Nuances of setting up an ICU

Nuances of setting up an ICU

Planning an ICU

  • Identifying Space – Utility areas, future expansion
  • Plan for Power back up
  • Maintain Ledgers and utilization registers
  • Include Maintenance costs while purchasing equipment
  • Manpower and Training

Location of ICU

  • Preferable – Ground Floor
  • Near the emergency room, Well Ventilated with emergency exits
  • Preferable an OT adjacent to the ICU
No. of Beds
  • Rule of thumb – 4-6 beds / 100 hospital beds
  • Economical to maintain 6-12 beds overall.

ICU Space - basics needs

  • Preferable to have 80 Sqft / bed
  • One Dirty utility room
  • One Clean utility room
  • One equipment and medication storage rooms
  • One male and female changing room
  • One room for helpers/AID

Equipment to set up 10 Beds

  • 10 ICU Beds semi-automated with air mattresses
  • 4 Ventilators with air compressor
  • 2 BiPAP/CPAP +/- 1 HFNC
  • 2 Suction Apparatus
  • 10 Multi-channel Monitors (Consider CNS)
  • 20 Infusion/ Syringe pumps
  • 1 Defibrillator
  • 2 DVT pumps
Optional
  • 1 Ultrasound machine
  • Plan for power back up
    – at least for vital equipment (ventilators, BiPAP) – 1.5 Kva/bed – minimum requirement

Maintain ledgers and utilization registers

  • A severe shortage of trained manpower in rural India
  • For 10 beds: Two trained intensivists and 3-4 resident doctors
Strategies
  • Short-term training for doctors and nursing staff
  • Recurrent training with feedback
  • Intermittent feedback and online/tele rounds

Manpower and Training

  • Help in tracking the utilization – thereby assessing future needs
  • Minimize wastage
  • Accountability
  • Prompt service/ preventive maintenance

Future

  • Live Tracking of the equipment utilization
  • Developing apps to remote monitor ICU patients