icu admission.2022 pptx.pdf
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The document discusses the Surgical Intensive Care Unit (SICU), describing it as a tertiary care facility that provides critical care to unstable, severely ill surgical patients requiring constant monitoring and emergency interventions. Anesthesiologists and surgeons play major roles in the SICU by managing airways, ventilation, resuscitation, and monitoring patients with critical illnesses or injuries. The document outlines patient admission criteria and monitoring, discharge criteria, and the roles and communication between intensivists and surgeons in managing and caring for patients in the SICU.
icu admission.2022 pptx.pdf
- 1. 悋惘忰 悋惘忰 悋 惡愕盒潮
- 2. Dr. Radhwan H. AL-Khashab consulatant anaesthesia & ICU Assisst prof. 2022
- 3. Surgical Intensive Care Unit (SICU) offers critical care treatment to unstable, severely ill patients in the perioperative setting, who have life-threatening conditions and require comprehensive care, constant monitoring, and possible emergency interventions. Definitions
- 4. So it`s tertiary care facility in the hospital that provides a state of medical care to critically ill patients referred to it via different surgical department
- 5. Who take care? Anesthesiologists played a major role in SICU . Relative to most other physicians, anesthesiologists have greater expertise in airway management, mechanical ventilation, drug and fluid resuscitation, and advanced monitoring techniques that are central to effective care in critical illness. The role of surgeons in SICUs provides specific insights and perspectives concerning the care of surgical patients, Trauma management and postoperative care require active input from surgeons in the intensive care unit . (Hellenic Journal of Surgery (2016) 88:1, 3-4)
- 6. A high-dependency unit is an area in a hospital, usually located close to the intensive care unit, where patients can be cared for more extensively than on a normal ward, but not to the point of intensive care. It is appropriate for patients who have had major surgery and for those with single-organ failure.
- 7. Indication of admission to SICU A. Surgical causes includes: Pre and post-operative patients of ASA IV and V, undergoing major and ultra major surgeries.which may includes: All craniotomy patients. All thoracotomy patients. All ultra major surgeries.
- 8. B- Severely injured patient : whether there is indication for mechanical ventilation or not. C-Medical causes : any previous medical problems in which the anesthesia & surgery increase the severity of pre- existing disease e.g. patient with COPD, restrictive lung disease ,heart failure , uncontrolled DM or H.T. . D- Anaesthesia related causes : Cardiac arrest , sudden hyper or hypotension, cardiac dysrrhythmias , delay recovery from anaesthesia , oliguria or anuria.
- 9. Generally speaking, any surgical patient who requires continuous monitoring, 1:1 nursing and /or continuous life support is a candidate for SICU admission. As with any other treatment, the decision to admit a patient to an intensive care unit should be based on the concept of potential benefit. Patients who are too well to benefit or those with no hope of recovering to an acceptable quality of life should not be admitted.
- 10. 惶忰悸 惆悋悧惘悸 悋惠惺 悋悴惘 愕惠愆 悋惘慍悸 悋惺悋悸 悋惠悽惆惘 愕 ICU admission forma Patient name: .. Age: Sex: Primary diagnosis: Indication to ICU admission: 惺悋惠 惠惆 愕惠 悋悋愕惠悋惘悸 悵 惡惆 惘惷 悋 悋惆悽悋 悋惠 :悋忰惴悸 悋惺悋悸 愆惺惡悸 惆惘 惡 悋惘惷 悋愕悗 悋悋惆 悋 悋惠惴惘 悋悋悽惠惶悋惶 悋愀惡惡
- 11. Who should manage surgical patient in SICU To provide quality critical care to this patients the surgeon & intensivist should be in close communication through out the patient stay in SICU. The surgeon should inform the SICU team preoperatively regarding a patient who may need postoperative admission. Postoperatively the surgeon & intensivist will need to work side by side , goals of care should be discussed frequently & the plans should be communicated daily. Who should manage surgical patient in SICU Author: Stefan Alfred Hubertus Rohrig, Marcus D. Lance, M. Faisal Malmstrom,Publish Year: 2020
- 12. Patient`s monitoring Basic patient`s monitoring Advanced patient`s monitoring Heart rate Blood pressure Respiratory rate ETCO2 Pulse Oximetry Hourly urine output Temperature GCS ABG CVP IBP PCWP PAP ICP IAP
- 14. APACHE II scoring system APACHE : Acute physiology & chronic health evaluation. Published in 1985. Up to four points are assigned to each Physiological variable according to its most abnormal value. During the first 24 hours in intensive care. Points are also assigned for age, history of severe clinical conditions, and surgical status. The total number of points gives a score ranging from 0-71, with an increasing score representing a greater severity of illness. APACHE II allows the probability of death before discharge from hospital to be estimated.
- 16. Discharge from intensive care and high dependency care. A patient should be discharged from the ICU when the condition that led to the admission has been adequately reversed or when the patient is no longer benefiting from the treatment available. Unless a patients death is imminent, it is appropriate to transfer the patient to another area of the hospital and allow death with dignity. Intensive care patients may be discharged to high dependency care or to the general ward ,as appropriate.
- 17. Postanaesthesiacareunit(PACU) It is the unit where patients are temporarily admitted after any surgical procedures. It'is a vital part of hospitals and other medical facilities. It is normally attached to operating room suites, designed to provide care for patients recovering from anesthesia, whether it be general anesthesia, local or regional anesthesia such as epidurals and spinals.
- 19. Any Q.?