Definition

Intensive care unit (ICU) equipment includes patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation devices, and other life support equipment designed to care for patients who are seriously injured, have a critical or life-threatening illness, or have undergone a major surgical procedure, thereby requiring 24-hour care and monitoring.

Purpose
An ICU may be designed and equipped to provide care to patients with a range of conditions, or it may be designed and equipped to provide specialized care to patients with specific conditions. For example, a neuromedical ICU would care for patients with acute conditions involving the nervous system or for patients who have just had neurosurgical procedures and would require equipment for monitoring and assessing the brain and spinal cord. A neonatal ICU is designed and equipped to care for infants who are ill, born prematurely, or have a condition requiring constant monitoring.

Patient monitoring equipment

Patient monitoring equipment includes the following:

Acute care physiologic monitoring systemContinuously measures and displays data on vital signs, such as heart rate, blood pressure, cardiac output, and blood oxygen levels. Pulse oximeteronitors the oxygen saturation in the blood. Intracranial pressure monitoreasures the pressure of fluid in the brain in patients with head trauma or other conditions affecting the brain (such as tumors, edema, or hemorraging). Apnea monitorontinuously monitors breathing to detect cessation in infants and adults at risk of respiratory failure.

Life support and emergency resuscitative equipment

ICU equipment for life support and emergency resuscitation include the following:

Ventilator (also called a respirator)ssists with or controls pulmonary ventilation in patients who cannot breathe on their own. Infusion pumpevice that delivers fluids intravenously or epidurally, including continuous anesthesia, drugs, and blood infusions. Crash cartortable cart containing emergency resuscitation equipment for patients who are "coding" (that is, their vital signs are in a dangerous range), including a defibrillator, airway intubation devices, resuscitation bag/mask, and medication box. Intra-aortic balloon pump device that helps reduce the heart's workload and helps blood flow to the coronary arteries for patients with unstable angina, myocardial infarction, or patients awaiting transplants.

The use of diagnostic equipment is also required in the ICU. Mobile x-ray units are used for bedside radiography, particularly of the chest. Portable clinical laboratory devices, called pointof-care analyzers, are used for blood analysis at the bedside to provide results much faster than if samples were sent to the central laboratory. Disposable ICU equipment includes urinary (Foley) catheters, catheters used for arterial and central venous lines, Swan-Ganz catheters, chest and endotracheal tubes, gastrointestinal and nasogastric feeding tubes, and monitoring electrodes.

Description
ICU equipment includes patient monitoring, life support and emergency resuscitation devices, and diagnostic devices.

Patient monitoring equipment

Acute care physiologic monitoring systems are comprehensive patient monitoring systems that can be configured to measure and display various parameters, such as an electrocardiogram (ECG), respiratory rate, blood pressure (noninvasive and invasive), body temperature, cardiac output, arterial hemoglobin oxygen saturation, mixed venous oxygenation, and end-tidal carbon dioxide, via electrodes and sensors connected to the patient. Each patient bed in an ICU has a physiologic monitor, and all monitors are networked to a central nurses' Pulse oximeters measure the arterial hemoglobin oxygen saturation of the patient's blood with a sensor clipped over the finger or toe. Pulse oximetry is usually a capability included in a physiologic monitoring system, but the ICU also uses dedicated pulse oximeters for some patients. Intracranial pressure monitors are connected to sensors inserted into the brain through a cannula or bur hole. These devices warn of elevated pressure and record or display pressure trends. Intracranial pressure monitoring may be a capability included in a physiologic monitor. Apnea monitors use electrodes or sensors placed on the patient to detect cessation of breathing, display respiration parameters, and trigger an alarm if a certain amount of time passes without a patient's breath being detected. Apnea monitoring may be a capability included in a physiologic monitor.

Life support and emergency resuscitative equipment

Ventilators consist of a flexible breathing circuit, gas supply, heating/humidification mechanism, monitors, and alarms. They are microprocessor-controlled and programmable, and regulate the volume, pressure, and flow of patient respiration. Ventilator monitors and alarms may be interfaced to a central monitoring system or information system. Infusion pumps employ automatic, programmable pumping mechanisms to supply the patient with fluids intravenously or epidurally through a catheter. The pump is hung on an intravenous pole, which is located next to the patient's bed.

Crash carts, also called resuscitation carts or code carts, are strategically located in the ICU for immediate availability when a patient experiences cardiorespiratory failure. The cart holds a defibrillator, which is used to apply an electric shock to a patient in ventricular fibrillation. Two paddles are placed on the patient's chest and buttons are pressed to discharge an electrical shock of approximately 2,000 to 4,000 volts. The cart also holds a resuscitator, which is inserted into the patient's airway, and a bag is pressed to push air into the lungs. Intra-aortic balloon pumps use a balloon placed in the patient's aorta to help the heart pump. The balloon is on the end of a catheter that is connected to the pump's console, which displays heart rate, pressure, and ECG readings. The patient's ECG is used to time the inflation and deflation of the balloon.

Diagnostic devices most commonly used in the ICU are mobile x-ray units, which can be pushed to the patient's bedside to take x rays using a battery-operated generator that powers an x-ray tube, and point-of-care blood analyzers, which are handheld devices that require a small amount of whole blood and display blood chemistry parameters.

Operation
The ICU is a demanding environment due to the critical condition of patients and the variety of equipment necessary to support and monitor patients. Therefore, when operating ICU equipment, staff should pay attention to the types of devices and the variations between different models of the same type of device, so as not to make an error in operation or adjustment.