First, establish ICU.
(a) ICU mode can be roughly divided into the following modes:
1. Comprehensive ICU Comprehensive ICU is an independent clinical business department directly under the hospital.
2. Some general ICU is between specialized ICU and comprehensive ICU.
3. Specialized ICU is generally an ICU set up by clinical secondary departments.
(2) ICU scale
1.ICU bed layout design ICU bed setting should be determined according to the size of the hospital, the total number of beds or how many patients need to be monitored in a certain department. The number of ICU beds in general general hospitals accounts for1%-2% of the total number of beds in hospitals; Generally, 8 ~ 12 beds are more economical and reasonable, but in some specialties, such as cardiac surgery, it can be as high as 10%. The area of each bed in ICU is15m2, and the bed spacing is not less than1.5m.. The area of ICU beds in developed countries is not less than 20 square meters, and 25 square meters is appropriate.
2. In principle, the central monitoring station of 2.ICU should be located in the central area of all wards, preferably slightly above the ground, which can directly observe all patients, and is equipped with central monitoring recorder, computer and equipment.
3. Staffing ICU staffing has not been unified at home and abroad. ICU accepts all kinds of critically ill patients, with a wide range of medical intervention, fast knowledge update, modern equipment and new technology, which requires ICU doctors to have considerable theoretical and professional level. General ICU doctors should come from anesthesiology, internal medicine, surgery and emergency department, but now they tend to set up full-time ICU doctors, and the ratio of doctors to beds is 1.5 ~ 2: 65438. The ratio of nurses to beds in ICU should be 3 ~ 4: 1, and the ratio of nurses to beds in class should be 2 ~ 3: 1, so as to ensure the normal operation of ICU. The head nurse is responsible for overall management, in charge of nurses, nurses and nurses to form an echelon. Nurses should have a college degree or above, and those with good physical health and psychological quality are the first choice. Pay attention to qualifications and deep experience.
3.ICU equipment ICU equipment mainly includes monitoring equipment, treatment equipment and imaging equipment (see Table 4- 1).
Table 4-1Settings of Common Instruments and Equipment in ICU
classify
Types of instruments and equipment
Monitoring equipment
Keywords multifunctional life monitor, respiratory function monitor, oxygen saturation monitor, intracranial pressure monitor, hemodynamics monitor, gastrointestinal mucosa PH monitor,
Blood gas analyzer, electrocardiograph, etc.
Therapeutic equipment
Ventilator, ECG defibrillator, pacemaker, infusion pump, injection pump, cooling blanket, anesthesia machine, blood purification device, intra-aortic balloon counterpulsation device, etc.
imaging device
Bedside X-ray machine, ultrasound equipment, fiberoptic bronchoscope, etc.
4.ICU customers
Patients were admitted to ICU according to the following criteria: (1) patients with severe combined trauma; (2) Patients with serious diseases after operation, especially those with serious complications before operation (such as coronary heart disease, respiratory insufficiency, electrolyte disorder, etc.). ), patients with unstable circulation during operation. (3) Patients who need respiratory management and/or respiratory support. (4) Patients with cardiac insufficiency or severe arrhythmia. (5) Patients with acute myocardial infarction. (6) Patients with various types of shock. (7) Patients with acute renal insufficiency. (8) Patients with acute severe pancreatitis. (9) Patients with acute drug poisoning. (65438.999999999996
The following patients should not be admitted to ICU:( 1) brain death, (2) acute infectious disease, (3) chronic disease without acute symptoms, (4) advanced malignant tumor, (5) natural death in old age, (6) hopeless treatment or giving up rescue for some reason.