CCU Observation Report at Era Nursing

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The document describes an observation report on a cardiac care unit (CCU) from a student's posting. It provides details on the CCU, including its location and capacity, the types of cases ad…

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  • Admission Protocol
  • Cardiac Care Unit
  • Introduction
  • Staffing Pattern
  • Emergency Drugs and Equipment
  • ICU Equipment Details
  • Biomedical Waste Management
  • Conclusion
  • Discharge Protocol and Summary

ERA UNIVERSITY

ERA COLLEGE OF NURSING


LUCKNOW

OBSERVATION REPORT
ON

CCU

SUBMITTED TO-: SUBMITTED BY-:


Ms. SWASTIKA DAS ARCHANA DEVI

ASSISTANT PROFESSOR [Link]. NURSING 2nd YR.

ECON ECON

LUCKNOW LUCKNOW
INTRODUCTION

As a part of 2ndyr. MSc. Nursing curriculum, we were posted to CCU of Era hospital, Lucknow
from 30/8/2021 to 04-09-2021 for our medical-surgical nursing (cardio-vascular nursing
department) requirement. There, I came across with many patients with different diagnosis, learned
about functioning of CCU, its management.

CARDIAC CARE UNIT:

CCU is located is located in the ground floor of the hospital building with the capacity of 12 beds
unit. It is a very specialized unit which provides effective and efficient protocol based care to the
patients. An appropriate service is provided which include ongoing treatment, assessment,
diagnosis and reassessment before discharging the patient. This unit caters to patients with severe
or life-threatening illnesses and injuries, which require constant care, close supervision from life
support equipment and medication in order to ensure normal bodily functions. They are staffed by
highly trained physicians, nurses and respiratory therapists who specialize in caring for critically ill
patients.

ADMISSION PROTOCOL:

In CCU patients are admitted either directly from emergency or are transferred from the other ward
(if they rapidly deteriorate, or immediately after surgery required critical care) and some cases are
referred from other hospital as well. Intensive care is appropriate for patients requiring or likely to
require advanced respiratory support, patients requiring support of two or more organ systems, and
patients with chronic impairment of one or more organ systems who also require support for an
acute reversible failure of another organ.

CASES SEEN IN CCU:

A. Cardiac System

 Acute myocardial infarction with complications


 Cardiogenic shock
 Complex arrhythmias requiring close monitoring and intervention
 Acute congestive heart failure with respiratory failure and/or requiring hemodynamic support
 Hypertensive emergencies
 Unstable angina, particularly with dysrhythmias, hemodynamic instability, or persistent chest
pain
 S/P cardiac arrest
 Cardiac tamponade or constriction with hemodynamic instability
 Dissecting aortic aneurysms
 Complete heart block.

STAFFING PATTERN: (DOCTORS)

[Link]

[Link] JR 3rd

Dr. Utkarsh JR 2nd

STAFFING PATTERN: (NURSING STAFFS)

[Link] Khan (incharge)

Nursing staffs:

([Link], Arti Sharma, Priyanshi, Aftab, Sandhya, Faiz, Saumya Singh, Rattan, Bhavna,
Abdul, Aziz, Kanchan.)

Staffing pattern: (technicians)

[Link] (Incharge)

([Link], Yaushuf, Saiyauddin, Ansar, Yasir, Jyoti, Sudha)


EMERGENCY DRUGS AVAILABLE IN CCU:

Name of the Drug Classification.


Inj. Atropine. Parasympatholytic.
Inj. Adrenaline Sympathomimetic agents.
Inj. Dopamine. Catecholamines
Inj. Adenosine Anti arrhythmics.
Inj. Amiodarone Anti arrhythmics
Inj. Calcium gluconate. Electrolytes.
Inj. Dobutamine. Beta agonist.
Inj. Furosemide Loop diuretics.
Inj. Hydrocortisone Corticosteroids.
Inj. Epinephrine Alpha- beta adrenergics.
Inj. Magnesium Sulfate Electrolytes.
Inj. Sodium Bicarbonate Concentrated electrolytes.
Inj. Vasopressin Vasopressor.
Inj. 25% dextrose Concentrated electrolyte.
Inj. Mennitol Osmotic diuretics.
Inj. Trenexa. Coagulants.
Inj. Terbutaline Beta adrenergic receptor agonist.
Inj. Midazolam. Sedatives
Inj. Vitamin K Coagulants.
Inj. Fentanyl. Opoid
Inj. Noradralline. Sympathomimetic amine.
Inj. Phenobarbitone. Anti convulsant

EQUIPEMENTS REQUIRED IN CCU

Intensive care unit (CCU) equipment includes patient monitoring, respiratory and cardiac support,
pain management, emergency resuscitation devices, other life support equipment’s.

