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Critical Care Management

Critical care refers to the specialized healthcare service offered to critically-ill patients whose lives are at risk. Patients with sudden emergencies like stroke or cardiac arrest, accident victims with profuse bleeding and spine injuries, terminally-ill cancer patients, etc are some types of patients who receive critical care in the ICU. Since the ICU is the place which decides the life of the patient, the hospital quality management lends it the highest priority in all amenities.

Earlier, the ICU was considered to be a separate unit within the hospital. But now it is seen as a part of the patient’s journey within the hospital. Even healthcare time management  takes into account the patient’s hospital stay and health condition as pre and post ICU.

Critical care management is an operations management service that deals with the handling of the ICU or the critical care unit. Managing the ICU or critical care effectively improves both the hospital’s efficiency and its quality of clinical service To achieve this, the services of an expert healthcare consulting firm can be enlisted to develop strategies for effective critical care management.

Critical care management in a hospital is a continuous process

Yes, the process of caring for a critically-ill patient starts even before the person enters the hospital. In fact, it begins with the public, family members or ambulance attendants offering first aid or resuscitation. The focus here lies on stabilizing the vital signs and shifting the patient quickly to the nearest hospital’s ICU.

From now on, critical care management actually starts and can be viewed in a phased manner as follows.

PRE- ICU Critical care management

This phase can be for a new patient or an existing patient at the hospital who is to be shifted to the ICU owing to the deterioration of his condition. In both cases, the vital health parameters like pulse, BP, blood sugar, etc are monitored and the patient is shifted to the ICU.

Here the hospital quality management  must ensure frequent recording of the health parameters to identify the first instance of the patient’s deterioration.  The moment the patient’s health parameters take a downtrend, the patient must be shifted to the ICU. This is the first step in critical care management.

According to a research study, every hour lapsed in admitting the patient to the ICU can increase the risk of his death in the ICU by 1.5 times. To avoid this, warning systems connected to electronic alarms must be installed in the ICU to alert the deterioration of the patient instantly.

An alert alone will not suffice during an emergency. The entire hospital staff must be trained and be in readiness to respond rapidly to the critical condition. Instituting an emergency code with different colours like code-blue for cardiac arrests, red for stroke etc, might help the right staff to rush to the patient’s rescue immediately.

Every hospital must institute a Rapid -Response Team comprising of an intensivist, a cardiac specialist, an anaesthetist, a physiotherapist for helping in pulmonary distress and 2 nurses. This team should be available 24×7 at the ICU.  A shock room for initial resuscitation and a fully-staffed 4-bed ward. should be at the ICU’s disposal at all times.

IN-THE- ICU Critical care management

The critical care management is considered to be a success only if it ensures good quality of life in the post-ICU phase or provides dignity and pain relief to those dying in the ICU. To ensure this, the blood transfusions, sedations, oxygen infusions, etc are all regulated within the ICU as these might affect the post-ICU state of the patient.

Critical management within the ICU aims at offering a better “in-ICU” experience to the patient, Swift and timely mobilization of the patient helps in quick recovery. Similarly, reduced sedation and frequent visits by the family may also improve the psychological impact of the patient’s stay in the ICU.

For patients who have no hope of survival, all life-saving support must be stopped and palliative care must be initiated to help the patient die painlessly and with dignity.

POST- ICU Critical care management

The decision to discharge a patient from the ICU must be taken carefully. This is because the  premature discharge of the patient may result in ICU readmission or patient mortality. The time at which the patient is discharged is critical to his life. Out-of-hours discharge is often associated with patient death or readmission in the ICU.

Most importantly, good communication is the key factor in POST- ICU Critical care management. The patient’s family must be rightly informed about the precautions, dos and don’ts for the patient after the discharge. The presence of an intensivist is a must during discharge to ensure that all health parameters are fit for the process.

Critical care management is one aspect of hospital quality management that has a direct bearing on its competence and reputation, Hospitals must handle this carefully by seeking the help of an expert healthcare consulting firm.