I. Monitoring of key vital signs
1. respiratory function monitoring: including the setting and adjustment of oxygen saturation (SpO2), respiratory frequency, arterial blood gas analysis (PaO2/FiO2 and other indicators), lung compliance and mechanical ventilation parameters.
2. Cardiovascular function monitoring: continuously monitor heart rate and rhythm, record electrocardiogram, and pay attention to the change of heart rate. Blood pressure monitoring includes invasive arterial blood pressure monitoring (IBP) and noninvasive blood pressure monitoring (NIBP) to dynamically observe blood pressure fluctuation. Central venous pressure (CVP) monitoring reflects the state of cardiac preload and circulating blood volume.
3. Nervous system assessment: monitoring the level of consciousness (such as Glasgow Coma Scale score), pupil response, EEG, etc. It is especially important for patients with severe neurological diseases.
Second, organ function evaluation
1. Renal function monitoring: Understand renal function through laboratory tests such as urine volume, serum creatinine and urea nitrogen, and monitor continuous renal replacement therapy (CRRT) if necessary.
2. Liver function monitoring: Blood is drawn regularly to detect liver enzymes, bilirubin and other indicators to assess whether liver function is damaged.
3. Evaluation of metabolism and acid-base balance: monitor the results of electrolyte and blood gas analysis, evaluate the state of acid-base balance in the body, and ensure the stability of the internal environment.
Third, pain and sedation assessment
Use CPOT (intensive care pain observation tool) and other special tools to evaluate the pain of intensive care patients and adjust the analgesic scheme accordingly. According to the patient's facial expression, body language, physical activity and other changes to judge the degree of pain, and to ensure that the pain is controlled while avoiding excessive sedation.
Fourth, infection monitoring.
Closely observe the changes of body temperature, white blood cell count, procalcitonin and other infection markers, and find and deal with possible infection problems in time.
Individualized treatment and prognosis evaluation in intensive care
First, make individualized treatment plan.
Individualized treatment scheme is an important link in intensive care. Based on the above comprehensive and detailed vital signs monitoring data, organ function evaluation results and in-depth analysis of patients' basic disease status, age-specific physiological changes, nutritional status, immune response ability and other factors. Doctors need to comprehensively consider this information, make precise adjustments and implement personalized treatment measures.
Second, the prognosis evaluation
In the intensive care unit, the prognosis evaluation tools such as APACHEII (Acute Physiology and Chronic Health Rating System II) and SOFA (Sequential Organ Failure Assessment) were used to quantitatively analyze the disease severity and potential survival risk of patients. These scoring systems can scientifically predict the possibility of short-term mortality or long-term rehabilitation through various information of patients.