Welcome TO Intensive Care Unit

WELCOME
TO
INTENSIVE
CARE UNIT
Intensive Care Unit is an area inside the
hospital where it is possible to provide advanced
organ support to patientssuch as mecahnical
ventilator (lung support), hemodialysis (renal
support), and intra-aortic balloon pump (cardiac
support). It specializes in monitoring and treating
patients who need 24-hour care.
It is appropriate for patients requiring the following cases:
 require advanced respiratory support
 requiring support of two or more organ systems
 chronic impairment of one or more organ systems who also
require support for an acute reversible failure of another organ.
ROLES OF THE CRITICAL CARE NURSES
I. Practitioner Role
A. Care Provider – direct and indirect patient care (family)
B. Extended Roles as critical care nurses – also performs procedures and
therapies that are otherwise done by the doctor
ex. Perform and interpret ECG
Adjust IV analgesia/sedations
Initiate defibrillation to patient with VF and Vtach
C. Educator
D. Patient Advocate
II. Management and Leadership Role
a. Perform management and leadership skills in providing safe and quality care
b. Accountability for safe critical care nursing practice
c. Delivery of effective health programs and services to critically ill patients in the acute setting
d. Management of the critical care nursing unit or acute care setting
e. Take lead and supervision among nursing support staff
f. Utilize appropriate mechanism for collaboration, networking, linkage-building and referrals
ADVANCED PRACTICE LEVEL

The current healthcare environment demands intensive care nurses to have advanced knowledge and skills to
provide the highest possible level of care to the critically ill patients.
I. Expanded Roles
a. Nurse Specialist / Clinical Nurse Specialist
The critical care nurse specialist is responsible for building up nursing competencies in the ICU entity. He / She
contributes to continuous improvement in critical care nursing through staff and clients education and uphold
quality nursing guidelines and patient care through clinical research and refinement of ICU standards.
b. Advanced Practice Nurse
Advanced Practice Nurse (APN) in the critical care unit takes lead in developing
practices to meet changing clinical needs and to facilitate patient care processes across
professional and organizational boundaries. He/She executes the nursing team leader’s
responsibilities as designated in the position of APN (NO) or APN (Ward/Unit
Management).
c. Outcomes Manager
Outcome management has been introduced into the healthcare system to
ensure achievement of quality and cost-effectiveness in the delivery of patient
care. Qualified nurse experts are involved in the development and
implementation of patient outcomes management.
CONTINUING NURSING EDUCATION
CCNAPI recommends that all practicing CCN shall ensure that they continuously update their knowledge, skills and behavior
through active participation in related critical care nursing education. This shall include but not limited to the following adult and
pediatric concepts on:
a. Advanced Cardiac Life Support
b. Basic Critical Care Course (BCCC)
c. Cardiac Assessment
d. Neurological Assessment
e. Respiratory Assessment
f. Continuous Renal Replacement Therapy
g. Advanced Pharmacology
h. Advanced Intravenous Therapy
i. Others as may be deemed necessary to enhance critical care practice

COMMON EQUIPMENT IN
THE ICU
ICU Beds are specially designed to be
able to meet the unique needs of critically ill
patients.
 To transport critically ill, ventilated patients.
 To support the patient comfortably
 To provide room to carry portable oxygen
cylinders, suction equipment, emergency
resuscitation equipment, intravenous infusions
and their pumps, as well as a transport
monitor and ventilator.
CARDIAC MONITOR
provides ICU staff with real-time
information on important vital functions
such as heart rate and rhythm (ECG),
blood pressure, body temperature,
breathing rate and oxygen saturation.
ECG MACHINE
An electrocardiogram (ECG or EKG) records
the electrical signal from your heart to check
for different heart conditions. Electrodes are
placed on your chest to record your heart's
electrical signals, which cause your heart to beat.
The signals are shown as waves on an attached
computer monitor or printer.
VENTILATOR
It is commonly known as breathing machines
because they support patients to breathe for
themselves, or can take over breathing for a
patient completely.
INFUSION PUMPS
It is a medical device used to deliver fluids
into a patient’s body in a controlled
manner.
It may be capable of delivering 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.
ARTERIAL LINE
This is a line that goes into the
patients’ artery. It allows the nurse
to see the blood pressure
continuously and also allows the
nurse to take bloods when
required. It is a red line that usually
goes into a patients arm and is
connected up to the cardiac
monitor (the box that looks like a
tv) and shows a the blood pressure
constantly.
CENTRAL LINE
It is an intravenous line that is used for giving the