They are designed to care for patients who are-:

 Seriously injured
 Have a critical or life threatening illness
 Have undergone a major surgical procedure thereby requiring 24-hour care and monitoring.

TYPES OF DEVICES
Intensive care unit equipment includes

 Patient monitoring devices


 Life support and emergency resuscitation devices
 Diagnostic devices

I. PATIENT MONITORING EQUIPEMENT


 Arterial line
 Bedside monitor
 Blood pressure device (sphygmomanometer)
 Blood pressure monitor
 Electrocardiograph machine
 Intracranial pressure monitor
 Pulse oximeter
 Glucometer
II. LIFE SUUPORT AND EMERGENCY RESUSCITATION DEVICES
 Mechanical ventilator
 Laryngoscope
 Airway
 Infusion pump
 Crash cart (resuscitation cart)
 Intra-aortic balloon pump
 Continuous positive air pressure machine
 Defibrillator
III. DIAGNOSTIC DEVICES
 Mobile x-ray units
 Portable clinical laboratory devices
 Bronchoscope
IV. DISPOSABLE ICU EQUIPEMENTS
 Urinary catheter
 Urinary drainage collector
 Suction catheter
 Nasogastric tube
 Intravenous catheter
 Feeding tube
 Breathing tube (endotracheal tube)

BIOMEDICAL WASTE MANAGEMENT IN ICU

Waste is generated during the diagnosis, testing, treatment, research or production of biological
products for humans.

The hospital waste like body parts, organs, tissues, blood and body fluids with soiled linen, cotton,
bandage and plaster casts from infected and contaminated area are very essential to be properly
collected, segregated, stored, transported, treated, and disposed of in safe manner to prevent
nosocomial or hospital acquired infection.

 Waste collection
 Segregation
 Transportation and storage
 Treatment and disposal
 Transport to final disposal site
 Final disposal

TYPES OF BIOMEDICAL WASTES

WASTE CATEGORY TYPE OF WASTE


CATEGORY NO. 1 Human anatomical waste
CATEGORY NO. 2 Animal waste
CATEGORY NO. 3 Microbiological & biotechnological waste
CATEGORY NO. 4 Sharp waste
CATEGORY NO. 5 Discarded medicine and cytotoxic
CATEGORY NO. 6 Soiled waste
CATEGORY NO. 7 Solid waste
CATEGORY NO. 8 Liquid waste
CATEGORY NO. 9 Incineration ash
CATEGORY NO. 10 Chemical waste

COLOUR CODING TYPE OF CONTAINER WASTE CATEGORY


Yellow Plastic bag 1,2,3,6
Red Plastic bag 3,6,7
Blue/white translucent Plastic bag / puncture 4,7
Proof container
Black Plastic bag 5,9,10

DISCHARGE PROTOCOL FOR THE PATIENTS

The status of patients admitted to an CCU is been revised continuously to identify patients who
may no longer needICU care.

 When a patient's physiologic status has stabilized and the need for CCU monitoring and care is
no longer necessary
 When a patient's physiological status has deteriorated and active interventions are no longer
planned, discharge to a lower level of care is appropriate.

SUMMARY:

CCU is a special department of a hospital or health care facility that provides intensive treatment
medicine. It is a very specialized unit which provides effective and efficient protocol based care to
the patients. An appropriate service is provided which include ongoing treatment, assessment,
diagnosis and reassessment before discharging the patient. This unit caters to patients with severe or
life-threatening illnesses and injuries, which require constant care, close supervision from life
support equipment and medication in order to ensure normal bodily functions.

CONCLUSION:

During our posting, I got to learn about the different diagnosis of the presents and care to be
provided accordingly. Common conditions that are treated within CCUs include acute (or adult)
respiratory distress syndrome, hypertension, metastases and other life-threatening conditions.

