What does "Intensive Care" mean in context of Covid19?

1,682 Views | 6 Replies | Last: 5 yr ago by Infection_Ag11
chris1515
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AG
What exactly does it mean when I hear that X number of cases of the disease are in Intensive Care? What triggers that level of care, what is the treatment like at that point, and what are the general outcomes?

I assume you can be in ICU but not yet on a ventilator.

Are hospitals being quicker than normal to put these cases in ICU?
Reel Aggies
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AG
Means in a hospital ICU. You go to the ICU if you are hemodynamically unstable, or some sort of respiratory instability where intubation might be required. Can't intubate pts on a regular floor or usually even step down units. ICU is for someone that needs some sort of intervention every hour or less. You can't provide that much attn when someone is on a regular floor. Step down is usually an intervention every 2 hours. The floor is usually no more often than q4h.
Marcus Aurelius
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AG
2:1, sometimes 1:1 RN:patient ratio. Pulse, O2 sats, resp rate continuously displayed. BP (unless art line placed) and temp taken Q1 hr. In the case of COVID-19 ICU care is warranted mainly due to patients with severe hypoxemia requiring high FIO2 and/or ventilators. I have 3 on 100% NRBs for days teetering on intubation. Seeing the disease drag on insidiously. Others report rapid decline to ARDS / max vent peeps in hrs, minutes.
Infection_Ag11
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AG
Technically, the only thing that defines an ICU is the patient:nurse ratio. Floor units generally have a 4:1 patient:nurse ratio, whereas an ICU is generally 2:1 (sometimes 1:1).

Practically, patients who are in the ICU are generally hemodynamically unstable, profoundly hypoxic, come in with very high risk conditions that will potentially decompensate, recovering from high risk surgery and anyone requiring intubation.
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BowSowy
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AG
I understood maybe half of what you said
fightingfarmer09
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What I think many are wondering is the percentage of patients with COVID-19 that are sent to ICU, that if it was a typical pneumonia or flu case in 2018, would not be in ICU.

Basically from reporting and feedback the impression is patients known for COVID-19 are fast tracked to ICU because of the potential health issues, not the existing ones. So in a pinch, these would not be ICU cases and are there because of added benefits being devoted to COVID-19.

Can a confirmed positive severe COVID-19 case be ICU worthy, while a confirmed negative severe pneumonia case not be ICU worth in the same hospital?
One Eyed Reveille
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AG
Infection_Ag11 said:

Technically, the only thing that defines an ICU is the nurse:patient ratio. Floor units generally have a 4:1 nurse:patient ratio, whereas an ICU is generally 2:1 (sometimes 1:1).

Practically, patients who are in the ICU are generally hemodynamically unstable, profoundly hypoxic, come in with very high risk conditions that will potentially decompensate, recovering from high risk surgery and anyone requiring intubation.


A general floor is 4 nurse to 1 patient? Or do you mean 4 patients to 1 nurse?
Infection_Ag11
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AG
1 nurse for 4 patients, sorry I just noticed the typo. I'll fix it.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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