2. 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 2Prof. Dr. R S Mehta, BPKIHS
3. 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
3Prof. Dr. R S Mehta, BPKIHS
4. MONITORING IN CRITICAL CARE
AREAS…
Airway monitoring
Keep talking to your patient
Breathing check
Don’t forget to auscultate your patient
Circulation monitoring
When in doubt check bilateral limb BP and radio-femoral delay
Disability(neurological monitoring)
Keep an eye when your patients walking
Expose and look for problems
Keep an eye on all tubes and wires
Pain management is must
5. A
• ACIDOSIS
• AORTIC
DISSECTION
• ALCOHOL
• AIRWAY
B • BREATHING
• BABY
C
• CIRCULATION
• COMPRESSION
• COOLING
D
• DISABILITY
• DEFIBRILLATION
• TRENDELENBURG
POSITION
E
• EXPOSURE
• EFFUSION
• EMBOLISM
• ECG
6. Guidelines for monitoring the
patients in ICU:
Decrease anxiety & fear: reassure, sedation
Assess: all physiological parameters
Inspect & examine pt.: LOC, secretions etc.
Vitals : TPR BP RR HR Pao2, paco2, urine output
Weight gain
Capillary refill: 3-5 sec
Phy. Exam: head to toe & systematic
ETT, Airway, subcutaneous emphysema, chest tube,
Skin temp, gastric distention
All relevant Laboratory reports: ABG, BUN, LFT etc.
Prof. Dr. R S Mehta, BPKIHS 6
30. What is Clinical
Documentation?
Clinical documentation in a patient's
record includes any and all
documentation that relates to the care of
the patient during the patient's stay or
encounter.
30Prof. Dr. RS Mehta, BPKIHS
31. In the inpatient setting, some of the important
pieces of the patent’s clinical documentation
include:
• Patient History & Physical examination
• Progress Notes
• Orders
• Procedure Reports
• Anesthesia Reports
• Pathology Reports
• Radiology/Nuclear Medicine Reports
• Cardiology Reports
• Consultation Reports
• Notes Provided by Nursing Staff
• Discharge Summary
31Prof. Dr. RS Mehta, BPKIHS
32. Why is Clinical
Documentation Important
• Patient Care & Quality
• Legal Protection
• Operations and Management
• Strategic and Financial Planning
• Research
• Reimbursement & Revenue
32Prof. Dr. RS Mehta, BPKIHS
33. The move toward Electronic Medical Records
(EMRs)
and Critical Care Information Systems (CCIS)
33Prof. Dr. RS Mehta, BPKIHS
34. SEVEN Cs OF CRITICAL CARE
Compassion (empathy, concern)
Communication (with patient and family).
Consideration (to patients, relatives and
colleagues) and avoidance of Conflict.
Comfort: prevention of suffering
Carefulness (avoidance of injury)
Consistency
Closure (ethics and withdrawal of care).
34Prof. Dr. RS Mehta, BPKIHS