________ Scared and afraid ________________ Inquisitive _________________

How to care for the family members? Practice _________________ Care!!! Intensive Care Unit How to care for the family members? Practice _________________ Care!!! Be ___________________ EDUCATE, EDUCATE, ________________ ___________________ needs Keep them _____________

What’s next? Transfer to _____________ Take to _________________ Discharge (rare)

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

Intensive Care Unit There is more than one type of ICU? WHAT?

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…