Critical events in intensive care unit

Challenges faced in establishing a dedicated 250 bed COVID-19 intensive care unit in a temporary structure

An Intensive Care Unit (ICU) is an organized system for the provision of care to critically ill patients that provides intensive and specialized medical and nursing care, an enhanced capacity for monitoring, and multiple modalities of physiologic organ support to sustain life during a period of life-threatening organ system insufficiency. While this availability of trained manpower and specialized equipment makes it possible to care for critically ill patients, it also presents singular challenges in the form of man and material management, design concerns, budgetary concerns, and protocolization of treatment. Consequently, the establishment of an ICU requires rigorous design and planning, a process that can take months to years. However, the Coronavirus disease-19 (COVID-19) epidemic has required the significant capacity building to accommodate the increased number of critically ill patients. At the peak of the pandemic, many countries were forced to resort to the building of temporary structures to house critically ill patients, to help tide over the crisis. This narrative review describes the challenges and lessons learned while establishing a 250 bedded ICU in a temporary structure and achieving functionality within a period of a fortnight.

Implementing a Pervasive Real-Time Intelligent System for Tracking Critical Events with Intensive Care Patients

Nowadays, it is increasingly important to utilize intelligent systems to support the decision making process (DMP) in challenging areas such as Intensive Medicine. In Intensive Care Units (ICU), some of the biggest challenges relate both to the number and the different types of available data sources. Even though in such a setting the values for some variables are easy to collect, data collection is still performed manually in particular instances. In order to improve the DMP in ICU, a Pervasive Intelligent Decision Support System, called INTCare was deployed in the ICU of Centro Hospitalar do Porto in Portugal. This system altered the way information is collected and presented. Moreover, the tracking system deployed as a specific module of INTCare – Electronic Nursing Record (ENR) is made accessible anywhere and anytime. The system allows for the calculation of the critical events regarding five variables that are typically monitored in an ICU. Specifically, the INTCare tracking system characterizes a grid that shows the events by type and duration, empowers a warning system to alert the doctors and promotes intuitive graphics that allow care providers to follow the patient care journey. User acceptance was measured through a questionnaire designed in accordance with the Technology Acceptance Model (TAM) and results of implementing the INTCare tracking system, and its interface are reported.