Critically ill patient complication s

Question 1

What are short term complications of being critcally ill / being a patient admitted to ITU?

Answer 1

• intensive care delirium (discussed in next card)
• AKI
• VTE development
• infections from ward
• sepsis and shock
• blood transfusion reactions (anaphylaxxis, TRALI, TACO)
• barotrauma, tooth and lip injuries from intubation
• multiorgan failure

Question 2

How may patients with intensive care delirium present?

Answer 2

fluctuate from hyperactive to hypoactive delirium states

• agitated, restless, hyperaware, pulling tubes out
• very drowsy, unusually sleepy,quiet
• sometimes can be very scared of staff/scream, shout - feel like they will be killed/hurt.
• forgetful, easily distracted

Question 3

What are risk factors for intensive care delirium?

Answer 3

• low oxygen sats
• infections
• kidney or liver disease
• withdrawing from substances – for example if someone is used to smoking but has been in hospital for a long time.
• side effect of taking certain drugs
• immobility
• constipation
• dehydration
• sleep deprivation
• over 65
• known PMH of dementia, depression, anxiety, or other mental health challenges.
• poor vision or poor hearing

Question 4

What are medium term complications for critical care patients?

Answer 4

• nightmares
• adjustment to what has happened
• muscle atrophy
• malnourishment (usuallly present if they attended with it)
• loss of appetitie

Question 5

What are long term complications for critical care patients?

Answer 5

• polyneuropathy and myopathy
• disuse muscle atrophy
• ADLs reduced
• depression
• anxiety
• PTSD
• impaired memory, impaired attention and executive function
• reduced QofL due to deficits and psycho-socail burden
• impact on family - have anxieties and worries
• coping with new aspects of body - e.g. new stoma, new tracheostomy, requiring insulin
• sleep disorders