First-hand experience of being in an Intensive Care Unit?
I believe this question is not country specific. Basically, one of the protagonists finds himself in intensive care after an explosion where he received abdominal injuries
( Read more... )
I didn't even discuss dealing with the patient's primary reason for being in ICU (trauma, post op infection, multi-system failure...what have you)
OK. Ironically, abdominal wounds, fractures etc are the least of the staff's worries. The human body is a miracle unlike any other and left to it's own resources and fix just about anything. Now...it can't realign a fracture, but left alone a fracture will heal...not pretty, but amazing nonetheless...so....the real purpose of ICU is to support the whole patient while the body trying to heal what the docs fixed.
In an immobile patient, bedsores can kill. When they occur they can become easily infected and create a new assault on the patient already compromised. Vigilant nursing care is the single best thing in the treatment of bedsores (decubitus ulcers.) The patient should be turned (change position)not less than every two hours. Bed sores are caused by poor circulation to pressure points. Getting the patient off that side and giving the patient good skin care including cleaning, massage to stimulate circulation are key. There are only just so many positions a patient can be placed in and good body alignment is an issue nurses must consider as well, so things like lamb's wool skin protectors under problem areas like hips, lower spine(butt),heels, elbows can be helpful. Today, there are air mattresses and water beds available that cycle under the patient and reduce some of the problem, but nothing works like cleanliness, massage and vigilance. In patients with spine injuries where it is critical that the patient remain immobile lest moving cause more nerve damage the patients can be sandwhiched inbetween cot like apparatus and turned automatically. These patients are suspended somewhat and the body parts that are most vulnerable to bedsores are left uncovered. Now, it's been a few years since I worked in ICU so I'm sure they have even more sophisticated ways to handle the situation, but the principle remains the same. Poor circulation to an area will cause bedsores. The first indication that the skin is "breaking down" is a small blister appearing on the offending part. The nurse will then observe the area closely to see how big an area may be involved. She will report to all the other nurses on other shifts and even greater vigilance will follow. Again, there are products that can be placed on the skin that can support and protect the area somewhat, but unless the patient is moved and skin care is vigilant the bed sore will worsen.
So...to answer your question directly. A patient with an abdominal wound and secondary infection will probably have the wound dressed. Depending on how the surgeon is treating the wound, the dressings may be changed frequently, packed with sterile gauze and a disinfectant and/or other types of material to help keep the wound clean. This is often done at the bedside by the surgeon in the early stages of recovery. Of course the patient will be receiving broad spectrum antibiotics until they isolate the offending "bug' and then specific antibiotics will be given. This patient will be fairly easy to give skin care as positioning will not present any special problems like casts, or traction. Nutritionally, the patient will be supported with IV solutions with additives. If the treatment is a long one then there are more special IV solutions that provide a more complete nutrition. Again, it's all really basic. The body needs good nutrition to take care of itself on a day to day basis, so even more important if it needs to be busy healing.
TMI, I know, but being a nurse is what I am and I can't help but share! Good luck and I'm here for more if you need it!
Reply
Reply
Reply
Leave a comment