ICU (abbreviation for Intensive Care Unit) in the intensive care unit. Intensive medical care is medical organization management integrating modern medical care technology that has emerged with the development of medical nursing professions, the birth of new medical equipment, and the improvement of hospital management systems.
First, let’s take a look at one of the most developed countries in the world
In terms of ICU construction, Germany is also a very mature country.
The project will be contracted to a qualified specialized company, and it will be meticulous from design to final completion, which is both extremely practical and broad-looking.
For example, in the neurology ICU, there are more than 90 power outlets on the bedside pipeline system. There are plenty of humanized designs that take care of future expansion functions like this kind of room.
In general, the characteristics of the entire European countries are: the ICU with the strongest comprehensive treatment capability and the most representative level of care is often subordinate to the anesthesiology department. This is mainly due to historical reasons because the earliest monitoring was led by an anesthesiologist.
Contemporary German anesthesiologists are responsible for the daily work of four aspects including anesthesia, pain, emergency, and intensive care. Therefore, the ICU of the anesthesiology department can best represent the current level of treatment of critical illness.
Every instrument and every piece of equipment in the ICU of German hospitals is not necessarily very advanced or new. Many of them are the same as the domestic configuration, but they must make the best use of the equipment to maximize the treatment and life-saving effect of the instrument. For example, the bedside blood gas machine is equipped with a barcode recognizer. By scanning the patient’s exclusive barcode, each blood gas measurement value can be directly entered into the patient’s electronic medical record. Most of the so-called monitoring systems in China can only record vital indicators, but basically, they cannot record the parameters of ventilators, blood filters, and infusion pumps in real-time.
It can be seen that the biggest problem in China is not whether the equipment is available or not, but whether it is used or not, and how to use it.
The application scope of ICU is expanding day by day, and it is constantly improving and popularizing. How to use space, manpower, and capital more reasonably and effectively to configure, manage and maintain its equipment has become a very important issue.
Next, we will introduce three aspects of ICU infrastructure configuration, equipment configuration and purchase, and equipment safety and maintenance.
1
ICU infrastructure configuration
As the conditions of patients in ICU wards are different from those in ordinary wards, their ward layout design, environmental requirements, bed functions, peripheral equipment, etc. are different from those in ordinary wards, and ICUs of different specialties require different equipment. Not the same. The design and equipment configuration of the ward should be based on the principles of meeting needs, facilitating rescue, and reducing pollution.
Such as laminar flow equipment. ICU’s anti-pollution requirements are relatively high. Consider using laminar flow purification facilities to reduce the chance of infection. In the ICU, the temperature should be maintained at 24±1.5°C; in the ward for elderly patients, the temperature should be around 25.5°C.
In addition, the small operating room, dispensing room, and cleaning room of each ICU unit should be equipped with back-illuminated hanging UV lamps for regular disinfection, and an additional UV disinfection vehicle should be equipped to disinfect the unmanned space regularly.
In order to facilitate rescue and transfer, a sufficient power supply must be ensured in the ICU design. It is best to be equipped with dual-circuit and emergency power supplies, and important equipment should be equipped with uninterruptible power supplies (UPS).
In the ICU, there should be multiple gas pipelines at the same time. It is best to use the central oxygen supply, the central air supply, and the central suction vacuum. In particular, the central oxygen supply can ensure the continuous inhalation of large amounts of oxygen by ICU patients, avoid the frequent replacement of oxygen cylinders, and avoid the contamination of the oxygen cylinders that may be brought into the ICU.
2
ICU equipment configuration and purchase
The selection of ICU beds, to suit the characteristics of ICU patients, should have the following functions:
- Multi-position adjustment can meet different clinical needs.
- It can be controlled by foot pedal or hand held to help the patient to turn over.
- Convenient operation, multi-directional control of bed movement.
- Precise weighing function. In order to closely monitor changes in fluid exchange, fat burning, and sweat secretion.
- The back X-ray filming needs to be completed in the ICU, so the X-ray box slide rail is required on the back panel.
- It can move and brake flexibly, which is convenient for rescue and transfer.
Take a reference of ICU bed in detail:
https://www.hospitalbedscn.com/news-posts/what-makes-an-icu-bed-special/
ICU bed position for patient
https://www.hospitalbedscn.com/news-posts/put-a-patient-in-reverse-trendelenburg-position/
At the same time, the headboard of each bed should be equipped with:
1 power switch, multi-purpose power outlet that can connect 6-8 plugs at the same time, 2-3 sets of central oxygen supply devices, 2 sets of compressed air devices, 2-3 sets of negative pressure suction devices, 1 set of adjustable brightness headlights, 1 set of emergency lights. Between the two beds, a double-sided functional column should be set up, on which there are power sockets, equipment shelves, gas interfaces, call devices, etc.
Monitoring equipment is the basic equipment of ICU. The monitor can monitor multi-lead ECG, blood pressure (invasive or non-invasive), respiration, blood oxygen saturation, temperature, and other waveforms or parameters in real-time and dynamically, and can monitor the measured parameters. Perform analysis and processing, data storage, waveform playback, etc.
When designing the ICU, consider the type of patient to be monitored in order to select a suitable monitor. For example, the cardiac ICU and the infant ICU will have a different functional focus on the monitor.
The ICU monitoring equipment is divided into two types: single-bed independent monitoring system and central monitoring system.
The multi-parameter central monitoring system is to display the various monitoring waveforms and physiological parameters obtained by the bedside monitors of each bed patient on the large-screen monitor of the central monitoring through the network so that the medical staff can monitor each patient Implement effective real-time monitoring.
In modern ICUs, a central monitoring system is generally established.
In addition to conventional equipment and instruments, ICUs of different natures need to be equipped with special equipment.
For example, in the ICU of cardiac surgery, must be equipped with continuous cardiac output monitors, balloon regurgitators, blood gas analyzers, small rapid biochemical analyzers, fiber laryngoscopes, fiber bronchoscopes, as well as small surgical equipment, surgical lights, Disinfection supplies, 2 sets of thoracotomy surgical instrument kits, surgical instrument table, etc.
3
Safety and maintenance of ICU equipment
ICU is a place where a large number of electrical appliances and medical equipment are used intensively. There are many high-current and high-precision medical equipment. Therefore, it is necessary to pay attention to the safety of the use and operation of the equipment.
In order to ensure that the medical equipment works in a good environment, first of all, it is necessary to ensure that the equipment is provided with a stable power supply; the position of the monitor should be set at a higher place, which is convenient for observation and can be far away from other equipment to avoid interference to the monitoring signal.
The equipment of modern ICU has high technical content and high professional requirements for operation.
In order to ensure the normal operation and use of ICU equipment, ICU wards in large hospitals should set up full-time maintenance engineers to guide doctors and nurses in the correct operation and use of equipment; assist doctors in setting machine parameters; usually responsible for the maintenance and replacement of equipment after using Damaged accessories; regularly test the equipment and regularly perform measurement calibration as required; repair or send for repairs to the faulty equipment in time; register the use and repair of the equipment, and establish an ICU equipment file.
