How Do I Become an ICU Nurse?

ICU is the Intensive Care Unit, also known as the Integrated Treatment Unit of the Intensive Care Unit. Treatment, nursing, and rehabilitation can be performed simultaneously. It provides isolation and equipment for patients with severe or coma, and provides the best care, comprehensive treatment, Medical and nursing integration, early postoperative rehabilitation, joint care sports therapy and other services. Targeted monitoring supplies are also known as intensive care units. It is a form of medical organization management that integrates modern medical, nursing, and rehabilitation technologies with the common development of medical, nursing, and rehabilitation professions, the birth of new medical equipment, and the improvement of hospital management systems.

The ICU brings together the critically ill patients and gives them the best protection in terms of manpower, material resources, and technology, with a view to obtaining good treatment results. ICU has a central monitoring station that directly observes all monitored beds. Each bed occupies a wide area, and the beds are separated by glass or cloth curtains. ICU is equipped with bedside monitors, central monitors, multi-function respiratory therapy machines, anesthesia machines, electrocardiographs, defibrillators, pacemakers, infusion pumps, micro-syringes, tracheal intubation and tracheostomy. CPM joint motion therapy care device and other equipment.

Chinese name: Intensive care unit
Foreign name: Intensive Care Unit

English abbreviations: ICU
Also known as: Intensive care unit
Chinese abbreviation: ICU

Development of intensive care unit

ICU has a history of more than 30 years in the world and has now become a rescue center for critically ill patients in hospitals. The ICU's level of monitoring and whether the equipment is advanced has become an important indicator of the level of a hospital.

China's ICU started in the early 1980's and is growing faster and faster. At present, hospitals above the second level in China must be equipped with a monitoring room.

In the late 1970s, China's reform and opening up brought advanced medical care technology back home.

In the 1980s, China's domestic ICU business stage was mainly manifested by the establishment of a major in critical care.

In the 1990s, the establishment of the ICU became a reflection of the hospital's treatment of critically ill patients and an important symbol of hospital modernization.

After 2000, the development of intensive medicine has more prominently demonstrated systematization and standardization, and especially the development of hospitals has increasingly shown his influence on the international stage.

Classification of intensive care units

ICU is divided into comprehensive ICU and specialized ICU (such as burn ICU, cardiovascular surgery ICU, neonatal ICU, etc.) and some comprehensive ICU.

Specialist ICU: Cardiac Intensive Care Unit (CCU), Respiratory Intensive Care Unit (RCU), etc. CCU is one of the specialized ICUs. The first C is the abbreviation of Coronary heart disease, which is specially designed for severe coronary heart disease.

Comprehensive ICU: admission to critically ill patients in various departments of the hospital.

Partial comprehensive ICU: It is between comprehensive ICU and specialized ICU. Such as surgical ICU, internal medicine ICU, anesthesia ICU and so on.

Intensive care unit intensive care unit

Those who have severe trauma, major surgery and continuous and close monitoring and support of vital indicators;
Patients in need of CPR;
Organ failure (including heart, brain, lung, liver, kidney) failure or multiple organ failure;
Severe shock, sepsis and poisoning, physical and chemical factors leading to critically ill patients;
Patients with severe multiple injuries and multiple injuries
Patients with severe complications of myocardial infarction, severe arrhythmia, acute heart failure, unstable angina pectoris
Various postoperative critically ill patients or older, critically ill patients who may have accidents after surgery
Patients with severe water, electrolyte, osmotic pressure, acid-base imbalance
Patients with severe metabolic disorders, such as patients with endocrine crisis such as thyroid, adrenal gland, pituitary
Those who need to be monitored and strengthened before and after organ transplantation. After his condition improved, he returned to the general ward.

Intensive care unit ward equipment

ICU has a central monitoring station that directly observes all monitored beds. The area of each bed is 15-18, and the beds are separated by glass or cloth curtains. ICU equipment must be equipped with bedside monitors, central monitors, multi-function respiratory therapy machines, anesthesia machines, electrocardiographs, defibrillators, pacemakers, infusion pumps, micro-syringes, oxygen devices in standby, trachea Emergency medical equipment such as intubation and tracheotomy. In the better condition hospitals, there are also blood gas analyzers, microcomputers, electroencephalographs, B ultrasound machines, bedside X-ray machines, hemodialysis machines, intra-arterial balloon counterpulses, hematuria routine analyzers, blood Biochemical analyzer, etc.

In addition, there are also Pediatric Intensive Care Unit (PICU); Neonatal Intensive Care Unit (NICU); Medical Intensive Care Unit (MICU); Cardiovascular Intensive Care Unit (CCU); Cardiac Surgery Intensive Care Unit (ICCU) CICU); Emergency Intensive Care Unit (EICU); Neurosurgical Intensive Care Unit (NSICU).

