Infrastructure and Organization of Adult Intensive Care Units in Resource-Limited Settings

Papali, Alfred, Adhikari, Neill, Diaz, Janet, Dondorp, Arjen, Dünser, Martin, Jacob, Shevin ORCID: https://orcid.org/0000-0003-2425-9394, Phua, Jason, Romain, Marc and Schultz, Marcus (2019) 'Infrastructure and Organization of Adult Intensive Care Units in Resource-Limited Settings' in: Sepsis Management in Resource-limited Settings, Springer, pp. 31-68.

Full text not available from this repository.

Abstract

In this chapter, we provide guidance on some basic structural requirements, focusing on organization, staffing, and infrastructure. We suggest a closed-format intensive care unit (ICU) with dedicated physicians and nurses, specifically trained in intensive care medicine whenever feasible. Regarding infrastructural components, a reliable electricity supply is essential, with adequate backup systems. Facilities for oxygen therapy are crucial, and the choice between oxygen concentrators, cylinders, and a centralized system depends on the setting. For use in mechanical ventilators, a centralized piped system is preferred. Facilities for proper hand hygiene are essential. Alcohol-based solutions are preferred, except in the context of Ebola virus disease (chloride-based solutions) and Clostridium difficile infection (soap and water). Availability of disposable gloves is important for self-protection; for invasive procedures masks, caps, sterile gowns, sterile drapes, and sterile gloves are recommended. Caring for patients with highly contagious infectious diseases requires access to personal protective equipment. Basic ICU equipment should include vital signs monitors and mechanical ventilators, which should also deliver noninvasive ventilator modes. We suggest that ICUs providing invasive ventilatory support have the ability to measure end-tidal carbon dioxide and if possible can perform blood gas analysis. We recommend availability of glucometers and capabilities for measuring blood lactate. We suggest implementation of bedside ultrasound as diagnostic tool. Finally, we recommend proper administration of patient data; suggest development of locally applicable bundles, protocols, and checklists for the management of sepsis; and implement systematic collection of quality and performance indicators to guide improvements in ICU performance.

Item Type:	Book Section
Additional Information:	Chapter 3
Subjects:	WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WX Hospitals and Other Health Facilities > Clinical Departments and Units > WX 200 General works
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1007/978-3-030-03143-5_3
Depositing User:	Stacy Murtagh
Date Deposited:	05 Nov 2021 19:24
Last Modified:	05 Nov 2021 19:24
URI:	https://archive.lstmed.ac.uk/id/eprint/19354

Statistics

View details

Actions (login required)

Edit Item