A typical patient’s day
The day of an intensive care patient is punctuated by the activities of the various members of the care team, present 24 hours a day.
Each morning, the doctors examine each patient to establish the diagnosis and evaluate the effect of the treatments. If the evolution of the patient’s condition requires it, this examination can be repeated several times during the day. This step is important to prescribe the treatments your loved one needs. These prescriptions are updated throughout the day and will be adapted according to the patient’s condition and vital parameters (pulse, blood pressure, oxygen saturation, etc…). All these parameters are continuously recorded by the scope and monitored by the paramedical team.
A timed and coordinated organization
- A typical day usually begins early in the morning with blood work being taken so that urgent results can be obtained as early as possible in the day to determine the day’s treatment goals.
- Nurses perform monitoring and treatment administration rounds at least every 3 to 4 hours. The most time-consuming hygiene care is usually performed at the beginning of the day or night. Physiotherapists also perform their first round of care. The early morning is therefore a relatively busy time for care.
- At the end of the morning, a team meeting is generally held, called a “visit” or “staff”, a moment of coordination for all the actors to share the problems encountered and to determine together the objectives and priorities of the day for each patient, as well as the constraints and to organize the day of the team in order to be able to achieve all the priority objectives for all the patients of the unit. This is an important moment that you will be asked not to interrupt in order to allow the best possible quality to this organization.
- The afternoon is often the time for scheduled exams or longer rehabilitation sessions.
It may be necessary to perform examinations outside the department (scanner, MRI). In this case, the patient is taken to the department where the examination is performed by members of the resuscitation team who will ensure his or her surveillance and safety. These transfers are made only if necessary, at a time when the patient’s condition is sufficiently stable. The health care team can also call on specialists, who can come to the patient’s bed in certain cases or consult imaging tests remotely. Thus, the dialogue with the treating physicians, the specialists and the referring physicians is permanent.
At the end of the day, and/or at each shift change, the doctors and nurses of the day recall the history of each patient, and transmit the events of the day as well as the objectives to pursue to the night team. Physicians on call ensure that prescribed treatments are having the expected effect, examine patients who require them and adjust treatments as needed. The surveillance by the paramedical team continues at the same rhythm at night as during the day, trying as much as possible to create a more subdued atmosphere in order to protect the patients’ nycthemeral rhythm (day/night rhythm).
Complementary examinations can be performed during the hospitalization in the intensive care unit:
Ultrasound: An external, or in some cases internal, examination to explore the anatomy and function of certain organs such as the heart, kidneys, bladder, etc. with the help of ultrasound. In most cases, the ultrasound probe is placed on the skin after applying gel. In some cases, in order to get closer to the structures to be observed, the probe can be inserted in a natural way, for example in the esophagus in the case of transesophageal ultrasound, which allows a better vision of certain areas of the heart. This examination is performed at the patient’s bed by a trained physician.
Fibroscopy Fibroscopy: With the help of a device called a fiberscope, which consists of a probe at the end of which a miniature camera is installed, the physician can observe the interior of certain structures such as the airways up to the bronchial tubes (bronchial fibroscopy), upper digestive structures (oesophageal-gastro-duodenal fibroscopy), lower digestive structures (colonoscopy), or urinary structures. This examination is performed at the patient’s bed by a trained physician.
CT scan: An examination of the internal structures of the body using X-rays, which may require a drug injection and that the patient is fasting. This examination cannot be performed in bed and will require transporting the patient and the equipment that surrounds him (respirator, scope, continuous medication). Electroencephalogram (EEG): Examination to measure the electrical activity of the brain, performed using electrodes placed on the patient’s head. It is a painless examination for the patient.
Magnetic Resonance Imaging (MRI): An examination that provides two- or three-dimensional views of the inside of a patient’s body, non-invasively using a magnetic field technique.