PUBLIC SECTOR TRAINING

KAMALA NEHRU HOSPITAL

INTENSIVE CARE UNIT (ICU) GUIDED BY: Dr.D.K.Shirole

SUBMITTED BY: PALLAVI SARVAIYA() AISHWARIYA SHUKLA() KIRTHI KURAKULA() VRUSHALI KHNDZODE() SNEHAL KABARA()

KAMALA NEHRU HOSPITAL

Kamala Nehru Hospital is a 500 bedded hospital which provides primary and secondary Health services under Pune Municipal Corporation The hospital currently has an ICU which is non functional.

 ICUs are specialty nursing units designed, equipped and staffed with especially skilled personnel for treating very critical patients or those requiring specialized care and equipment. ICUs use sophisticated electronic instruments for Observations Signaling Recording and Measuring physiological functions besides monitoring temperature, BP and respiration rates.

ICU

Location
ICU should be in a centralized place and be contiguous with or readily accessible to other related departments. The ICU in KAMALA NEHRU hospital is located on the first floor which is ideal as per the hospitals architecture .

Some points to consider while designing ICU

1. DETERMINIG THE NO. OF ICU BEDS

By the rule of thumb it is recommended that a minimum of 10 % of the total beds be designated to the ICU . Considering Kamala Nehru Hospital which offers primary and secondary care should be 15-20 beded. Designed: functions ,accessibility and direct visual contact between the patient beds or rooms and the nurses station are of paramount important in designing ICU. The design should provide for minimum visibility of the patient, not only of the monitor. Ideally the nursing should be placed centrally in the icu so as to provide maximum visibility.

2. SPACE REQUIREMENT

Individual rooms with full height glass walls between the rooms and the corridor are recommended . This will allow visibility of patient and minimize cross infection. The entrance doors to rooms should be 3 feet 8 inches, for easy movement of beds and large equipments Rooms should be at least 120 sq feet with free moveable space surrounding the bed. In order to increase free flow space their should be minimum amount of movable furniture such as a bed , a chair, and overbed table.

 The central control station should be designed to seat two or three persons only. This will discourage staff from frequenting or idling in that area. One or more emergency carts also called crash carts ,red carts or blue carts ,depending on local preference should be kept ready in each icu immediately accessible to the icu nursing station.

3. EQUIPMENTS USED IN ICU Catheter A flexible plastic tube of varying sizes for withdrawing fluids from, or introducing fluids into, a cavity of the body. Frequently used to drain the urinary bladder. Central Venous (CVP) Line A very thin tube which is inserted into a vein to measure the venous blood pressure (the pressure of the blood as it returns to the heart). Chest Tubes Tubes inserted into the chest between the lung and ribs to allow fluid and air to drain from the area surrounding the lungs. Removing this fluid and air from around the lungs allows them to more fully expand Electrocardiogram (ECG/EKG) The recording made by small, round electrode pads located on the patient's chest to monitor heart rate and rhythm. These are connected to a monitor and uses routinely in the intensive care unit.

 Endotracheal Tube (E.T. Tube) GI Tube A tube inserted through a surgical opening into the stomach. It is used to introduce liquids, food, or medication into the stomach when the patient is unable to take these substances by mouth. Intracranial Pressure (ICP) Monitor A monitoring device to determine the pressure within the brain. It consists of a small tube (catheter) attached to the patient's skull by either a ventriculostomy, subarachnoid bolt or screw and is then connected to a transducer, which registers the pressure. Intravenous (IV) Tubing inserted into a vein through which fluids and medications can be given.

 The following items should be placed on the wall of the head end of each bed or on a free standing column 1.Medical gas outlets- 2 for oxygen , 1 for compressed air and 2 for suction. 2. Nurses call button 3. Telephone outlet optional 4. Electrical outlets- for ceiling lights ,dimmers, high intensity lights for examination and treatment. Outlets should be no lower than 76.2 cm off the floor 5. Wall mounted blood pressure equipment with a cuff basket for which bed 6.Recessed plastic pan below the medical gas module to hold vaccumm bottles

4. HUMAN RESOURCES At least 1 MBBS doctor specialist in emergency handling. Doctor should be available on call basis. Ideally a ratio of 3:1 of nurses for 3 shifts of the day should be there. More nurses are required per no. of patients in the ICU.