The Intensive Care Unit (ICU) also termed as critical care unit is one of the most critically operational environments in a hospital. It offers specialised treatment to patients who are in need of critical medical care. Dr Sam Muhumuza, the Head of Perioperative at Oshen King Faisal hospital, explains that this kind of facility cares for critically ill patients that need intense care than other patients. ICU grand round Describing how the system works at Oshen King Faisal hospital in order to ensure quality care for patients in the ICU, Dr Muhumuza, said they have ‘The ICU grand round’. He explains that this is a weekly meeting, which is clinical and academic. This meeting, he says, takes a multidisciplinary approach, convening all doctors to discuss patients especially those who are very critical in ICU. “We discuss everything from when a patient was admitted to the management done so far, we also look at whether treatment has been proper and discuss the way forward, this helps to manage the patient better,” Dr Muhumuza says. The programme has developed and facilitates doctors to make more informed decisions. “We teach one another and of course patients benefit a lot because as you know two heads are better than one. This platform also gives a chance to oversee practice, if someone is making a mistake we can easily identify and rectify it.” Nurse Judith Kyengo, the Manager for the hospitals Critical Care Unit, notes that the ICU grand round is basically getting the entire team together where surgeons of different types, physicians among others come together to share ideas on how best patients can be cared for. “Basically, when we meet, we are discussing the cases and identifying various issues we are having and what the way forward is. This does help on the management of the patient; it’s like supplementing each other in every area,” she explained. She says this approach is among the many other strategies in place that is helping the hospital to have an ICU, adequate enough to cater for all patients. “Our ICU is multidisciplinary, we are able to admit all patients who need ICU services here because when you go to other places you either find a surgical ICU, medical ICU or cardiac ICU but we can accommodate all of these here,” she points out. What to expect in ICU Kyengo explained that ICU takes care of patients who are really critical, meaning the ones who cannot, for instance, that need a machine to support their breathing. “ICU mostly comes in when there are organs let’s say the heart has failed or when the brain is not working or having a urinary system that is also not working, our job in ICU is to support all these organs,” she says. The critical care unit involves the ICU, high dependency unit and the neonatal ICU. Neonatal ICU is for the new-borns below twenty eight days while the high dependency unit caters for pediatrics (from a baby who is above 28 days) to the adults. This unit is usually situated close to the intensive care unit, where patients can be cared for more extensively than on a normal ward but not to the point of intensive care. Kyengo explains that the ICU admits patients who are on ventilation (process of moving breathable air in and out of the lungs, to provide breathing for a patient who is physically unable to breathe) and have many organs which are not functioning let’s say the heart or the renal. How are patients managed in ICU? There are specific ways of managing patients in ICU according to Kyengo. “We individualize the care of the patient but the most important aspect is for the medics to work as a team. There is no way you can work as an individual in an ICU,” she notes. ICU teams are multi-disciplinary and are usually made up of highly skilled specialists trained in providing critical care for patients with a diverse nature of medical conditions. When a patient has a medical problem and is admitted in ICU, Kyengo says there is a whole team attending to them, for example a medical doctor, an anesthetist, a physiotherapist, a nutritionist among others. The medical care in the ICU department is completely different from others because treatment is usually offered through machines. And also the close monitoring of patients for their blood pressure, their heartrate. “There is something we call infusion pumps, we use these machines to carry fluids, such as nutrients and medications. Sometimes there are those who need hemodialysis, we still use these machines with them,” the medic points out. This kind of care Kyengo says is continuous because within one hour a patient can be okay and gone in another hour. editorial@newtimes.co.rw
