The Intensive Care Unit is located on the first floor adjacent to main theatres.
It is a seven-bedded unit, with facilities for an additional patient on a short-term basis when the Unit is extremely busy. The nurse staffing level is currently for 7.5 beds.
Patients are admitted to the Intensive Care Unit when they are likely to benefit from the admission. The Intensive Care Unit provides three things that are not available on a general ward:
- A higher level of clinical observation, both Medical and Nursing.
- More invasive monitoring.
- Specific therapies not available on the general ward.
Any patient may be admitted to ICU, who may benefit from any of the above and has a reasonable prognosis. The requirement for mechanical ventilation is not the sole indication for admission.
When called, either to a patient in ICU or on the ward, the Trainee must make a rapid initial assessment of any clinical problems brought to his/her attention, but senior assistance will always be available. Trainees must always contact the on-call consultant about:
- Requests for admission of a patient to ICU
- Refusal of admission to ICU
- Discharge from ICU
- Deterioration of a patient, involving significant new support e.g. large increase in ventilatory support, new requirement for Inotropes
- Any other matters about which they are concerned.
The nursing staff in ICU are a valuable source of experience and much can be learned from them.
Shift Patterns
There is a consultant on call at all times, both during the day and at night. There is a daily multidisciplinary ward round lead by a consultant Intensivist 7 days/week, with a second business round in the afternoon. A Trainee/SAS doctor will be assigned to ICU, with duties usually divided into shifts. Working patterns during the day can fall into one of the following categories:
- Continuous 12 hour shift at weekends
- Daytime shift 8am-5:30pm
- Evening shift 5pm-8.30pm
- Night shift 8:00pm – 8:30am
Highland Critical Care 