Respiratory Intensive Care Unit

 
 

Introduction:

Respiratory Intensive Care Unit is a sub-class of Medical ICU which is dedicated to manage primarily the patients with potentially reversible critical respiratory conditions who need different respiratory supports and interventions. Our Respiratory ICU is an eight bedded well equipped unit to serve the critical respiratory patients.
 
 

Location:

Respiratory ICU is located at the eastern side of 2nd Floor of NAC, NIDCH, next to Respiratory Lab.
 
 

Establishment:

Respiratory ICU was established first at the ground floor in October, 2009 and subsequently shifted to the current location in February, 2016.
 
 

Mission:

The Respiratory Intensive Care Unit is committed to improving the health and wellbeing of critical respiratory patient population by providing specialized medical and nursing care by a trained staff utilizing the available technological equipment. Our mission is to deliver the highest quality patient care with compassion and to advance Respiratory Medicine through education and research.
 
 

Vision:

Leaders in exemplary care, innovation and academic excellence.
 
 

Values:

  • Caring - We will act with concern for the wellbeing of all critically ill respiratory patients.
  • Accountability - We will create value accept responsibility for our activities.
  • Respect - We will treat every individual with dignity and courtesy.
  • Innovation - We will look for opportunities to be creative and open to new ideas to improve patient care.
 

Fighting Forces at Respiratory ICU:

Our ICU is open for 07 days a week round the clock. For serving the patients round the clock, our ICU is empowered with a fighting force comprising of doctors, nurses and supporting staff. There is regular round in the morning headed by ICU chief and associated by ICU consultant, ICU registrar, Medical Officer/s and post graduate students.
 

Inclusion Criteria for Respiratory ICU admission:

Our aim is to provide the appropriate patients with available best treatment and services. To ensure this, certain inclusion criteria are set for respiratory ICU admission:
  • Primary respiratory disease with or without potentially reversible component who will be benefitted from ICU support.
  • Complete history mentioning any ongoing comorbid condition and previous medical and surgical illness or/and intervention.
  • Referral note from responsible physician/surgeon of respective unit mentioning the indication for referral.
  • Recent ABG report, SPO2, CXR, ECG, etc.
  • Recent Sputum AFB status (Smear/Genexpert/BAL) in suspected pulmonary TB cases.
  • In some special cases recent reports of S. electrolytes, Blood glucose, S. creatinine, Echocardiogram, CT scan, etc.
  • As it is a respiratory ICU at NIDCH, the patients admitted here are given top priority, but patients admitted in other facilities who need primarily respiratory support can also get entrance here through proper case report and documents/reports through proper channel (R/P, R/S), provided bed is available and inclusion criteria for admission are met.
 

Activities:

  • Regular routine and special round and follow up of the admitted patients by ICU team/doctor in morning, evening and night shifts.
  • Patient visit by doctors of respective Medicine/Surgical Unit/s as/when necessary.
  • Arrangement of Medical Board as necessary for any critical patient.
  • Arrangement of medical (ET intubation, FOB, CV line, Thoracentesis with/out USG guidance, Paracentesis, etc.), surgical (IT intubation, Tracheostomy, etc.), or pathological (bed side FNA) invasive procedure.
  • Noninvasive procedures, e.g., Portable CXR, USG, ECG, etc.
  • Consultation of other unit/discipline as/when necessary for decision making.
  • Regular data keeping of the admitted patients.
  • Regular CME on ICU and contemporary other medical issues to upgrade knowledge and skills of the ICU doctors and post graduate students placed here.
  • Presentation on ICU topics in Central Presentation at NIDCH and other National and International Seminars.
 

Facilities:

The following facilities are available at our ICU-
  • 24 hrs patient's cardiac and respiratory monitoring.
  • 24 hrs central oxygen supply.
  • 24 hrs ABG and emergency blood/other sample collection and report delivery system.
  • Urgent Echocardiogram, CT scan and other imaging procedure on request from reliable Diagnostic Centre after office hour.
  • Invasive Mechanical ventilation
  • Noninvasive positive pressure ventilation.
  • Bed side USG, ECG, Portable CXR.
  • FOB.
  • Central venous line introduction.
  • Syringe pump, infusion pump, etc.

 

Future view:

To make our respiratory ICU a state-of-the art reference Centre of world class in Respiratory ICU patient management.
 
 

Limitations:

  • As our ICU is a respiratory ICU, comprehensive management for other critical illness (e.g. specialized cardiac, renal, neurological, diabetic management, etc.) is not possible in our ICU.
  • There is no bed for critical infectious TB or MDR/XDR-TB cases, so, it is a great limitation of managing this type of critical patients.
  • Lack of adequate ICU staff is a limitation for us.
  • Lack of uninterrupted supply of logistics is also a limitation.
  • Lack of basic and on job training on ICU management is a bar of up gradation of knowledge and skill of ICU doctors and nurses.