I.C.U (--General Units--)

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Our Emergency Department team of medical professionals has made a commitment to see patients within 30 minutes.

I.C.U (--General Units--)

INTENSIVE CARE UNITS

· ICU is one of the hospital units through which a high quality of patient’s care is applied.

ICU may involve one specialty or general admitting all critically ill patients

ADMISSION CRITERIA

§ Patients admitted to the ICU when their management requires or potentially require advanced intervention in their airway, breathing or circulatory support.

§ Patients may be admitted to the ICU when they require intensive monitoring such as major postoperative or impending need for airway, breathing or circulatory support.

§ Al post CPR patients must be admitted to the ICU.

§ Patients whose prognosis will not be altered by critical care support (such as terminally ill patients) are not considered candidate for ICU admission.

PRIORITIES

· Priority I:-

Critically ill, unstable patients, in need of intensive treatment and monitoring that can not be provided outside the ICU. This include, ventilator support, continuous vasoactive drug infusion.

Examples:- postoperative , acute respiratory failure, shock in previously healthy patient.

· Priority II:-

Require intensive monitoring and potentially need immediate intervention.

Examples:- patients with co morbid conditions who develop acute severe acute medical or surgical illness.

· Priority III:-

Unstable critically ill patients, who have reduced likehood of recovery of an underlying disease or nature of their acute illness.

Example:- patients with metastatic malignancy complicated by an acute event such as airway obstruction or infection.

· Priority IV:-

Generally regarded as not candidates for ICU admission.

General:-
©After cardiopulmonary – cerebral resuscitation.
©Any patient need invasive monitoring.
©Shock and circulatory dysfunction (hypovolemic – septic – cardiogenic - ,,).
©Drug abuse, overdose and withdrawal syndromes.
©Drowning and near drowning.
©Heat stroke – hyperthermia – hypothermia.
©Anaphylactic reactions.
©Immunocompromized patients.
©Multiple organ dysfunction
©Any bleeding disorders with hemodynamic unstability.
Trauma:-
©Any trauma patient in need for close monitoring and hemodynamic support.
©Head trauma.
©Burn and inhalational injury.
Cardiovascular disorders:-
©Acute coronary syndrome
©Acute vascular embolism
©Advanced valvular heart disease.
©Aortic dissection
©Massive pericardial effusion and pericardial tamponade.
©Acute vascular embolism
©Hypertensive emergency
©Advanced heart failure
©Post cadiac surgery.
©Tachy- or brady-arrythmia
Pulmonary disorders:-
©Airway obstruction
©Acute exacerbation of COPD
©Acute exacerbation of bronchial asthma
©Respiratory failure
©Advanced pleural disease (massive effusion, pneumothorax ,,,,,)
©Any patient need mechanical ventilation
©Pneumonia and aspiration with respiratory decompensation
©Any patient in need for MV.
©Acute lung injury and ARDS
©Pulmonary embolism and deep venous thrombosis.
©Pulmonary hypertension with hemodynamic unstability.
Endocrinal and metabolic disorders:-
©Thyroid emergency (hypothyroidism and thyroid storm).
©Duabetic emergencies (Diabetic coma and diabetic ketoacidosis)
©Adrenal insufficiency.
©Acid-base disorders.
©Electrolyte disorders
Abdominal Disorders:-
©Acute abdomen
©Severe GIT bleeding
©Hepatic failure
©Acute pancrititis
©Renal failure
Central nervous system:-
©Coma.
©Acute ischemic stroke
©Intracerebral heamorrhage
©Siezures and status epilepticus
©Post neurosurgery.
©Advanced neuromuscular disorders as myasthenia graves,,,,
Organ transplantation.
Cancer for organ support
Geriatric patient for organ support
Severe malnutrition and parenteral nutrition.
Post operative of major or complicated operations.
Systemic inflamotory response and severe sepsis.

CODE BLUE RESUSCITATION TEAM

· Purpose:- To administer Advanced Cardiac Life Support (ACLS) to individuals who have experienced a cardiopulmonary arrest.

· Policy:-

I. The Code Blue Resuscitation team shall include critical care specialist (Team leader), the patient's primary physician or his designee, critical care nurse, in addition to the charge nurse of ward where the code blue is tacking place and the security supervisor.

II. Hospital staff shall call and inform the switchboard the location of the code(floor, room &bed No.)

III. The switchboard immediately notify the ICU.

IV. Registered nurse assigned to the code team shall have a training in ACLS.

V. The Code Team shall be responsible for :-

§Responding immediately to the code blue.

§Conduction the code according to the current ACLS protocol.