3 AnswersThis is a somewhat difficult question to answer as all hospitals are different in the resources that are available to interact with family members of patients within their ICU. In my experience, almost all hospitals have a mechanism for communicating with the ICU staff so that the family can stay updated on a patient's progress. Obviously, the hospital may put limits on such communications as constant interaction may not be possible due to patient care concerns. The important thing for family members is to work out a plan with the ICU staff on how best to communicate and try to limit these communications to specific family members to that the ICU staff does not become overburdened.
1 AnswerI think the answer here depends on many factors. If the patient is awake and not sedated with drugs then the patient will need some help with coping. This can be in the form of explaining everything to the patient before it is done so to alleviate fears and anxieties. Patients who cannot have sedation, or are being weaned from the ventilator will need some coaching, that is support for the processes and coping with the ventilator process. Alternate forms of communication can be established (writing boards, electronic devices, symbol boards). The presence of family might be comforting when allowable. There are few patients who can tolerate the presence of a ventilator without some type of pharmacologic (medicine) support. It also depends on why the patient needs the tube in the first place. Other needs such as hydration, pain, and elimination must be addressed to help a patient cope.
1 AnswerDebra Dibartolo , Nursing, answered
You may not be able to prevent an acute exacerbation of your COPD completely but there are several things that you can do to help prevent your COPD from flaring up so badly that you do require an ICU admission.
- Get your immunizations—Flu and pneumovax as recommended by your doctor or nurse practitioner
- Stop smoking and avoid people and places with cigarette smoke
- Take your medications exactly as prescribed.
- Establish a relationship with a primary care doctor or nurse practitioner and a pulmonologist (if needed) that you respect and trust so you can manage your COPD as a team.
- Do not ignore symptoms-if you are not feeling well or are more short of breath than expected talk to your doctor or nurse practitioner
- Encourage members of your family and yourself to practice good hand hygiene to prevent the spread of upper respiratory viruses
- Exercise to your tolerance-Consider physical therapy with your primary care provider to prevent deconditioning
- Eat well-check out my plate.gov for tips on healthy eating and talk with your primary care doctor or nurse practitioner regarding your food intake
- Have a health care proxy-If a catastrophic event occurs with your health you will have already discussed what your wishes are for treatment and this person can advocate for you and your wishes if you are unable
- Use your oxygen, bi-pap and nebulizers as directed by your health care team
- Be honest and let you doctor or nurse practitioner know if a particular treatment or medication they are recommending does not fit in to your life routine or you do not like how it is making you feel
- Consider mental health support if needed chronic illness like COPD can be a stress on you and your family emotional. Being emotionally well balanced is as important as being physically well balenced
Electric shocks are known to help convert the heart from an unstable rhythm to a stable rhythm. Heart rhythms such as ventricular tachycardia and fibrillation can be life-threatening. Delivering a shock at the right time can covert the heart to a rhythm that can support normal blood pressure. These shocks can be delivered anywhere in the hospital, but it usually means the patient is quite sick and needs to be in a critical care unit.
1 AnswerDr. Stuart A. Linder, MD , Plastic Surgery, answeredHand hygiene guidelines must be followed by all members of the surgical team. According to the Association of Surgical Technologist, the surgical team should practice on a daily basis effective hand and fingernail hygeine. This will help to remove dirt, skin oil, debris and microorganisms to prevent transmission to the patient. The hand washinig indications include hands with dirty or contaminated blood or body fluids. All personnel entering into the surgical suite, prior to having contact with a patient, after removal of gloves, immediately after using restroom. Fingernails should be short, debris free and not extend past the fingertips. Interesting findings include: artificial fingernails should Not be worn by surgical team members (fungal infections can occur), no problem with painted nails, and chipped fingernails may support microbial growth.
Pain management is a focus of care in the critical care unit, regardless of the age of the patient. Patients should expect that pain will be treated and managed, but it is unrealistic to expect the patient to be entirely pain free. Nurses will work with the patient to determine the need for and effectiveness of pain medications. There may be times when it is not appropriate to give pain medications, particularly when the effects of pain medication mask symptoms and change neurological status. The nurse will explain these situations to the patient and the family members. The important thing is for patients to communicate verbally or nonverbally to the critical care staff when they are in pain.
3 AnswersDr. Devi E. Nampiaparampil, MD , Pain Medicine, answered
In the ICU setting, all patients are typically checked for bedsores. They are usually moved in the bed every 2 hours to help prevent bedsores from forming.
A healthy person, for example, may sit in a chair to do work. After awhile, the body will sense that there is too much pressure on certain spots, such as the elbows and the back of the thighs. The body will send a signal to redistribute the pressure. Without even realizing it, the healthy person will shift in his chair or get up to do something else and then return to the chair. A person in the ICU may be too sick or too sedated to recognize this signal from the body. He may also be too weak to independently shift his position. That's how bedsores (also called pressure sores) form.
1 AnswerDr. Karen L. Gorton, PhD, MS, RN , Emergency Room Nursing, answered on behalf of Honor Society of Nursing (STTI)
If you have access to the internet at home, you can go to the Lifeline web site at: http://www.lifelinesys.com/content/lifeline-products. If you do not have access to the internet at home, you may be able to access the internet at your local library and go to the above web site.
You can also call Lifeline at 1-800-380-3111 for further information.
Age is not a limiting factor for care in the ICU. It is the type of illness that determines the need for critical care. Some patients who are elderly have made the decision that if they get a life threatening illness, they do not want aggressive treatment such as critical care.