– Patients with Respiratory failure.
– Post successful CPR.
– Post neurosurgery (Brain surgery).
– Fluids and electrolytes imbalance.
– D.I.C. (Disseminated intravascular co-agulopathy.
– Pneumothorax and hemothorax affecting respiration.
– Chest trauma (Flail chest).
– Post major surgery.
– Coma with unknown cause.
– Acute renal failure
Assessment of Critically Ill Patient
– F: Fluid: movement of fluid and electrolytes among body compartment.
“ Electrolyte imbalance, Dehydration, hypervolemia,
hemodynamic stability (V/S)”
– A: Aeration: assess the patient clinically and laboratory.
“ Type of respiration, normal and extrabreathing sounds, color of skin & mucous membrane, rate of respiration, ABGs determination is the best indicator for the patient condition.
– N: Nutrition: assess the patient through physical examination and lab. Investigation and ask the following question:
“ Can we use the normal GI tract, what about the GI system condition, does the patient need biologic nutrition (TPN), what about vitamins and minerals supplementation”.
– C: Communication: Assess neurological function (GCS), look at the patient eyes, does he cooperative, does he oriented.
– Activity: bed rest with mild activity (ADL), complete bed rest,
– Up with help—-need assistant.
– Up in chair —— cannot walk.
– P: Pain: Physiological pain from the disease process, psychological pain from lone less, hopelessness‘, fear.
P.Q.R.S.T. criteria for assessment of pain
– P: (Precipitating & palliating factors).
– Q: (Quality of pain) how would describe the pain “burning, stabbing, squeezing” description may indicate the cause.
– R: (Region & radiation) where is the pain, as; the patient to point the area of pain, does it travel any where.
– S: (Severity) does it make you stop what you are doing, double over.
– T: (Time factor) how often does the pain occur, how long does it lasts, when did you first experience the pain.