Common questions

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The staffing pattern in a CCU, composed of highly trained physicians, nurses, and respiratory therapists, provides continuous and specialized care for critically ill patients. The presence of skilled professionals ensures that any deterioration in a patient's condition can be immediately addressed, while specific protocols and teamwork enable efficient management of complex health issues .

The discharge procedure from a CCU involves continual revision of patient status to determine whether intensive care is still necessary. Patients are discharged once their physiological status stabilizes or if active interventions are no longer planned. Patient safety is ensured by carefully assessing their needs and transferring them to an appropriate level of care, ensuring a smooth transition and continued monitoring until stability is assured .

Essential monitoring and life support equipment in a CCU includes arterial lines, bedside monitors, mechanical ventilators, and defibrillators. These devices help in continuous assessment of a patient's vital signs, provide critical support for failing organs, and allow for immediate intervention in life-threatening situations, thereby maintaining normal bodily functions .

Protocol-based care in a CCU benefits patients by ensuring consistent, efficient, and evidence-based practices are applied to manage severe conditions. This approach allows for ongoing treatment, assessment, diagnosis, and reassessment, which leads to tailored interventions that address each patient's specific needs promptly. The systematic processes improve patient outcomes by maintaining stability or providing rapid interventions when needed .

The significant learning outcomes for nursing students in a CCU include acquiring knowledge in the management of critical cardiac conditions, understanding the functioning and protocols of a specialized unit, and developing skills in patient assessment and response to emergency situations. The intensive environment provides students with practical experience in high-stakes decision-making and collaborative care practices .

Common conditions treated in a CCU include acute myocardial infarction, cardiogenic shock, complex arrhythmias, acute congestive heart failure, and hypertensive emergencies. This implies the unit's capability to manage severe cardiovascular conditions that require intensive monitoring and interventions such as hemodynamic support and life support measures .

The use of disposable equipment, such as urinary catheters and suction catheters, contributes to infection control by reducing the risk of cross-contamination between patients. Disposables ensure that each patient uses clean, sterile instruments, which prevent the transmission of pathogens within the CCU environment, thereby maintaining high hygiene standards and protecting patient health .

Emergency drugs in the CCU, such as adrenaline, dopamine, and atropine, play a critical role in managing life-threatening conditions by quickly stabilizing vital signs or reversing acute symptoms. Their availability ensures immediate treatment of emergencies like cardiac arrest or arrhythmic episodes, thus significantly improving the chances of patient survival and recovery .

Key components of biomedical waste management in a CCU include proper collection, segregation, storage, treatment, and disposal of waste. This involves using color-coded containers for different types of waste, such as human anatomical waste, sharp waste, and liquid waste. Effective management prevents nosocomial infections and ensures safe disposal of hazardous material .

Patients are admitted to the CCU either directly from the emergency or transferred from other wards if they rapidly deteriorate or require critical care immediately after surgery. The admission is appropriate for patients requiring advanced respiratory support or support for two or more organ systems. Additionally, those with chronic impairments of one or more organ systems who require support for an acute reversible failure of another organ are also admitted .

ERA UNIVERSITY 
ERA COLLEGE OF NURSING
LUCKNOW
OBSERVATION REPORT 
ON
CCU 
SUBMITTED TO-:
SUBMITTED BY-:
Ms. SWASTIKA DAS 
 A
INTRODUCTION
As a part of 2ndyr. MSc. Nursing curriculum, we were posted to CCU of Era hospital, Lucknow
from  30/8/2021  to
Complete heart block.
STAFFING PATTERN: (DOCTORS)
Dr.IrshadWani
Dr.Ziel JR 3rd
Dr. Utkarsh JR 2nd
STAFFING PATTERN: (NURSING
EMERGENCY DRUGS AVAILABLE IN CCU:
           Name of the Drug
                 Classification.
Inj. Atropine.
Parasympatholyt
Intensive care unit equipment includes
Patient monitoring devices
Life support and emergency resuscitation devices
Diagnos

Breathing tube (endotracheal tube)
BIOMEDICAL WASTE MANAGEMENT IN ICU
Waste is generated during the diagnosis, testing, tre
Blue/white translucent
Plastic bag / puncture
Proof container
4,7
Black 
Plastic bag
5,9,10
DISCHARGE PROTOCOL FOR THE PATIEN

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