Feeding and Osmolarity pH = 6
Fluids : = 75
Overall
volume of mOsm/L
TPN = 2000
ml Amino acid Total
= 44 gram calorie =
1,215 Kcal
Feeding and IV fluids like :
Fluids :Fluids ➢Normal Saline
➢Ringer’s lactate
➢Dextrose 5%
➢Dextrose 10%
➢Dextrose Saline
Analgesics: It works 600 times more effectively than
Fentanyl Morphine and reduces the pain and increases
the pain threshold
Used in moderate and severe pain
In ICU 50 – 100 µg per Kg
Antidote Naloxone 0.05 mg/ Kg
Analgesics:Morphine Reduces pain
Chiefly used in MI
2-4 mg dissolved in 10 ml NS
Antidote: Naloxone
Supplied by hospital
Analgesics: Often more effective than opioids in
Acetaminophen reducing pain from pleural or pericardial
and NSAIDs rubs, a pain that responds poorly to opioids.
particularly effective in reducing muscular
and skeletal pain
Tab form: 500mg OD
Sedatives : Benzodiazepines
Midazolam
❑Short acting sedatives and hypnotics
❑In intubated patients
❑Dose 0.01- 0.05 mg/Kg for several hours
Diazepam
❑Adult dose = 0.2 – 0.5 mg/ Kg
❑Not given in MI patients 100
Dissociative Anaesthesia
Ketamine
• Adult dose= 1 – 3 mg/kg IV
Propofol
• Arousal is rapid 10- 15 min
• Used in neuro cases and those with increased ICP,
during tracheostomy procedure
INOTROPES
Dopamine Dobutamine Nor-
adrenaline
Thrombolytic agents
TEDS SCD (Systematic LMWX Heparin flush
compressive Compressive
Device)
stocking
Head Head is elevated to
30 degree
elevation
ULCER
Two hourly position change
Back care in each shift
Oxygen therapy
Each shift dressing of pressure sore
Air mattresses
Glucose 1.RBS as prescribed
monitoring 2.Insulin therapy
3.Careful monitoring of signs of
Hypoglycemia (trembling, clammy
skin, palpitations, anxiety,
sweating, hunger, and irritability)
Infection • Hand washing before, during and after
control the procedure
• Sterility maintenance during procedures
• Use of disinfectants
• Weekly high wash
• Monthly culture test of health
personnel, equipments and
infrastructures
• Regular inspection by infection control
team
• Each shift CVP dressing
Specific equipments used in ICU and CCU
Ventilators Infusion Cardiac
pumps monitors
Defibrillator ABG ECG
machine machine
Drugs used Aspirin
in CCU Clopidogrel
Nitroglycerine
Atorvastatins
LMWX
Morphine
Number Characteristics Sedation score in ICU is done by RASS : Intervention
+4 Combative Richmond Agitation Sedation Scale = (RASS) Restrain and
Definition sedate
Restrain and
Violent, immediate danger to staff
sedate
+3 Very agitated Aggressive, pull or remove tubes Restrain and
+2 Agitated Frequent non purposeful movement, fights ventilator sedate
Anxious movement but not aggressive or vigorous Sedate
+1 Restless
0 Alert and calm Not fully alert but has sustained awakening, eye contact to voice (>10 Verbal stimulation
sec)
-1 Drowsy Briefly awakens, eye contact to voice (<10sec) Verbal stimulation
Moderate or eye opening to voice but no eye contact
-2 Light sedation Verbal stimulation
No response to voice but movement or eye opening to physical stimuli
-3 Moderate Physical
sedation stimulation
-4 Deep sedation Physical
stimulation
-5 No response No response to voice or physical stimuli