Medical Equipment: An ICU setup at home requires technologically advanced medical equipment such as IV stand, para monitor, oxygen cylinder, suction machine, alpha mattress, nebulizer, DVT pump etc.

1. Dr.Anjalatchi Muthukumaran
Vice principal Cum Nursing Supt.
ELMCH, ECON Era University
Intensive /critical care unit
ideal set up
training for health care professional

2. CRITICAL word denote that
 Crucial
 Crisis
 Emergency
 Serious
 Requiring immediate
action
 Thorough and constant
observation
 Total dependent
(Oxford Dictionary)

3. Critical care meaning
 Critical Care Is A Term Used To Describe As The
Care Of Patients Who Are Extremely Ill And
Whose Clinical Condition Is Unstable Or
Potentially Unstable.

4. Critical care Unit
 It Is Defined As The Unit In Which
Comprehensive Care Of A Critically Ill Patient
Which Is Deemed To Recoverable Stage Is
Carried Out.

5. Critical care Nursing meaning
 It Refers To Those Comprehensive, Specialized
And Individualized Nursing Care Services Which
Are Rendered To Patients With Life Threatening
Conditions And Their Families.

6. Critical care technology means
 Continues cardiac monitoring of
patients
 ECG monitoring
 Arterial Lines in site
 Oxygen Saturation support
 Ventilation support
 Intracranial Pressure Monitoring
support
 Temperature monitoring
 Pulmonary Artery Catheter pressure
monitoring
 IABP
 Extensive use of pharmaceuticals

7. ICU set UP

8. Ideal ICU patient Room

9. system

10. Types of ICU
General
 Medical Intensive Care Unit(MICU)
 Surgical Intensive Care Unit
 Medical Surgical Intensive Care Unit(MSICU)
Specialized
 Neonatal Intensive Care Unit(NICU)
 Special Care Nursery(SCN)
 Paediatric Intensive Care Unit(PICU)
 Coronary Care Unit(CCU)
 Cardiac Surgery Intensive Care Unit(CSICU)
 Neuro Surgery Intensive Care Unit(NSICU)
 Burn Intensive Care Unit(BICU)
 Trauma Intensive Care Unit

11. Multidisciplinary & Collaborative
approach to ICU care
 Medical & nursing directors : co-responsibility for
ICU management
 A team approach : doctors, nurses, R/T,
pharmacist
 Use of standard, protocol, guideline consistent
approach to all issues
 Dedication to coordination and communication
for all aspects of ICU management
 Emphasis on research, education, ethical issues,
patient advocacy

12. CLASSIFICATION OF CRITICAL
CARE PATIENTS
 Level O : normal ward care
 Level 1: at risk of deteriorating , support from
critical care team
 Level 2 : more observation or intervention, single
failing organ or post operative care
 Level 3; advanced respiratory support or basic
respiratory support ,multiorgan failure

13. ORGANIZATION OF ICU
DESIGN OF ICU :
 1. Should be at a geographically distinct area within
the hospital, with controlled access.
 2. There should be a single entry and exit. However, it
is required to have emergency exit points in case of
emergency and disaster.
 3. There should not be any through traffic of goods or
hospital staff. Supply and professional traffic should
be separated from public/visitor traffic.
 4. Safe, easy, fast transport of a critically sick pt
should be a priority in planning its location. Therefore,
the ICU should be located in close proximity or ER,
OT, trauma ward etc.
 5. Corridors, lifts and ramps should be spacious
enough to provide easy movement of bed/trolley of a
critically sick patient.
 6. Close, easy proximity is also desirable to diagnostic

14. BED STRENGTH
 1. It is recommended that total bed strength in
ICU should be between 8-12 and not less than 6
or not more than 24 in any case.
 2. 3-5 beds per 100 hospital beds for a Level III
ICU or 2 to 20% of the total no of hospital beds.
 3. 1 isolation bed for every ICU beds.

15. BED AND ITS SPACE
 1. 150-200 sq.ft per open bed with 8 ft in
between beds.
 2. 225-250 sq.ft per bed if in a single room.
 3. Beds should be adjustable, no head board,
with side rails and wheels.
 4. Keep bed 2 ft away from head wall.

16. ACCESSORIES
 1. 3 O2 outlets, 3 suction outlets (gastric, tracheal and
underwater seal), 2 compressed air outlets and 16
power outlets per bed.
 2. Storage by each bedside.
 3. Hand rinse solution by each bedside.
 4. Equipment shelf at the head end of patient unit.
 5. Hooks and devices to hang infusions/ blood bags,
extended from the ceiling with a sliding rail to position.
 6. Infusion pumps to be mounted on stand or poles.
 7. Level II ICUs may require multi channel invasive
monitors.
 8. ventilators, infusion pumps, portable X ray unit, fluid
and bed warmers, portable light, defibrillators,

17. Staffing pattern/manpower
STAFFING :
 1. Medical Staff – the best senior medical staff to
be appointed as an Intensive Care Director or
Intensivist.
 Less preferred are other specialists from
anesthesia / medicine who has clinical
commitment elsewhere.
 Junior staff are intensive care trainers and
trainees on deputation from other disciplines.
 2. Nursing staff – The major teaching tertiary
care ICU requires trained nurses in critical care
nursing officer, special training like CPR, BLS,

18.  The no of nurses ideally required for such unit is 1:1
ratio, for ventilator case management .however it
might be possible to So 1 nurse for 2 -3patients is
acceptable in non ventilator case management .
 The staff acuity record to be maintain in intensive
critical care unit for patient and staff ratio for direct
patient care monitoring evaluation .
 The no. of trained nurses should also be worked out
by the type of ICU, the workload and work statistics
and type of patient load.
 3.Allied Services – Respiratory services, Nutritionist,
Physiotherapist, Biomedical engineer, technicians,
computer programmer, clinical pharmacist, social
worker / counsellor and other support staff, guards ,
GDA and grade IV workers

19. Design of icu summary
 For critically ill: unstable patients
 Level: I II III
 Bed strength: ideal 8-14
 Each pt. > 100 sq. ft. ( 125-150 desirable)
 Additional space = 100%
 10% isolation bed
 At least 2 barriers to enter ICU

20. Maintenance plan for ICU
 Only one entry and exit, emergency exit
 Proper fire extinguisher
 At least 2 ft. away from head wall
 Central nursing station: all pt.
 visible Environment requirements: Heating, ventilation, air-
conditioning system in ICU (HVAC system)
 Fully air-conditioned : 6 cycle/hr, 2 cycle outside air
 Temperature = 16-25 oC Prof. Dr. R S Mehta,
 Light: high illumination, 150 foot candle (fc), overhead light =
20fc, floor light at night = 10fc
 Noise control: Under 45 dBA in day, <40 in evening, <20 in
night. (watch tick= 20 & normal conversation at 55)
 Furniture: solid, non-porous, stain resistant.
 Floor: easy to clean and non-slippery
 Wall= 4-5 ft. finished with tiles
 Ceiling: paint with soft color, no wire lines

21. Core Competencies
 Patient Care
 Medical Knowledge
 Professionalism & Ethics
 Interpersonal Communication Skills
 Practice-based Learning and Improvement
 Systems-based Practice
 Staff stressors: Nurses role is to decrease stress:
examining feeling about death, listen attentively
to needs, use touch therapy as applicable, family
care, maintain privacy, allow cultural practices as
possible.

22. Nursing Organization Chart

23. Hospital administration –Nursing
dept

24. System to be monitor in ICU
Team

25. Thank you