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Monitoring and organ support

While in the ICU, patients are monitored more frequently than they can be in the regular hospital wards. Vital signs such as heart rate, blood pressure, and respiratory rate, as well as oxygen and carbon dioxide level, which give information about your lungs may be monitored continuously with electronic devices and monitors. In addition to the continuous monitoring, nurses may also manually check vital signs more frequently in the intensive care unit than they would on the regular hospital ward.

More information is provided on the monitoring and support of the Heart, Lungs, Gut, Brain, Kidneys and Muscles and Nerves

Please see the link to www.explainmyprocedure.com/gsticu which explains:

  • Ventilation
  • Tracheostomy
  • Induced coma
  • Covid treatment
  • Central line insertion
  • Renal replacement therapy - kidney dialysis
  • Delirium
  • Recovery after ICU

The intensive care support of vital organs is continued until a patient recovers from the illness or surgery. However, some patients fail to improve despite this support and the ICU team need to speak to family about difficult discussions regarding decisions about care. This will include decisions about cardiopulmonary resuscitation (CPR).

Cardiopulmonary resuscitation (CPR) is when we try to start someone's heart and breathing again if they have stopped unexpectedly.

  • CPR works well for people who were reasonably healthy before. However, it is unlikely to help people who are frail or have a background of poor health.
  • CPR will not be successful for people naturally approaching the end of their life. It is likely to prevent a peaceful and dignified death. In some cases, CPR can prolong dying or suffering and cause harm (such as broken ribs or damage to internal organs).

Do not attempt CPR (DNACPR) decisions

  • It's important for us to decide whether CPR is right for you or your loved one. We might recommend a do not attempt cardiopulmonary resuscitation order (a DNACPR) if we believe that CPR is not right for you. This can also be called DNAR (do not attempt resuscitation) or DNR (do not resuscitate). They all mean the same thing.
  • We write the DNACPR in your hospital notes and give you a paper copy that you can take home with you.
  • If you do not agree with the decision, you can ask for a second opinion.
  • A DNACPR decision is about CPR only and you get all the other treatment that you need. Many people think about their wishes for resuscitation and levels of treatment that are acceptable to them before coming into hospital. If you have thought about these issues, please tell us. The following link, gives important information and there are videos from a palliative nurse and patient.
 

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Web Link: After birth (postnatal) information Guy's and St Thomas's Hospital

On this page, there is information about: General information Care after giving birth Infant feeding support Expressing breast milk Medicines and healthy breastfeeding Bottle feeding Tongue tie Safe sleep Relationship building with your baby Your mental health and emotional wellbeing

Web Link: After having ECMO

This weblink provides information on what to expect when recovering from an ECMO stay.

Article: Bowels management in ICU

Bowel management system (BMS) is a tube that is inserted into the rectum from the bottom. It is used in patients in ICU who have problems with diarrhoea. The diarrhoea is collected in a drainage bag. This often used when the skin on the bottom gets very sore and red from frequently having diarrhoea. Using the BMS will help the skin to heal. Laxatives are a type of medicine that is used in ICU to patient constipation (not pooing regularly). Constipation is commonly seen in ICU patients...

Web Link: Breast feeding - Global health media support videos

We bring care to life. Engaging, crystal clear, short, and practical. Our videos enable learners of all levels to easily understand, and remember critical teaching points.

Web Link: ECMO - an overview

This link takes you to Guy's and St Thomas' webpage giving an overview on ECMO.

Video: ECMO explained Glenfield Hospital

This video was produced at Glenfield hospital and explains ECMO support.

Web Link: Explain my ICU procedure - central line insertion

This video explains how a 'central line' or tube is inserted into a large vein in the neck or groin to give medication to support the heart.

Web Link: Explain my ICU procedure - CT scans and x-rays

This video explains an x-ray on ICU and a CT scan are performed.