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    FMRI Obs Icu & Hdu

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    Apoorv Jain
    This document discusses organizing an obstetric critical care unit. It compares a medical/surgical ICU to an obstetric ICU. An obstetric ICU ensures adequate obstetric and critical care simultaneously for severely ill pregnant or postpartum patients. It has a short average patient stay of 2 days but very high survival rates and low residual morbidity. This is a low-cost, high-impact intervention compared to a standard medical/surgical ICU. The document also outlines the roles and qualifications for obstetricians, intensivists, nurses and other staff on the obstetric ICU team. It provides criteria for admission to the obstetric ICU and considerations for caring for newborns while their mothers are

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd

    FMRI Obs Icu & Hdu

    Uploaded by

    Apoorv Jain
    164 views13 pages
    This document discusses organizing an obstetric critical care unit. It compares a medical/surgical ICU to an obstetric ICU. An obstetric ICU ensures adequate obstetric and critical care simultaneously for severely ill pregnant or postpartum patients. It has a short average patient stay of 2 days but very high survival rates and low residual morbidity. This is a low-cost, high-impact intervention compared to a standard medical/surgical ICU. The document also outlines the roles and qualifications for obstetricians, intensivists, nurses and other staff on the obstetric ICU team. It provides criteria for admission to the obstetric ICU and considerations for caring for newborns while their mothers are

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    FMRI Obs icu & hdu

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    This document discusses organizing an obstetric critical care unit. It compares a medical/surgical ICU to an obstetric ICU. An obstetric ICU ensures adequate obstetric and critical care simultaneously for severely ill pregnant or postpartum patients. It has a short average patient stay of 2 days but very high survival rates and low residual morbidity. This is a low-cost, high-impact intervention compared to a standard medical/surgical ICU. The document also outlines the roles and qualifications for obstetricians, intensivists, nurses and other staff on the obstetric ICU team. It provides criteria for admission to the obstetric ICU and considerations for caring for newborns while their mothers are

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    164 views13 pages

    FMRI Obs Icu & Hdu

    Uploaded by

    Apoorv Jain
    This document discusses organizing an obstetric critical care unit. It compares a medical/surgical ICU to an obstetric ICU. An obstetric ICU ensures adequate obstetric and critical care simultaneously for severely ill pregnant or postpartum patients. It has a short average patient stay of 2 days but very high survival rates and low residual morbidity. This is a low-cost, high-impact intervention compared to a standard medical/surgical ICU. The document also outlines the roles and qualifications for obstetricians, intensivists, nurses and other staff on the obstetric ICU team. It provides criteria for admission to the obstetric ICU and considerations for caring for newborns while their mothers are

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 13

    Organizing An

    Obstetrical
    Critical care Unit
    Medical/Surgical ICU Obstetric ICU
     Critical care is primary objective  Ensures adequate provision of
     Severely morbid cases requiring obstetric and critical care
    prolonged admission (Weeks to simultaneously
    months)  Overall short duration of stay
     Moderate to poor rates of even in critical cases (median
    survival stay – 2 days)
     Residual morbidity high  Very high rates of survival
     Residual morbidity is very low
    (intact survival high)

    High cost, low impact Low cost, High Impact


    intervention Intervention
    Staff pattern
    Charecterstics and job chart of Team
    Members---
     Obstetrician---Head of the team , should be
    skilled obstetrical care provider along with the
    skilled knowledge of maternal – fetalMedicine.
    His skilled training in this field will help in
    assessing physiological changes in pregnancy in
    body systems and their effect in utero---
    compromise / compensation and complication to
    fetus that can jeopardize the well being of fetus
    and mother.
    Characterstics and job chart of Team
    Members---
     Intensivists-- physicians---
    Whose day to day work is in the management
    of critically ill patient’s vital sign care– His skills
    help in early identification of forth coming
    complications and timely management, in
    reducing fetal and maternal mortality and late
    sequelae , reduce cost factor and hospital stay
    too.
    Time to time he may need immediate help of
    specialists and super specialists of other
    medical disciplines as and when a new
    problem develops.
    Characterstics and job chart of Team
    Members---
     Nursing Staff—
    High risk obstetric nursing care requires a
    confident, companssionate , skilled and well
    trained nurse willing to under take complexities
    and challenges of higher acuity care.
    Staffing pattern should be should be 1:1nurse
    to patient ratio.
    At times it may be 2: 1 in cases of unstable
    patients.
    Care of New Born during
    mother's stay at ICU/HDU:
    Decision to keep new born with mother will be based on the maternal conditon
    If mother is critically ill (e.g. multi organ failure or ventilator support), newborn
    should be cared by the
    relatives or by the paediatric units of the respective hospitals.
    Majority of mothers admitted to ICU/HDU will require additional support to care
    for new born.
    Whenever mother is conscious and able to breastfeed child, the same should
    be encouraged.
    New born can also be roomed in with mother wherever possible.
    All new born shall receive check up by a paediatrician to screen for any new
    born defect or complications.
    Paediatricians will play an important part in overall care of new born during
    mother’s stay at ICU.
    Criteria for
    admission

    High probability of MI Compromised gas


    Hemodynamically Eclampsia
    exchange
    unstable Arrhythmias Seizure from
    At risk for impending known or
    Congestive heart failure respiratory failure
    Pacing requirement unknown cause
    (Asthma/Pneumonia/P
    Urgent/Emergent ul monary edema) Known prior
    hypertensive crises neurologic event
    Requirement for that places current
    with/without evidence
    of end organ failure minute- minute maternal well
    HELLPSyndrome monitoring of vital being in jeopardy
    signs
    Eclampsia
    (suspected/confirmed
    PE) or need for
    aggressive pulmonary
    physiotherapy

    1
    0
    Criteria for
    admission

    Need for UGI/LGI bleeding DKA


    frequent requiring Thyrotoxicosis/
    neurologic transfusion therapy Storm
    assessment Hepatic failure Complicated
    parathyroid/cal
    Need for cium
    continuous metabolism
    pulmonary/card Congenital
    iac monitoring metabolic
    that is at risk disorders
    for
    hemodynamic
    1
    instability
    1
    Criteria for
    admission
    • Surgical • Renal
    –Severe hemorrhage –Unstable
    requiring MTP AKI
    Morbidly adherent –Chronic
    placenta Kidney
    PPH Disease/un
    stable
    Peripartum
    hysterectomy that –CRRT
    requires close –
    monitoring/fluid Plasmaphere
    resuscitation sis
    1
    2
    Criteria for
    • Miscellaneous
    admission –SLEcrisis (Lupus
    Nephritis/Cerebritis)
    • Sepsis/Septic shock –Sickle Cell Crisis
    –Hypotensive (Sickle lung disease)
    –Decreased –Thrombotic
    oxygen microangiopathies
    delivery/elevated –Trauma
    Lactate levels –Thermal and electrical
    –Gram injury
    negative/positive
    bacteremia
    –Vasopressor
    –Multisystem end
    organ
    dysfunction/failur
    1
    3
    e

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