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Navigating the realm of critical care, the Intensive Care Unit (ICU) at our esteemed medical facility is meticulously designed to provide the highest standards of care for patients requiring specialized attention. Let's delve into the intricacies of the ICU admissions process, investigations, initial management, admission criteria, and the rights and obligations of families involved in the care journey:
ICU/HDU Infrastructure:
A well-equipped ICU/HDU comprises a bed, and working monitor, and maintains an optimal nurse-to-patient ratio ranging from 1:1 to 1:1:5.
Essential equipment such as a resuscitation trolley, incubation equipment, suction machine, and defibrillator are readily available.
Admission Process:
Patients within the hospital undergo a thorough review by the ICU doctor/Clinician, who consults with the primary doctor and anesthesiologist/intensivist.
Eligible patients are confirmed for bed availability by the ICU team leader, and admission plans are set in motion.
Patients from external sources receive communication through the designated Nurse, confirming bed availability with the ICU team leader.
The intensivist/anesthesiologist is notified by the ICU leader/Clinician for the admission of sensitive and post-operative patients. Transfers from private ICU facilities occur after 5 pm over the weekends.
Investigations:
Patients must undergo essential investigations before admission, including a head CT Scan for head injuries and suspected CNS lesions, a coagulation profile for suspected coagulopathies, and a full haemogram.
Concurrent investigations during admission encompass UECS, LFTS, blood sugar, CXR, and ABGA.
Initial Command:
Admitting doctors/clinicians conduct a comprehensive assessment and consult with the responsible consultant.
Initial management includes proper patient clerking, severity score determination, catheterization, NGT placement, intubation with subsequent CXR for ETT depth assessment, DVT prophylaxis, peptic ulcer prophylaxis, septic screening, and other necessary interventions.
Admission Criteria:
Patients eligible for ICU admission include those with reversible physiological impairment, severe sepsis requiring hemodynamic and respiratory support, various forms of shock necessitating monitoring and inotropic support, respiratory failure requiring ventilator support, traumatic head injuries requiring cardiorespiratory support, and post-cardiac arrest care among other criteria.
Family Rights:
Families have the right to pre-admission counseling, information, prognostication, and counseling through family conferencing.
The right to receive daily accrued bills is emphasized, while it is explicitly stated that euthanasia is not practiced per the constitution.
Family Obligations:
Families of patients with reversible physiological impairment are obligated to disclose the bona fide next of kin and appoint a family spokesman, with these details duly documented in the patient's file.
Meeting incurred bills and providing specimen signatures of the next of kin are fundamental family obligations.
In essence, the ICU at our hospital is a bastion of critical care, adhering to stringent protocols, embracing advanced medical technologies, and recognizing the importance of family involvement in the care process. It stands as a testament to our commitment to providing optimal care for those entrusted to our services.