Critically Ill Patient

Question 1

What is Critical Illness?

Answer 1

an acute life-threatening multisystem process that is reversible and can result in significant morbidity or mortality

Question 2

How do you identify a Critically Ill Patient?

Answer 2

Triage
Diagnosis based
Procedure based
Speciality based
Vital signs based

Question 3

Differentiate a normal and crirically ill patient using vital signs?

Answer 3

REFER TO HANDOUT

Question 4

Triage the patients according to the ABCDE approach?

Answer 4

REFER TO HANDOUT.

Question 5

How do you manage a critically ill patient?

Answer 5

Call for help!
ABC assessment
ABC management – save the patient’s life!
Diagnosis
Disposition + FAST HUGS IN BED PLEASE

Question 6

What is the FAST HUGS IN BED approach?

Answer 6

It is a simple strategy which is used for identifying and checking the significant aspects in general care of ICU patients.

Question 7

Describe each element of the FAST HUGS approach?

Answer 7

Fluid therapy and feeding
Analgesia, antiemetics and ADT (AAA)
Sedation and Spontaneous breathing trial- is the sedation being minimized? Does the patient qualify for SBT and has it been performed?
Thromboprophylaxis- Is the pateint on any VTE prophylaxis? if not consider VTE and bleeding risks and initiate the appropriate prophylaxis
Head up position (30 degrees) if intubated
Ulcer prophylaxis - if the the patient is at risk of a stress ulcer.
Glucose control- as per guidelines
Skin/ eye care and suctioning -Opiod/sedative tapering and timely removal of mechanical ventilation play a pivotal role in liberating patients form the ICU.

Indwelling catheter - do the still need it? and other lines too( central or arterial)

Nasogastric tube
Bowel cares
Environment (e.g. temperature control, appropriate surroundings in delirium)
De-escalation (e.g. end of life issues, treatments no longer needed)
Psychosocial support (for patient, family and staff)