Resusciation equipments in icu

Intensive care unit (ICU) equipment includes patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation devices, and other life support equipment.

1. RESUSCITATION EQUIPMENTS IN ICU Dr. VINOLI.S.G Professor Cum HOD Medical Surgical Nursing Dept Universal College of Nursing Bangalore

2. INTRODUCTION Intensive care unit (ICU) equipment includes patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation devices, and other life support equipment. They are 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. 10/6/2020 2 DR.VINOLI.S.G

3. TYPES OF DEVICES Intensive care unit equipment includes 1) Patient monitoring devices 2) Life support and emergency resuscitation devices, and 3) Diagnostic devices 10/6/2020 3 DR.VINOLI.S.G

4. PATIENT MONITORING EQUIPMENT • Arterial line • Bed side monitor • Blood pressure device (sphygmomanometer ) • Blood pressure monitor • Electrocardiograph(ECG or EKG machine) • Electroencephalograph(EEG machine) • Intracranial pressure monitor • Pulse Oximeter • Glucometer 10/6/2020 4 DR.VINOLI.S.G

5. LIFE SUPPORT AND EMERGENCY RESUSCITATION DEVICES • Mechanical Ventilator • Laryngoscope • Airway • Infusion pump • Crash cart(Resuscitation cart) • Intra aortic balloon pump (IABP) •Continuous Positive Air Pressure Machine (CPAP) • Defibrillator 10/6/2020 5 DR.VINOLI.S.G

6. DIAGNOSTIC EQUIPMENT • Mobile x-ray units • Portable clinical laboratory devices • Bronchoscope • Colonoscopy • Endoscope • Gastroscope 10/6/2020 6 DR.VINOLI.S.G

7. Tubes & Catheters in the ICU Disposable ICU equipment includes 1 . Urinary catheter 2 . Urinary drainage collector 3 . Suction catheter 4 . Nasogastric (NG) tube 5 . Intravenous(IV) line or catheter 6 . Feeding tube 7 . Breathing tube ( Endotracheal tube ) 8. Central venous catheter (CVC) 9. Shunt 10/6/2020 7 DR.VINOLI.S.G

8. ARTERIAL LINE Arterial line placement is a common procedure in various critical care settings. Intra-arterial blood pressure (BP) measurement is more accurate than measurement of BP by noninvasive means, especially in the critically ill. 10/6/2020 8 DR.VINOLI.S.G

9. PURPOSES Patients may require an arterial line for: 1.Monitoring continuous blood pressure especially in patients with hemodynamic instability. 2 . When vasoactive medications are needed and the responses to such medications require continuous blood pressure monitoring. 3 . For patients who require frequent blood sampling. 10/6/2020 9 DR.VINOLI.S.G

10. COMPLICATIONS Potential Complications Associated With Arterial Lines Hemorrhage Air Emboli Infection Altered Skin Integrity Impaired Circulation 10/6/2020 10 DR.VINOLI.S.G

11. CENTRAL I.V CATHETERS A central venous catheter is a special IV line that is inserted into a large vein in the body. Several veins are used for central venous catheters including those located in the shoulder ( subclavian vein), neck (jugular vein), and groin (femoral vein ). 10/6/2020 11 DR.VINOLI.S.G

12. Purposes of central vein I.V catheter • W hen the patient either does not have adequate veins in the arms or needs special medications and/or nutrition that cannot be given through the smaller arm veins. • Serve as a guide of fluid balance in critically ill patients. • Determine the function of the right side of the heart. 10/6/2020 12 DR.VINOLI.S.G

13. Nurses role in patient with central I.V lines 1 . Monitor for the signs of complications. 2 . Assess for patency of the CVP line. 3 . Sterile dressing should be done to prevent infection (CVP care per the hospital protocol) 4.The length of the indwelling catheter should be recorded and regularly monitored. 5 . Follow strict aseptic technique when handling CVC 10/6/2020 13 DR.VINOLI.S.G

14. BEDSIDE MONITOR/CARDIAC MONITOR • A bedside monitor is a display of major body functions on a device that looks like a television screen or computer monitor . • The monitor is attached to wires, called leads. At the other end, the leads are attached to sensing devices attached to the patient's body . 10/6/2020 14 DR.VINOLI.S.G

15. The sensing device sends electronic signals to the monitor, which displays the readings for the specific body function being monitored. • The monitor is typically used when the doctor wants to measure functions like the heart rate, respiratory rate, blood pressure and temperature. 10/6/2020 15 DR.VINOLI.S.G

