A cardiac monitor is a comprehensive patient monitoring system that can be configured to continuously measure and display a number of parameters via electrodes and sensors that are connected to the patient. These may include the electrical activity of the heart via an ECG, respiration rate (breathing), blood pressure, body temperature, central venous pressure (cardiac output), and amount of oxygen or carbon dioxide in the blood.

Each patient bed in an ICU has a Cardiac monitor that measures these physiological activities. All monitors are networked to a central monitoring station located next to the ACC desk.

Endotracheal Tube (ET Tube)

Often, patients in critical care do not have the same or usual level of alertness. This can mean they may need help to breathe.

If your loved one needs this help, an ET tube will be placed into the mouth or nose and then into the trachea (windpipe). The tube attaches to the ventilator (see below for more on ventilators). The ET tube passes through the vocal cords, so your loved one will not be able to talk until the tube is removed.

Ventilator

Assists with or controls pulmonary ventilation in patients who cannot breathe on their own. Ventilators consist of a flexible breathing circuit, gas supply, heating/ humidification mechanism, monitors, and alarms.

IV Pumps

An IV pump is a device that delivers fluids intravenously through a catheter. Infusion pumps employ automatic, programmable pumping mechanisms to deliver continuous fluids, anesthesia, drugs, and blood infusions to the patient. The pump is hung on an intravenous pole placed next to the patient's bed.

Central Venous Access Device (CVAD)

This is a large catheter (IV) placed into one of the large blood vessels of the shoulder, neck, or groin. The catheter’s large size allows drugs and fluids to be given quickly and easily. With these IVs, several solutions can be given at the same time. It can also measure blood pressure. This helps us know if the patient needs more or less fluid.

The dietician and ICU physician determine the amount of liquid (enteral) tube feeding that a patient needs for each day. This amount is entered into the liquid(enteral) tube feeding pump by the ICU nurse. The tube feeding pump delivers the liquid tube (enteral) feeding to the patient at a constant rate over a twenty-four-hour period. The liquid (enteral) tube feeding will be seen at the patient’s bedside usually hanging from an IV pole. The tube feeding is usually in a container/bag that is connected to the feeding pump. The tube feeding flows through the feeding pump into the patient through a nasogastric, nasoduodenal, jejunostomy, or gastrostomy tube.

Not all patients receiving enteral feeds need a liquid(enteral) tube feeding pump. The nursing staff may safely give a measured amount of liquid tube feeding to patients several times daily.

Dialysis is a form of treatment that cleans the blood of toxins when the kidneys are not working. The patient's blood enters the dialysis machine and goes through a special filter that works like the kidney to remove fluid and toxins from the blood. The use of the dialysis machine at QCH ICU is termed sustained low-efficiency dialysis (SLED), this form of dialysis is short-term. A patient undergoing SLED treatment must be connected to the dialysis machine by tubing that allows blood to flow to and from the dialysis machine. The tubing is connected to the patient by way of a dialysis shunt or catheter.

Dialysis Catheter

The dialysis catheter is placed by the doctor into the patient's shoulder (subclavian), neck (jugular), or groin (femoral) vein. When the patient needs dialysis, the catheter is attached to the dialysis machine by dialysis tubing. The patient's blood flows into the dialysis machine and is filtered to remove fluids and/or toxins, and then returned back to the patient. The dialysis catheter is usually used for dialysis only.

Compression devices are plastic wraps that are placed around a patient's legs in order to decrease the chance of blood clot formation. They have compartments that inflate and deflate, gently squeezing the muscles of the legs. The stockings are connected to a small compressor that controls the timing of the inflation/deflation cycles. The squeezing action of the compression stockings improves the circulation in the leg veins, thus decreasing the chance of clot formation.

Most ICU patients have an increased risk of blood clot formation and compression stockings are one of the measures used to decrease this risk. Unfortunately, no measure is 100% effective at preventing the formation of blood clots in the leg veins of ICU patients.

Critically ill patients frequently have profound abnormalities in their blood pressure. The arterial line provides a way to constantly measure a patient's blood pressure and may be essential to the stabilization of the patient. Arterial lines may be useful in patients with very high or low blood pressure.

The arterial line also provides access for frequent blood sampling. Blood can be withdrawn from the patient through the arterial line tubing without having to use a needle for each blood draw. Arterial lines may be inserted in the wrist (radial artery), armpit (axillary artery), groin (femoral artery), or foot (pedal artery). The arterial line is inserted into the artery by the same technique used to insert a regular peripheral IV.

The arterial line can be sutured (sewed) or attached via a stabilization device (transparent dressing) to the overlying skin to assure that it remains in the artery. An arterial line insertion causes a similar discomfort to that associated with the insertion of a regular peripheral IV. The arterial line tubing is connected to the bedside monitor, where the patient's blood pressure is constantly displayed.