ICU Intensive care intensive care unit ICU

ICU treats all kinds of critically ill patients. Different patients often need different emphasis on monitoring and treatment, so it is impossible to formulate a unified ICU monitoring program suitable for each patient. However, ICU patients have a common feature, that is, they are critically ill. In addition to special monitoring, they need at least basic daily monitoring, that is, general monitoring.

General guardianship

Monitor heart rate, ECG and breathing with a monitor; record respiratory rate and blood pressure at least once every hour; measure and record body temperature every 2 hours; strictly record the amount of input and output; measure urine specific gravity, urine routine and ketone body every 8 hours, Check the fecal occult blood once; accurately measure the weight once a day, and accurately record the heat snap-in amount once.

2. Special Guardianship

Varies by illness:

1) Intravascular intubation patient monitoring: change the catheter irrigation fluid, intravenous fluid, infusion tube and dressing daily. When changing dressings, check the catheter site for signs of infection. If the catheter is placed for a long time, take a sample from the catheter for bacterial culture at least every 3 days. In patients with catheters placed in the central vein, artery, or pulmonary artery, fever above 38.5 ° C should be used for peripheral blood culture, and blood should be taken from each catheter for culture. If the patient has symptoms of sepsis or a positive blood culture, remove the infected catheter. If the catheter is still needed, the catheter needs to be replaced and re-intubated. When the catheter in the artery, central vein or pulmonary artery is removed, the tip of the catheter should be sampled and cultured. Catheters inserted into arteries, central veins, and pulmonary arteries, and screw-locked joints should be used at each connection of the pipeline to prevent accidental shedding and bleeding and air embolism.

2) Monitoring of tracheal intubation and tracheotomy patients: proper methods are needed to fix oral tracheal intubation, nasal tracheal intubation and tracheotomy cannula, and the limbs must be restrained and fixed. Clear the secretions in the intubation or cannula in time, sucking sputum at least every two hours. Check the tracheal aspirate at least weekly for Gram-stained bacteria and sensitivity tests twice.

3) Monitoring of peritoneal dialysis patients: To prevent infection, catheter placement should be performed in the operating room. Use a closed sterile drainage device. Drainage devices should be replaced once a day, gloves and masks should be worn when changing, and strict attention should be paid to aseptic operation techniques. When replacing the drainage tube, the drainage fluid should be counted, classified, Gram stained, and cultured to observe the occurrence of peritonitis. When hypertonic glucose is used for the dialysate, blood glucose is measured every two hours. When using potassium-free dialysate to reduce blood potassium, the blood potassium should be measured every 4 hours until the blood potassium is normal. When the potassium level is changed to a potassium-containing dialysate, the number of potassium levels can be reduced. If the amount of dialysate is too large, it can cause excessive abdominal distension, increase blood pressure and respiratory insufficiency, and should be observed carefully.

4) Surveillance of comatose patients: closely monitor the neuropsychiatric state (see coma).

There are two types of patients to be isolated: one is an infectious disease patient and is contagious to others; the other is not itself an infectious disease, but is susceptible to infection due to the disease. The isolation techniques and treatment of patients with severe infectious diseases are the same as those in general infectious diseases. As for critically ill patients who have no infectious disease and need protective isolation, this is a special problem in the ICU. Patients with severe burns (area> 15%, second- or third-degree burns), and immunocompromised patients (especially those undergoing bone marrow transplantation) need protective isolation. It is best to separate protective isolation from infectious disease isolation. If only the same isolation area can be used due to conditions, the same nurse cannot take care of two patients who need isolation.

Cases admitted to intensive care unit

October 2018, 28 years old in Suzhou

Little Li was taken to Suzhou Municipal Hospital by his family due to unbearable abdominal pain. After a series of examinations, it was found that triglyceride levels were more than 20 times higher than normal, and CT showed swelling of the pancreas, which was hyperlipidemic acute pancreatitis. Taking into account the critical condition of Xiao Li, she was urgently sent to the nephrology department for plasma exchange treatment.

According to the headquarters of Suzhou Municipal Hospital, when Xiao Ligang was admitted to the hospital, there was a thick layer of oil on the blood that was used to check the blood. "The patient is obese and weighs an astonishing 230 pounds. With diabetes, hyperlipidemia will increase blood viscosity, cause pancreatic microcirculation disorders, and eventually lead to the occurrence of acute pancreatitis. The main reason for this is inattention to diet."

In order to relieve Xiao Li's abdominal pain and prevent the disease from developing. The hospital's emergency department immediately performed a plasma exchange for its nephrology department. The normal plasma is pale yellow, but the milky white liquid replaced by Xiao Li. The two sacks of milky "milk blood" surprised the doctors present. After emergency treatment, Xiao Li was finally out of danger. ^[1]