Intensive Care Unit (ICU), also known as Intensive Care Unit (ICU) in English. Firstly, upon entering the thick door of ICU, life receives double the care at this moment. It can be said that nurses are inseparable from patients from the moment they come into contact with them. Upon receiving critically ill patients, regardless of their body shape, how many tubes are left on their bodies, and how many intravenous fluid channels are available, nurses must safely transport the patients to the monitoring bed, and then inspect the patient's condition from head to toe, connect electrocardiogram monitoring, monitor various vital signs, observe changes in the condition, follow medical advice to take a series of necessary emergency rescue measures, and write special care records. Afterwards, patients will receive 24-hour uninterrupted and meticulous care in the intensive care unit. What are the ICU nursing measures and nursing techniques? Next, let's take a look together.
1. Implement relevant specialized disease nursing routines.
2. Perform routine symptom care for patients with high fever, coma, shock, etc.
3. Closely observe the patient's vital signs, consciousness, pupils, SPO2, etc., record the special care record once every hour, and keep track of any changes in the patient's condition.
4. Conventional use of oxygen driven nebulization for oxygen inhalation, with oxygen flow rate (oxygen concentration) adjusted according to medical advice. For patients receiving low flow oxygen therapy, nasal cannula oxygen therapy can be used. Keep the face mask and nasal cannula clean, replace the face mask, nasal cannula, humidification bottle, and nebulizer every week.
5. The condition requires assistance from the doctor in performing deep vein catheterization (femoral vein, cervical vein, subclavian vein), taking care of the catheter, keeping the puncture site clean and sterile, disinfecting the area with 0.5% iodine solution daily, and replacing the transparent patch. If contaminated, replace it at any time, and record the nursing time. If there is suspicion of catheter-related infection, blockage, swelling of the puncture side limb, etc., immediately remove the catheter. When suspected of catheter-related infection, take 5cm of the front end of the catheter for bacterial culture.
6. Provide basic nursing care and prevent nursing complications:
(1) If there are no special requirements for the condition, raise the patient's bedside by 30-45 °.
(2) Oral care should be taken 2-3 times a day. Patients who are able to eat orally should be assisted in rinsing their mouth before and after meals to maintain oral hygiene and no odor.
(3) External genital care: Wash the perineum of female patients twice a day (female patients will wash the perineum after defecation), and clean the urethral opening of male patients.
(4) For patients with indwelling urinary catheters, take good care of the external genitalia, follow medical advice for bladder irrigation if necessary, and replace the catheter every two weeks.
(5) Turn over and pat the back every 2 hours, encourage patients to take deep breaths, cough, and expectorate, and perform skin care to prevent bedsores. Perform passive limb movements and functional exercises twice a day for patients.
(6) Wipe the patient's bed twice a day to ensure that the patient's skin is clean, without any odor, bloodstains, drug traces, adhesive tape marks, etc. The patient's fingernails are short and the male patient's beard is short.
7. Proper management of artificial airway: (1) Tracheal intubation: Replace the tape, straps, and dental pads daily, fix the tracheal intubation properly, check the airbag pressure every shift, and maintain an appropriate pressure level. The airbag pressure should be ≤ 18mmHg. Ensure effective intubation calibration.
(2) Tracheotomy: Disinfect the local skin with 0.5% iodine solution and replace sterile dressings in each shift. If it is a metal casing, replace the inner casing once per shift.
(3) On demand suction, strict aseptic operation techniques, selecting appropriate suction pressure and suction tube. The suction joint and protective cover should be replaced daily to keep them clean. If sputum is not suitable for aspiration, follow the doctor's advice for nebulization inhalation.
8. For patients undergoing mechanical ventilation, perform routine mechanical ventilation nursing, follow medical advice to test arterial blood gas analysis on time, closely observe the patient's respiratory improvement and the working condition of the ventilator, and manage the artificial airway well.
9. Keep various drainage tubes unobstructed, observe the amount and shape of various drainage materials and accurately record them, and perform nursing routines for various drainage tubes.
10. Ensure reasonable nutrition for patients, provide diet according to medical advice, and assist patients in eating; Patients who cannot eat orally should follow the doctor's advice to place a nasogastric tube and receive nasogastric fluid on time. During nasogastric feeding, closely observe the patient's reaction and pay attention to whether there is reflux, coughing, etc. The gastric tube should be replaced every 2 weeks (according to the instructions) and properly secured to prevent dislodgement.
11. For patients who are unconscious, restless, prone to extubation, or have unclear consciousness, appropriate restraint should be given when necessary to prevent self injury and accidental extubation. Strengthen communication with patients and their families, timely understand their feelings or needs, and provide psychological care.
12. When patients are transferred or discharged, they should organize and register their personal belongings, and hand them over to their family members for counting and signing. The patient retains a venous pathway during the transfer and receives routine fluids (high concentration potassium, vasoactive drugs, etc. are prohibited). They are escorted by a doctor and nurse throughout the entire process, with continuous oxygen inhalation, monitoring of SPO2 and heart rate, and emergency kits if necessary.
In the hearts of critical care workers, there is always a silent desire, which is to dedicate our love, let the smile of life bloom on the patient's face, give love, transmit love, and protect the green channel of life. May every ICU patient achieve a complete victory in this battle within the ICU.