Surviving itu placements
Download
1 / 20

Surviving ITU Placements - PowerPoint PPT Presentation


  • 500 Views
  • Uploaded on

Surviving ITU Placements. INTRODUCTION TO ITU. ITU: Ventilated or at risk of 2 or more organ failures. HDU: Self-ventilated or at risk of 1 organ failure. General wards: Self-ventilated with basic level of nursing care. General thoughts of ITU. Sick people Noisy/Busy People dying Smell

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Surviving ITU Placements' - salena


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Surviving itu placements l.jpg

Surviving ITUPlacements


Introduction to itu l.jpg
INTRODUCTION TO ITU

  • ITU: Ventilated or at risk of 2 or more organ failures.

  • HDU: Self-ventilated or at risk of 1 organ failure.

  • General wards: Self-ventilated with basic level of nursing care.


General thoughts of itu l.jpg
General thoughts of ITU

  • Sick people

  • Noisy/Busy

  • People dying

  • Smell

  • Lots of machines

  • Overwhelming

  • Frightening

  • Arrests frequently

  • Blood

  • Scared of making people worse

  • Casualty/ER style!!


What itu is actually like l.jpg
What ITU is actually like

  • Calm

  • Supportive

  • Large presence of medical staff

  • People who are critically ill

  • Cleaners! (very clean)

  • Demand for beds. Moved out ASAP

  • Highly trained staff. Each person knows their job

  • Friendly and approachable

  • Infection control


Monitoring in itu l.jpg
MONITORING IN ITU

  • Heart Rate

  • Blood Pressure

  • Temperature

  • Central venous pressure

  • Oxygen staturation

  • Cardiac output


Head injuries l.jpg
Head Injuries

  • Inter cranial pressure

  • Jugular oxygen saturation

  • Cerebral perfusion pressure

  • End tidal Carbon dioxide


Blood gases l.jpg
Blood Gases

  • PaO2

  • PaCO2

  • H+

  • pH

  • HCO3

  • Base excess (BE)


Ventilator l.jpg
Ventilator

  • Setting

  • Tidal volume

  • Respiratory Rate

  • Peak Airway Pressure

  • Minute Volume

  • Fraction of inspired O2


Modes of ventilation l.jpg
MODES OF VENTILATION

  • SIMV

  • SIMV + PS

  • CPAP + PS

  • EXTERNAL CPAP

  • BiPAP


Assessment in itu l.jpg
Assessment in ITU

  • Communicate with nurses

  • Look at medical notes

  • Look at nursing notes

  • Look at last PT notes

  • Look at chest X-rays


Assessment in itu11 l.jpg
ASSESSMENT IN ITU

  • Observation

  • Palpation

  • Auscultation

  • Tape


Analysis l.jpg
Analysis

IS THE PATIENT STABLE ENOUGH TO BE TREATED?

  • If the pt is unstable will they deteriorate further without PT input?

  • Will PT cause further instability?

  • ?  WOB

  • ? SPUTUM RETENTION 

  • ?  LUNG VOLUME


Treatment l.jpg
Treatment

  • Ward fitITU

  • Active treatment passive treatment

  •  WOB

  • Rest/sleep

  • Positioning

  • Pacing

  • Relaxation

  • Breathing re-education

  • BiPAP/CPAP

  • Ventilation

  •  *Intubating and ventilating a pt is a MDT decision with consultant having final say.


Sputum retention l.jpg
SPUTUM RETENTION

  • Mobilising

  • Deep breathing/ ACBT

  • Re-hydration

  • Positioning

  • Postural drainage

  • Flutter etc.

  • Humidified Oxygen

  • Bird

  • Bagging

  • Suctioning


Lung volume l.jpg
LUNG VOLUME

  • Mobilising

  • Deep breathing

  • Insentive spirometer

  • Positioning

  • Bird

  • CPAP/ BiPAP

  • Bagging


Slide16 l.jpg

  • FINALLY…….

  • Although ITU seems daunting, remember it is one of the safest environments to work in!


Vascular l.jpg
VASCULAR

  • What it involves?

  • Diabeties

  • V.V

  • Ischaemia-grafting

  • Arterial and venous ulcers

  • Aortic aneurysms

  • Amputees post op


Typical patients l.jpg
Typical patients

50+male

  • Multiple problems

  • Alcohol abuse

  • Smoking-COPD


Physio input l.jpg
Physio input

  • CHEST PHYSIO POST OP

  • MOBILITY PHYSIO BEFORE D/C

  • VV- in/out

  • Aneurysms- aim 1 week.

  • Amputees- awaiting wound heeling


Slide20 l.jpg

  • Use M/D notes

  • Work alongside O.T

  • Transfering pt to suitable physio….D/C, outpatients, further rehab.