What is Critical Care Nursing?

• Subspecialty within nursing that deals specifically with human

responses to life-threatening problems
Scope of Critical Care Nursing
• The scope of Critical care nursing is described as a dynamic process
and provides a framework within which an individual can receive a
service.

Three components:
• Critical care patients and Their significant relationships
• The critical care nurse
• The environment where critical care nursing is
practiced
Critical care patients and Their significant
relationships
• Biophysical component that is undergoing crisis
• May have extraordinary dependence to healthcare team or
technology for survival

• Needs: Physical and non-physical

Critical Care Nurse
• Assessment
• Sound Clinical Judgement
Critical Care Nursing is based on the following principles:
Accountability
Knowledge
Recognition and appreciation of holistic
nursing practice
Critical Care Environment
• PATIENT
• NURSE
• ENVIRONMENT

• The goal of the CCN is to ensure that effective interaction of these 3

components occurs
AMI /ACS
 Myocardial Infarction
• Is the irreversible death (necrosis)
of the heart muscle secondary to
prolonged lack of oxygen
(Ischemia).
• Causes:
Atherosclerosis (90%)
Non-atherosclerosis (vasculitis,
vasospasm, acute pulmonary
disorders)
MI-Risk Factors and Types

• Non modifiable: age, sex, family

history
• Modifiable:
Smoking
DM
Hypercholesterolemia
Sedentary Lifestyle
 Acute Coronary Syndrome
• Is a spectrum of conditions
associated with sudden reduced
blood flow to the heart.
• Two main categories:
Non ST segment elevation MI
ST segment elevation MI
*patients with chest discomfort may
or may not have ST segment or T wave
changes on ECG
Case • 50 year old male
• Hypertensive
• Diabetic
• Smoker
• Experienced body malaise, fatigue,
chest discomfort 3 days ago
• Substernal chest pain 9 AM
• Arrived at ER 930 AM, still having
chest pain 6/10, radiating to left
side of his neck down to his left
arm and diaphoretic
• BP 140/80, HR 98 RR 18 T 37
Diagnostics
• Laboratory Studies
Cardiac Biomarkers- ACC/AHA and ESC recommends that biomarkers
should be measured at presentation in patients with MI;
Troponin- shall be used in diagnosing acute MI due to superior
sensitivity and accuracy
CBC, electrolytes
• ECG
• Echocardiogram
• Coronary Angiography
Management
Management
• Cardiac Catheterization
• Fibrinolysis Laboratory
Streptokinase • Emergency Angiography
rTPA • Coronary Angioplasty
• IABP
• Pacing wire insertion
• PA Catheter insertion