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Archive for April 20th, 2009

General Treatment Strategies of the ICU

Posted by medliorator on April 20, 2009

Although care for each patient in the ICU is customized, there are general treatment strategies that are used by all trauma and critical care physicians in treating severely injured patients

On the transfer to the trauma bay, the patient would receive packed red blood cells. Upon arrival in the trauma bay, a series of diagnostic and therapeutic events take place.

The classic teaching for trauma surgeons upon arrival of a patient in the trauma bay is evaluating a patient using the protocol is known as the ABC’s  [airway, breathing, and circulation].

A patent airway is needed for the patient to be ventilated and oxygenated. …if the airway had not been placed in the field, it would be done immediately either by intubation or cricothyroidotomy.

The assessment of breathing is an assessment of the function of the lungs. …Loss of lung sounds in one or both lungs are a sign of pneumothorax, hemothorax, tension pneumothorax, and malposition of the endotracheal tube in one of the main stem bronchi.

Circulation is assessed by the heart rate of the patient and the systolic and diastolic blood pressure. …The blood pressure is taken initially manually by sphygomanometer (blood pressure cuff), with many trauma programs requiring the first three blood pressure recordings to be manual recordings.

The initial goal in the first 24 to 48 hours is to stabilize the patient in the face of any ongoing blood loss and the likely massive systemic inflammatory response (SIRS) patients that are severely injured undergo.

She would be continued on a ventilator and given pain medication and sedation. A typical regimen would be an around-the-clock infusion of the narcotic fentanyl (i.e., a fentanyl drip) and an around-the-clock infusion of midazolam (Versed).

Chimp Attack Victim Charla Nash Improving in the ICU [Inside Surgery]

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