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Care Guide for family members: this is what happens when a Covid patient enters the ICU
Covid-19: The pressure is maximum in ICUs and hospitals are already opening other alternative areas
The Intensive Care Units of the hospitals of our country have always been there for when we need them.
An accident, a serious infection, a myocardial infarction or any other problem that seriously compromises our health and our lives can end up leading to one of them. Often forgotten by the general population, the pandemic caused by the coronavirus has put them more than never in the spotlight and have gone on to grab big headlines in the press
a, precisely because they are vital but at the same time also limited.If for any reason
you end up putting a foot in them
, something that is not my wish, they will verify that
we will most likely insert a wide variety of cables and probes connected to all types of machines through almost all the holes in your body
And where there is no natural hole, we will open one without hesitation. If you want to understand a little more what each of these cables is for and what information they provide to us healthcare professionals who work in ICUs, I invite you to continue reading.
By placing four adhesive electrodes along the patient's forehead that we will connect to an electroencephalographic monitor, we will obtain the BIS or bispectral index.
Thanks to this, we can continuously monitor the degree of depth in the patient's sedation: the maximum value, 100, together with fast and low-amplitude brain waves, would represent total consciousness;
while 0 would be the deepest sedation.
Coming out of the mouth we find a long, transparent tube, with a numerical scale and of considerable thickness.
The final end will be housed in the patient's trachea, while on the outside we will connect the tubing of the respirator that will be responsible for maintaining the patient's respiratory function: it will introduce air with oxygen and collect and eliminate the expired air.
It is a thin tube that we will see generally coming out through the patient's nose (although it can also do so through the mouth together with the endotracheal tube).
Its function is none other than to have direct access to the stomach from the outside, for several reasons: to avoid abdominal distention that causes stagnation of gastric juices, to allow these liquids and air to escape into a collection bag that is placed at the end of the tube, and be able to administer food, medication or water to the patient through it.
Central venous catheter
We will generally find it in the neck, although it is also common to see it in the groin.
It is a large caliber catheter that we insert into a vein, from which several finer ones come out.
We will use these (with or without the help of infusion pumps) to administer to the patient all kinds of serums, antibiotics, antipyretics, analgesics, a special type of nutrition that goes directly to the vein, anesthetic drugs ... even blood, plasma or platelets.This catheter will also be very useful to extract the blood samples that we need for analysis, avoiding punctures to the patient.
In addition, and thanks to a sensor that we will connect, we will obtain the central venous pressure (PVC) value of the patient, something essential to know his hemodynamic status.
Knowing how our patient's heart is beating is essential, so for this we will place several adhesive electrodes on the thorax to which we will connect cables of different colors attached to a monitor.
There we can monitor the appearance of arrhythmias or heart rate, among others.
An external digital thermometer, placed in the armpit, will give us the patient's temperature value.
It can be connected to the monitor or not.
The classic cuff that we have all seen in any health center could not be absent in an ICU.
Connected to the monitor by means of a long rubber band, it will inflate automatically at the intervals that we set to monitor blood pressure at all times.
We will see it inserted generally at the height of the patient's wrist (although it can also be in the groin).
It is a fine catheter that we introduce into a patient's artery and then connect to a blood pressure measurement system on the monitor.
If we have this catheter, we will no longer need the tension cuff, and in turn it will serve to extract the arterial blood samples that we need for analysis.
Placed on a finger and shaped like a clamp, this sensor with bright red light connected to the monitor will give us the oxygen saturation value in the patient's blood.
Acceptable values, provided there is no pulmonary pathology, are between 96 and 99%.
Leaving the urethra we will find a thin, flexible and opaque tube whose function is to help the expulsion of urine.
The probe is introduced to the bladder, where one end is housed, and at the other end we will place a collection bag that quantifies the expelled urine.
It also allows us to extract urine samples to analyze in a totally sterile way.
Patients admitted to the ICU may have severe respiratory compromise or hemodynamic instability, in addition to being candidates for diarrhea and fecal incontinence.
In these and other cases, and to avoid the risk of ulcers or skin lesions, a rectal probe is inserted.
This will facilitate the exit of the feces, which will end up in a collection bag that quantifies the expelled content.
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