Critical Care

Critical care is also known as intensive care. When a person is in need of care from life threatening illnesses and injuries is when a person may need critical care. Critical care involves a small to large team of specially trained health professionals that give the patient close, constant care. Critical care is usually given in a trauma center or intensive care unit or ICU. Death is a possibility for people who are in critical care, although patients can recover while in the ICU.

Some of the equipment that is included when it comes to critical care include, but are not limited to: ventilators, intravenous or IV tubes, monitors, catheters, feeding tubes, and other primary care units that will sustain life. Some of these instruments and pieces of equipment can also increase the risk of infection. Some of the patients who need critical care include, but are also not limited to: accidents, infections, severe breathing problems, and people who have had complication from surgery.

Respiratory Failure

Respiratory failure is when there is inadequate gas exchange in the respiratory system. As a result of this, the arterial oxygen and carbon dioxide levels will not be able to be maintained within the normal ranges. You will notice a drop in blood oxygenation which is known as hypoxemia. Hypercapnia which is a rise in arterial carbon dioxide can also be observed. Normally the oxygen level should be greater than 60 mmHg, and the carbon dioxide level should be less than 45 mmHg. There are two different types of respiratory failure; classification of a patient to either one depends on the absence or presence of hypercapnia.

Mechanical ventilation is when the patient’s breathing cannot be controlled or maintained on their own. This is when the mechanical ventilation will have to breathe and regulate their breathing for them. There are a number of mechanical ventilation strategies that can be used. Each doctor has their own method, and will then pass that knowledge down to their students. Depending on the situation of the patient, one method might be better suited than another. Ensure that you always wear gloves while ventilating or intubating a patient. PEEP or Positive End Expiratory Pressure is a term that is used to go along with mechanical ventilation which refers to an airway pressure that is kept above any atmospheric pressure at the end of the breathing cycle. PEEP is set right on the mechanical ventilator.

If the patient does not acquire air shortly after going into respiratory failure, they may die. This is a serious and life threatening condition that can happen. Those peoples who are at increased risk for respiratory failure include: asthma patients, allergies, any persons who have lung diseases or conditions, and any patient with a disease or condition that affects the nerves, bones, muscles, or tissues that support breathing.

Shock

Shock can be a life threatening condition where the body suffers when there is an inadequate blood flow through the body. Shock normally will accompany a severe illness or injury. Going into medical shock means that it is a medical emergency and can lead to many other conditions. Some of these conditions include, but are not limited to: hypoxia or lack of oxygen in the tissues of the body, heart attack or cardiac arrest, or even organ damage. Immediate treatment is necessary since symptoms can worsen rapidly. Medical shock is different than other shocks such as psychological and emotional shock. There are a few different types of shock: hypovolemic, anaphylactic, septic, cardiogenic and neurogenic.

Hypovolemic shock is an extreme emergency condition where severe blood and fluid loss is evident and makes the heart unable to pump and supply enough blood to the body. This can cause a number of organs within the body to stop working. You can go into hypovolemic shock if you lose 1/5 or more of blood from cuts, injuries, or internal bleeding. You can also lose fluids from diarrhea or vomiting which can make blood pressure decrease. The greater, and more rapid the blood loss is, the more sever the shock is. Seek medical attention as soon as possible if you think you or someone you know may have hypovolemic shock.

Heart rate and stroke volumes with gradually decrease as the person worsens with the shock. It is recommended that you seek medical attention as soon as possible to reduce any organ damage or cardiac arrest in the patient.

Renal Failure

Renal failure is when your kidneys suddenly stop working. Without the use of your kidneys, you will not be able to remove waste products, balance water, salt, and other minerals or electrolytes in your blood. These will then build up on your body, and can cause serious health problems that can be deadly. There are three main causes to renal failure that include: a sudden, serious decrease in the blood flow to the kidneys, damage from poisons, infections, or medications, a sudden blockage that will stop urine flow from going out of the kidneys. If you have long term health problems such as kidney or liver disease, you’re an older adult, you’re very ill, or had heart or stomach surgery.

Renal Pathophysiology is the study of the kidneys, how they work, what components go with them, and why renal failure might develop in some patients. Studying these key factors will provide the medical field with more knowledge in order to find, and correct the issue of renal failure. Oliguria is classified as a low output of urine in a human. The urine output is usually around 300 to 500 ml per day. It can be a sign of many different disorders, and also contrasted with anuria which is the absence of urine all together. This is usually 50 ml or less per day.

There are a number of renal replacement therapies that include hemodialysis, hemofiltration, renal transplantation, and peritoneal dialysis. Hemodialysis is a treatment that removes wastes from the body that are not being filtered by the kidneys such as urea, creatinine, and water from the blood. Peritoneal dialysis is for severe renal failure patients. This treatment uses the peritoneum in the abdomen of the patient. Fluid is put through a permanent tube in this area, and then flushed out throughout the day or at night while the patient sleeps. Hemofiltration is done in the intensive care unit, and is a slow and continuous therapy. The sessions can last anywhere from 12 to 24 hours, and are done daily. The patient’s blood is taken out slowly, cleaned up and replaced with electrolytes and then given back to the patient. Kidney transplantation is when one organ from a donor is given to the patient at the end stage of renal disease. The donor kidney can come from a living or dead persons who match the blood and tissue type of the patient.

Sepsis

Sepsis or Septicemia is blood poisoning. It is when toxins and bacteria enter the blood stream. The blood is then infected with this infection via the blood stream and the patient may experience septic shock. The blood pressure will decrease over time once the infection spreads. Older people, younger infants, and people with poor immune systems are at risk for getting sepsis. This is a serious and pretty common disease. The public should be made aware of it, and to note the symptoms. The deaths associated with this condition have almost doubled over the years. Sepsis can only be diagnosed and treated at a hospital. The patient with sepsis should be brought in as soon as possible.

Sepsis can be treated by putting them on oxygen, saline to raise their blood pressure, medications to clean the blood, tubes in the abdomen may be necessary if there is an infection within the stomach. There is no actual cure for sepsis at the time. Sepsis Paradigm is the change in fluids and infection within the patient’s body. To understand how to treat the sepsis, you have to understand how the sepsis is attacking the patient’s body. Septic shock is a medical condition that is very serious, and is caused by a decrease in tissue perfusion and oxygen. This can be a result of sepsis and infection. It can cause multiple organs to fail, and even death is common.