This document outlines the principles and organization of a critical care unit. It discusses the importance of anticipation, early detection, collaborative practice, communication, and infection prevention. It recommends that critical care units have a single entry/exit, be located near emergency rooms and operating theaters, and have spacious corridors for patient transport. The document also provides guidance on bed strength, bed space requirements, necessary medical equipment, and staffing ratios for critical care units.

1. PRINCIPLES OF CRITICAL CARE
UNIT
KUSUM LATA
(Nursing Trainer)
GNC SLBSGMCH
(Nerchowk)

2. PRINCIPLES
• Anticipation
• Early detection and Prompt Action
• Collaborative Practice
• Communication
• Prevention of infection
• Crisis intervention and Stress Reduction

3. ORGANIGATION OF CRITICAL CARE
UNIT
• DESIGN CONSIDERATION:
1. Critical Care Unit is vital area in the hospital
and organization of a critical care unit and it
is a strategically planned process.
2. There should be a single entry and exit.
However, it is required to have emergency
exit point in case of emergency and disaster.

4. DESIGN OF ICU
3. There should not be any traffic of goods or
hospital staff. Supply and professional traffic
should be seprated from public/visitor traffic.
4. Safe , easy ,fast , transport of a critically sick
patient should be a priority in planning its
location. Therefore, the ICU should be located
in close proximity or ER, OT, Trauma ward etc.
5. Corridor, lifts and ramps should be spacious
enouh to provide easy movement of bed/trolley
of a critically sick patient.
6. Close ,easy proximity is also desirable to
diagnostic facilities, blood bank , pharmacy etc.

5. Continue…
• 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.

6. Continue……
• 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.

7. Continue………..
• ASSESSORIES:
1. 3 Oxygen 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 bed side.
4. Equipment shelf at the head end.
5. Hooks and devices to hang infusions/ blood
bags , extended from the ceiling with a
sliding rail to position.

8. Continue………………..
6. Infussion pump should 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 lights,
defibrillators, anaesthesia machines and
difficult airway management equipments are
necessary.

9. Continue…………….
• STAFFING:
1. Medical Staff- The best senior medical staff to
be appointed as an Intensive Care Director. Less
preffered are other specialists from
anaesthesia/medicine who has clinical
commitment elsewhere. Junior staff are
intensive care trainers and trainees on
deputation from other deciplines.
2. Nursing Staff-The major teaching tertiary care
ICU requires trained nurses in critical care.

10. Continue….
• The number of nurses ideally required for such
unit is 1:1 ratio.So 1 nurse for 2 patients is
acceptable. The no of trained nurses should be
worked out by the type of ICU.
3.Allied Services- Respiratory services, nutritionist ,
physiotherepist , biomedical engineer,
technicians ,computer programmer, clinical
pharmacist, social worker ,counsellors and other
support staff, guards and guard IV workers.