Introduction to icu.pptx

ICU setup and design.

1. INTRODUCTION TO ICU MS. JASKEERATAN KAUR ASSISTANT PROFESSOR (SCHOOL OF HEALTH CARE AND PARAMEDICAL SCIENCES)

2. Definition ICU is a dedicated facility for critically ill patients who required invasive life support, High levels of medical and nursing care and Complex treatment. These specialty units are designed, equipped and staffed to treat critically ill patients or those requiring specialized care and equipment.

3. Objective To provide appropriate and specially equipped place for the management of critically patients and those requiring specialized care/monitoring. Critical care provided by ICU varies depending on role of particular hospital, staffing, equipment and availability of support services.

4. TYPES OF ICU ICU,s may be multi-disciplinary, or single decentralized speciality units such as, Cardiac care unit Neonatal icu Pediatric icu Neurology icu Neurosurgery icu Burn care centre/unit Organ transplant unit

5. Key planning and design parameters Location No. of icu beds Size of units Bed space Lighting Environment control Doors Beds Bed head panel

6. Electrical requirement (minimum 6) Minimum space to allow resuscitation and other procedures Visibility of patients Equipment installation storage /utility area Visitor waiting area Nursing station

7. Location Close proximity to Operation Theatre, accidental and Emergency Department and Medical Imaging Department (Radiology). Sterile supply Department (CSSD), Pathology, medical laboratory unit, pharmacy Located within unit.

8. No. of icu beds No. of beds required depends on the type of hospital and services it provides. it is recommended that at least 5% of total hospital beds may be designed as icu beds. However, in cardiac and neurosurgical centers, about 10-15% beds may be icu beds.

9. Size of unit At least 6-12 beds is recommended. Unit <6 beds is economically not viable, where requirement >12 beds, multiple units may be planned. Icu may be planned as a single room having beds or individual single bed accommodation. Separate cubicle/bedrooms should have dimensions of 4.0m x 4.0 m

10. Bed space Bed space should be 2-3 times more than general bed; 22m 2 of floor area for single bed accommodation which is exclusive of services area and 20m 2 for multiple bed accommodation is recommended.

11. Lightning 300 lux light illumination is recommended for patient area with anti-glare arrangement, 100 lux for corridor, 150 lux for staff area and floor light for monitoring drainage seal and suction equipment, Moreover, provision of natural light should be made to maximum. Colour of walls and ceiling should not affect perception of skin colour by staff.

12. Environment control Sound proof Recommended noise level : range 35-50 decibels. Air conditioned with facilities of environmental control for each room. Air conditioning should ensure 50-55% humidity, 20-24 degree temperature . Ceiling, flooring and walls should be constructed of material with high sound absorption capabilities.

13. Environment control Recommendation for ventilation in icu: 8-10 air changes per hour and positive air pressure maintained. Special provision exhaust to eliminate any odour in icu as when required.

14. Doors To facilitate easy p assage of equipment, stretcher best door having width of 1.25m are recommended.

15. Beds Mechanically or electronically operated beds should be provided in icu. Adjustable to therapeutic positions and should have x ray transparent bedstead bottoms. Base of bed should be firm to enable effective cardiac compression during resuscitative procedures as and when required. Detachable rails at head end to facilitate tracheal intubation, if required.

16. Bed head panel Minimum Two 02 outlets, Two inlets of suction, One compressed air outlet per bed, Wall mounted monitoring and Blood pressure equipment.

17. Electrical requirements(minimum 6) Backup source of power from emergency generator in event of power failure from primary source.

18. Minimum space to allow resuscitation and other procedure Minimum space 0.9m between head end and wall and 1.2m between foot end and wall. Recommended to have minimum distance of 3.5m between centre of two adjacent beds. These spaced are required to facilitate resuscitative procedures, endotracheal intubation and use of radiology equipment.

19. Visibility of patients Should be visible from nursing station. There should be individual rooms with full height glass walls between room and corridor. Curtains may be drawn over glass walls as and when required. Need of patient privacy should be an essential design consideration.

20. Storage area: easily accessible BY STAFF Visitor waiting area: provide outside icu

21. Nursing station location provide optimum visual observation of patients. provision of computerized individual monitor at bed side with automatic communication to computer located at the nursing station. Hand washing facilities for staff and visitors. Staff changing and rest room should be separate for male and female staff. Other imp: depending on type of health care facility, an icu bed may be equipped with wall mounted or portable hemodialysis unit.

22. An ICU Is Filled With Various Different Types Of Medical Equipment Such As – • Mechanical Ventilators • Dialysis Machine • External Pacemakers • Syringe Pump • Infusion Pump • ECG ( Electrocardiogram ) • Defibrillator • Ventilators • Blood Warmer • Patient Monitor • Feeding Tubes(NG/ Ryles Tube), Suction Tubes(Suction Catheter), Etc.

23. The Most Common Injuries Which Definitely Need An ICU Treatment Are • Patients Who Are Having Severe Heart Problems Like Heart Attack, Extremely Low Blood Pressure . • Problems Faced By The Patients In The Respiratory System Due To Asthma Or Complicated Pneumonia . • Accidents That Cause Severe Conditions Need Major Surgery And Immediate Action . • Patients In Coma Definitely Need ICU Treatment.