ICU

Question 1

minimum requirements for an intensive care unit

Answer 1

• Two oxygen outlets
• One air outlet
• Two suction outlets
• Twelve mains electricity 
outlets
• Appropriate physiological 
monitoring

Question 2

Criteria for admission to ICU

Answer 2

• Threatened airway
• All respiratory arrests
• Respiratory rate of >40 or < 8 breaths/min
• Oxygen saturation <90% on > 50% Oxygen
• All cardiac arrests
• Pulse rate < 40 or > 140 beats/min
• Systolic BP < 90mmHg
• Sudden fall in level of consciousness (fall in GCS of >
2 points)

Question 3

Students in ICU – Objectives (Knowledge)

Answer 3

• Develop an understanding of physiological changes occurring in a patient
developing a critical illness.
• Improve assessment skills and realise the importance of fluid status in a
critically ill patient
• Recognise causes and management of hypotension, oliguria, respiratory failure
and decreased conscious level.
• Gain a beginning understanding of arterial blood gas (ABG) analysis.
• Gain a basic understanding of airway support including CPAP and BiPAP.
• Observe circulatory support including inotropes.
• Identify ethical issues surrounding critically ill patients.

Question 4

Students in ICU – Objectives (Skills)

Answer 4

• Conduct an examination of the critically ill patient.
• Begin to recognise and interpret data, including ECG, blood
pressure, respiratory rate, blood gas analysis and CXR.
• Familiarity with basic airway management, use of oxygen masks
and resuscitation devices.
• Practice identifying patient deterioration
• Learn to determine if there is an emergency in ventilated
patients

Question 5

Students in ICU – Objectives (Attitudes)

Answer 5

• To be able to communicate effectively with staff, patients and
relatives.
• To learn how to care compassionately for critically ill patients
and their relatives.
• To demonstrate a professional approach to the unconscious
patient.
• To develop a clinical approach that includes attention to detail.
• Be supportive to colleagues and care for self.

Question 6

Where do I start? ICU

Answer 6

• WASH HANDS!
• Introduce self to nurse, patient and/or family
• General handover at bedside – assess together
• ICU flow chart, medications and infusions
• Look to see where emergency equipment is located (black bag,
suction, emergency trolley, defibrillator, clamps)
• Look at position of transducers and alarms on monitors and check to
see that they are on and correctly set.
• Establish a baseline for your shift, and observe trends
• Any planned procedures/tests in this shift?
• Any ICU routines (ventilator tubing changes safety check, etc)

Question 7

Head to Toe (Systematic) Assessment

Answer 7

• Central Nervous System (Neuro/neurovascular Assessment)
• Respiratory Assessment
• Cardiovascular Assessment
• Gastrointestinal Assessment
• Genitourinary Assessment
• Musculoskeletal Assessment
• Integument Assessment
• Psychosocial/Other

Question 8

Visual Inspection

Answer 8

• Colour – central and peripheral
• Patient position, do they seem comfortable (non verbal cues)
• Injuries, landmarks, wounds, skin integrity
• Invasive lines and monitoring (arterial, CVC)
• IV infusions, time of expiry
• IV fluid orders
• Site inspection, dressing integrity

Question 9

Vital Signs /Observations

Answer 9

• Calibrate transducers
• Heart rate, rhythm
• BP (Mean Arterial Pressure - MAP)
• Oxygen saturation (note FiO2)
• End tidal Carbon Dioxide (CO2)
• Respiratory Rate (patients breath or ventilator breath or both?)
• Temperature
• Central Venous Pressure (CVP)

Question 10

Central Nervous System

Answer 10

Glasgow Coma Scale
• Level of consciousness with sedation (continuous infusion/bolus)
• If the patient is paralysed and sedated the GCS is not attended.
• In brain death, spontaneous breathing, cranial nerve function and
reflexes are absent.
• Intra Cranial Pressure (ICP) monitoring.

Question 11

Glasgow Coma Scale

Answer 11

pupils, motor response, position,

orientation to Time, Person, Place (TPP)

Question 12

Communication icu

Answer 12

• Body language
• Lip reading
• Writing
• Pictures
• Gestures
• Voice assisted equipment/procedures (eg: finger over tracheostomy)
• Alphabetical boards

Question 13

Pain – non verbal cues

Answer 13

• Body language (non verbal signs)
• Clenching of teeth, biting ETT
• Wrinkling of forehead
• Thrashing, kicking, tensing muscles
• Massaging or rubbing areas of body, 
pulling at tubes
• Restlessness