16. ELECTROCARDIOGRAPHIC (ECG) • Electrocardiographic (ECG) monitoring is routinely used in hospitals for patients with a wide range of cardiac and non-cardiac diagnoses. • Besides simple monitoring of heart rate and detection of life-threatening arrhythmias, the goals of ECG monitoring include detection of myocardial ischemia , diagnosis of complex arrhythmia, and identification of a prolonged QT interval. 10/6/2020 16 DR.VINOLI.S.G

17. ELECTROENCEPHALOGRAPHY (EEG) Electroencephalography, technique for recording and interpreting the electrical activity of the brain. The measurements given by an EEG are used to confirm or rule out various conditions, including: seizure disorders (such as epilepsy ), head injury, Encephalitis brain tumor, memory problems, stroke etc. 10/6/2020 17 DR.VINOLI.S.G

18. INTRACRANIAL PRESSURE MONITOR • Patients with brain injury of any etiology are at risk for developing increased intracranial pressure. • Acute intracranial hypertension is a medical emergency requiring immediate intervention to prevent permanent damage to the brain • Intracranial pressure (ICP) data from electronic monitoring equipment are usually calculated and recorded hourly in the clinical chart by trained nurses. 10/6/2020 18 DR.VINOLI.S.G

19. PULSE OXIMETERY • Pulse oximetry is universally used for monitoring patients in the critical care setting . • A pulse oximeter is the device that measures and displays the oxygen arterial saturation. 10/6/2020 19 DR.VINOLI.S.G

20. LIFE SUPPORT AND EMERGENCY RESUSCITATION DEVICES Mechanical ventilator Defibrillator 10/6/2020 20 DR.VINOLI.S.G

21. I.V INFUSION PUMPS • An external infusion pump is a medical device used to deliver medications & fluids into a patient’s body in a controlled manner. • Infusion pumps may be capable of delivering medications & fluids in large or small amounts, and may be used to deliver nutrients or medications – such as insulin or other hormones, antibiotics, chemotherapy drugs, and pain relievers. 10/6/2020 21 DR.VINOLI.S.G

22. TYPES A number of commonly used infusion pumps are designed for specialized purposes. These include: • Enteral pump - A pump used to deliver liquid nutrients and medications to a patient’s digestive tract. • Patient-controlled analgesia (PCA) pump - A pump used to deliver pain medication, which is equipped with a feature that allows patients to self-administer a controlled amount of medication, as needed. • Insulin pump - A pump typically used to deliver insulin to patients with diabetes. Insulin pumps are frequently used in the home 10/6/2020 22 DR.VINOLI.S.G

23. Nurses role in patient with I.V infusion pump • Using aseptic technique and universal precautions, IV infusion should be set. • Monitor the pump and patient frequently to ensure correct operation. • Keep the pump plugged in when possible to ensure that the battery is fully charged at all times. • Set the flow rate as prescribed calculating the amount of fluid. • Observe for the signs of infiltration or other complications such as thrombophlebitis . • Fluid or electrolyte overload and embolism before administration. 10/6/2020 23 DR.VINOLI.S.G

24. RESUSCITATION CART (CRASH CART) The Resuscitation cart contains all of the equipment and medications needed for advanced life support and CPR (cardiopulmonary resuscitation ). 10/6/2020 24 DR.VINOLI.S.G

25. PURPOSES OF RESUSCITATION CART (CRASH CART) To enhance the Code Blue team’s response to patients with emergency medical situations by providing immediate access to supplies and medications. A specific crash cart type facilitates staff familiarity with equipment It is help to ensure a properly stocked emergency cart will be readily available It also ensures a properly functioning defibrillator will be readily available. It helps to save the valuable time at the time of emergency. 10/6/2020 25 DR.VINOLI.S.G

26. CONTENTS RESUSCITATION CART (CRASH CART) • Monitor/defibrillators , suction devices, and bag valve masks (BVMs) of different sizes. • Advanced cardiac life support (ACLS) drugs such as 1. Epinephrine 2 . Atropine 3 . Amiodarone 4 . Lidocaine 5 . sodium bicarbonate 6 . Dopamine and vasopressin. 10/6/2020 26 DR.VINOLI.S.G

27. CONTENTS RESUSCITATION CART (CRASH CART) Drugs for rapid sequence intubation: succinylcholine or another paralytic , and a sedative such as etomidate or midazolam ; endotracheal tubes and other intubating equipment & different sizes of ET tubes. Drugs for peripheral and central venous access Pediatric equipment (common pediatric drugs, intubation equipment, etc.) 10/6/2020 27 DR.VINOLI.S.G

28. Some common items used in Critical care unit Bed pad Bedpan Gloves Hand-washing Foam Hospital Beds and Mattresses Hospital Clothing Intravenous (IV) Feeding Intravenous (IV) Fluids Liquid Tube Feeding Oxygen Supply Drug supply etc. 10/6/2020 28 DR.VINOLI.S.G

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