5. Interventions that Save Lives: Seconds Count
A. Respiratory Support
· Oxygen Treatment (nasal cannulas to non-rebreathers)
· BiPAP/CPAP Non-invasive ventilation
· Mechanical ventilators
· Prone methods of treating ARDS patients
B. Heart Support
- Low blood pressure IV vasopressors
- Antiarrhythmic medications on heart rhythm disorders
- Intra-aortic balloon pumps
- In severe cases the use of ECMO (Extracorporeal Membrane Oxygenation)
C. Renal Support
- Repeated Renal Replacement Therapy (CRRT)
- Hemodialysis
D. Control of Infection
- Clinical regimens of antibiotics
- Isolation precautions
- Only sterile technique on any intervention
6. Communication and Collaboration
A Team Sport To work with a critically ill patient, there should be perfect coordination of all the departments.
A. Interdisciplinary Rounds Daily
Each morning the team sits and:
- Lab review vitals
- Discuss progress
- Revises care plans
- Establish 24-hour goals
B. Communications within the Family
Critical care personnel provide regular, genuine, and caring communication to the families particularly in end of life considerations or in matters dealing with codes.
7. Palliative and Ethical Decision-Making
A. Patient Autonomy
- The advance directives and DNR (Do Not Resuscitate) orders are respected.
- Capacity evaluations will be carried out in case the patients are not able to communicate.
B. Early Palliative Care Introduction
In situations when recovery is unlikely, palliative care comes in to:
- Control symptoms and pain
- Enable the proper end-of-life treatment
- Assist emotional and spiritual health
Critical care is not necessarily aggressive care, but it is the sound judgment that is ethically responsible.
8. Critical Care Transport: ICUs in the Mobile Environment
There is also Critical Care Transport Teams offered by service providers such as Infina Health, where transfers are staffed with ICU-level care expertise.
A. Special Transport Units
They have ventilators, defibrillators, infusion pumps
Critical care paramedics, nurses, and occasionally physicians staff them
B. Usual Situations
- Transporting a trauma patient in rural hospital to a trauma centre
- Transporting a post-operative patient in a long term ICU
- Assistance of the neonate or paediatric critical patients
- Such teams guarantee continuity of care at times when a patient is at his or her most vulnerable in the patient journey.
9. Transformational Technology
A. Artificial Intelligence and predictive analytics
Machine learning models have the ability to predict:
- Sepsis onset
- Risk to re-intubate
- The risk of cardiac arrest
B. Tele-ICU platforms
In rural hospitals or during periods when hospitals are overwhelmed, there is a remote intensivist (who observes patients through cameras and software).
C. Smart Infusion pumps and closed systems
These reduce human error and make the delivery of drugs to be optimum.
10. Post-Critical Care Rehabilitation
It is not the end of the road once a certain patient goes out of the ICU.
A. Post-ICU Syndrome (PICS) Patients can encounter:
- Muscle weakness
- Cognitive issues
- PTSD / anxiety
B. Transition between Care
- Stepdown units
- Rehabilitation or home care centres
- Specialty and primary care follow up
- Critical care units plan recovery since Day 1.
11. Training and Simulation: Worst of the Best
To deal with the situations (rare but lethal) that occur occasionally, critical care teams receive extensive lifelong learning:
- Mock codes, airway drills and high-fidelity simulation training
- Certification course (ACLS, CCRN, FCCS)
- Learning complex cases through Morbidity and Mortality conferences
The course of training on the subject is continuous and never-ending at Infina Health and in most hospitals of the country.
The Unseen Heroes of Critical Care
High-risk patients are a very challenging, exhaustive, and emotionally draining task – yet one of the most rewarding ones. The science, skill and soul that critical care teams apply to rescue patients at the point of death or right before death is what they are all about returning someone to life when they can and when not providing soul and dignity in the process.
Either in an ICU of a hospital or being inside a rolling ambulance with Infina Health being inside, these professionals have life in their own hands.