The basic technical requirements of ICU doctors should include the following aspects: cardiopulmonary cerebral resuscitation ability; Respiratory support ability (tracheal intubation, mechanical ventilation, etc.). ); Can continuously monitor geocentric electricity; Able to identify and deal with arrhythmia and invasive hemodynamic monitoring; Ability to conduct emergency temporary cardiac pacing; Be able to respond quickly to various test results and give immediate feedback; Ability to support multiple stolen devices; The ability to implement total parenteral nutrition; The ability of micro-infusion; Master various monitoring technologies and the ability to operate various technologies; Life support ability (oxygen inhalation, ventilator, ECG monitoring ability) in the process of transporting patients; Have the ability to deal with various medical diseases urgently.
At present, the Chinese translation of ICU is not uniform. It is generally translated as "intensive care unit" or "intensive care unit" in Chinese mainland and "intensive care unit" in Hongkong. From the original text, it seems that the word strengthening has been translated into "strengthening" without doubt, but the meaning of nursing can be scrutinized, which includes two meanings: "nursing" and "treatment". The modern concept of "nursing" can be translated into "guardianship". So some people think that ICU translation may be more accurate. In fact, ICU is characterized by extensive and close physiological function monitoring, and based on this, judgment and treatment are carried out. No matter how it is named, the basic purpose of ICU is to provide higher quality medical services for critically ill patients. Because ICU is engaged in the most dynamic and cutting-edge critical medicine, it is very pioneering, and it can innovate continuously from theory to clinic, doing many things that ordinary wards can't do. On the other hand, the special ICU is also based on the development of medicine, and the significance of "strengthening" is actually only to concentrate the existing methods and means, and it is impossible to go beyond the development of the times and do things that medicine has not been able to do so far. Fully understanding this can standardize the behavior of ICU and dispel some people's doubts and misunderstandings.
ICU is the abbreviation of English intensive care unit, which means intensive care unit. With the development of medical nursing specialty, the birth of new medical equipment and the improvement of hospital management system, intensive care is a medical organization and management form that combines modern medical nursing technology. Small and medium-sized hospitals are a ward, and large hospitals are a special department. Only by focusing on critically ill patients and giving them the best protection in manpower, material resources and technology can we get good treatment results.
ICU has a history of more than 30 years in the world, and now it has become a rescue center for critically ill patients in hospitals. ICU monitoring level and advanced equipment have become an important symbol to measure the level of a hospital. ICU in China started late, starting in the early 1980s. At present, hospitals with ICU in China are not common, but they have been paid attention to and are estimated to develop rapidly. ICU is divided into comprehensive ICU and ICU specialized ICU (such as burn ICU, cardiovascular surgery ICU, neonatal ICU, etc. ). CCU is a specialized ICU, and the first C is the abbreviation of coronary heart disease, which is specially aimed at severe coronary heart disease.
There is a central monitoring station in ICU, which can directly observe all the monitored beds. Each bed covers a wide area, and the beds are separated by glass or cloth curtains. The main patients in ICU are: ① severe trauma, patients after major surgery, patients who must be closely monitored and supported by vital indicators; ② those who need cardiopulmonary resuscitation; ③ Failure of one organ (including heart, brain, lung, liver and kidney) or multiple organs; ④ Patients with severe shock, septicemia and poisoning; ⑤ Patients who need intensive care and treatment before and after organ transplantation. After the condition improved, he was transferred back to the general ward. ICU equipment must be equipped with bedside monitors, central monitors, multifunctional respiratory therapy machines, anesthesia machines, electrocardiographs, defibrillators, pacemakers, infusion pumps, micro-syringes, first-aid equipment for tracheal intubation and tracheotomy. In hospitals with good conditions, there are also blood gas analyzers, microcomputers, electroencephalographs, B-ultrasound machines, bedside lead adjusters, hemodialysis machines, intra-arterial balloon counterpulsation machines, routine hematuria analyzers, blood biochemical analyzers, etc. Because ICU monitors and treats critically ill patients under modern medical equipment, the staff working in ICU must have solid basic medical theoretical knowledge, rich clinical experience, strong adaptability, and be proficient in the operation of complex instruments.
ICU can make critical patients get early and accurate diagnosis and emergency and appropriate treatment. Therefore, for critically ill patients struggling with death, ICU ward is undoubtedly an excellent battlefield to overcome death.
Nursing management in intensive care unit
Intensive care provides patients with continuous and intensive care and measures to restore their condition and prevent complications, so that patients can maintain their best health.
A, ICU nursing staff equipped with:
1, ICU beds and personnel should be equipped according to the scale, nature and tasks of the hospital.
The nursing operation and work in ICU is much more arduous and tense than that in general wards. In order to let every patient be cared by a nurse for 24 hours, and let the nurses have legal rest days, holidays, sick leave and maternity leave, each bed should have 3 ~ 4 nurses.
At present, it is difficult for many hospitals in China to meet this standard, and the relevant departments have no specific regulations on the setting of ICU nurses. I think the ratio of patients to nurses in general ICU should be at least 1: 2 ~ 3, and that in specialized ICU should be 1: 1 ~ 2. Only on the premise of ensuring enough nurses can the nursing quality in ICU be guaranteed.
2, including different levels of nursing staff, the responsibilities of nursing staff at all levels should be clear.
Second, the quality requirements of ICU nurses:
ICU nurses should have good physical fitness, be hard-working, have a strong view of caring for the sick and wounded, be honest and trustworthy, be careful and patient, have strong insight, have strong adaptability, strong acceptance, and have solid professional knowledge and related knowledge.
Third, ICU nurse training:
ICU nurses should be professionals with nursing practice license. At present, there is no training center and professional certificate for ICU nurses in China, and there is a big gap between China and foreign countries in this respect. Now all hospitals are training ICU nurses according to their own conditions.
Training content should generally include:
1, observation and nursing of patients with shock.
2. Invasive stress monitoring.
3. Hemodynamic monitoring.
4. Application and management of artificial airway.
5. The application of mechanical ventilation.
6. ECG monitoring.
7, cardiopulmonary cerebral resuscitation and first aid measures training.
8, blood purification treatment and nursing.
9. Observation and nursing care of patients with disseminated intravascular coagulation.
10, nutritional support for critically ill patients.
1 1, the use of various instruments. Including ECG monitors, ventilators, anesthesia machines, various pumps, defibrillators, thermostats and so on.