patient fluids and / or medications. It may be used
when the patient’s veins in the arms are difficult to
access or when certain medications or nutrients
need to be given that cannot be administered into
the smaller veins found in the arm.
NASOGASTRIC (NG) FEED PUMP
This machine will deliver feed to a patient at a set amount

per hour. There will be a bag of beige coloured liquid (feed)
hanging above the pump with a thin purple tube attached
to it. This tube will go from the bag, through the pump and
to the patient where it is attached to a tube in the patients
nose (NG).
Endotracheal tube (ET):
An ET tube is a tube that is inserted through
the patients’ mouth into their wind pipe. It is
used in the ICU for patients who are having
difficulty breathing because of a lung
problem, or for patients who are not awake
enough to breathe for themselves. The ET
Tube is connected to tubing which is
connected to a ventilator.
TRACHEOSTOMY
It is an opening created at the front of the
neck so a tube can be inserted into the
windpipe (trachea) to help you breathe. If
necessary, the tube can be connected to
an oxygen supply and a breathing
machine called a ventilator.
A tracheostomy is sometimes and option
to patients who require long term
ventilation, difficult weaning from the
ventilator, and patients with copious
secretions (phlegm).
SEQUENTIAL COMPRESSION DEVICES (SCD)
They are used in intensive care to reduce

the risk of deep vein thrombosis (DVT) in
the lower limbs of critically ill patients. SCD
are sometimes referred to as ‘calf
compressors’.
RESUSCITATOR BAG/
AMBUBAG
These bags are used to inflate the

lungs during procedures
including intubation.
RESPIRATORY THERAPIES
High Flow Nasal Cannula
High flow nasal prongs allow for high
concentration of oxygen to be delivered to
patients comfortably. Somethings this is
used as a therapy of it’s own, or may be
used when the patient has a break from a
tighter mask. The oxygen is routed
through a humidifier to ensure it is moist
and does not dry the airways.
Non Invasive Ventilation (NIV):
Non Invasive Ventilation means the patient would be
helped to breath, without any tubes going into their
mouth. A tight mask usually covers the nose and
mouth, and it is connected to a small machine which
will give extra oxygen or support with every breath.
The mask is secured tightly in order to function,
there cannot be any air leaks. It usually helps
increase blood oxygen levels and reduced carbon
dioxide levels. The NIV would only be used on a
conscious patient, as you have to make every breath
yourself. Sometimes it is used to try and prevent
needing a ventilator, and sometimes it might be
needed with the patient comes off the ventilator.
TOTAL PARENTERAL
NUTRITION (TPN)
Parenteral nutrition is the feeding of nutritional
products to a person intravenously, bypassing
the usual process of eating and digestion.
PRESSURE RELIEVING
MATTRESS
It is used to prevent pressure injuries or 'bed

sores'. The air mattress is constantly
distributing air and alternating the pressure
under the body.
It provides the framework
for communication
between members of the
health care team about a
patient’s condition
BRADEN SCALE ASSESSMENT
 It is an evidenced-based tool that predicts the risk for developing a hospital
or facility acquired pressure ulcer or injury.
 There are six categories within the Braden Scale: sensory perception,
moisture, activity, mobility, nutrition, and friction or shear.
NEUROLOGICAL ASSESSMEN
GLASGOW COMA SCORE (GCS)
• It is composed of three parameters: best eye response (E), best verbal

response (V), and best motor response (M). The components of the GCS are
recorded individually; for example, E2V3M4 results in a GCS of 9.
• Scores for verbal and motor response should reflect the best possible level of
function. If the patient has an ETT or tracheostomy tube impairing the verbal
assessment, a "T" can be used to indicate that the patient could be better
than the score indicates. Document in the graphic record and report changes
in the GCS to a physician.

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WELCOME

ADVANCED PRACTICE LEVEL

a. Nurse Specialist / Clinical Nurse Specialist

a. Advanced Cardiac Life Support

b. Basic Critical Care Course (BCCC)

f. Continuous Renal Replacement Therapy

h. Advanced Intravenous Therapy

i. Others as may be deemed necessary to enhance critical care practice

It is an intravenous line that is used for giving the

This machine will deliver feed to a patient at a set amount

They are used in intensive care to reduce

These bags are used to inflate the

It is used to prevent pressure injuries or 'bed

• It is composed of three parameters: best eye response (E), best verbal

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