MMMC-ICU ORIENTATION

Orientation: Mary Mediatrix Medical Center Affiliation

Area: Intensive Care Unit

• 8 cubicles (Adult); 4 cubicles (Pedia)

Student’s Tasks:
• PPE Level-3 (isolation gown) donning and doffing.
• To receive endorsement
• ECG rhythm identification
• cephalocaudal assessment
• review of chart
• ICU routine care
• vs monitoring q hour
• I&O monitoring every hour.
• meds preparation and computation
• meds administration
• ET/per Orem suctioning
• NGT feeding.
• ACLS
• Documentation

Equipment:
• ventilators
• infusion pump
• syringe pump
• CBG monitoring machine
• suction machine
• ECG machine
• cardiac monitor
• bedridden weighing scale
• pulse oximeter
• nebulizers
Procedures to be reviewed:
• IV medications administration
• skin test, IM, subcutaneous injection
• ECG taking and interpretation
• foley cath insertion
• NGT insertion
• NGT feeding
• Lavage
• medication administration via NGT
 • IV insertion
• suctioning via ET tube
• CPR/code blue
• Post-mortem
• minor suturing – assist/actual
• ACLS

Computations:
• Inotropic med (e.g., Dopamine, Dobutamine, Norepinephine)
• OF dilution
• ECG manual computation
• Pedia medications
• GCS assessment

ABG interpretation:
• Normal values
• Compensatory mechanism
• acid-base imbalance
• acid-base imbalance mgt
• nursing implication

ECG Interpretation/intervention:
• Premature ventricular contraction (PVC)
• Sinus bradycardia / Sinus tachycardia
• Supraventricular tachycardia (SVT)
• Ventricular tachycardia with pulse (Vtach)
• Pulseless ventricular tachycardia (Vtach)
• Ventricular fibrillation (Vfib)
• Pulseless electrical activity (PEA)
• Asystole

Emergency Drugs:
• Atropine Sulfate 1mg
• Adenosine 6mg/2ml
• Amiodarone 150mg/3ml
• Epinephrine 1mg
• Dopamine 200mg
• Dobutamine 250mg
• Nitroglycerine / Aspirin
• Morphine Sulphate 10mg/10ml
• Furosemide 20mg/2ml
• Magnesium Sulphate 5gm/10ml
• Mannitol 200mg/ml (20%)
• Lidocaine 20mg/ml (2%)
• Na HCO3 1mEq/ml
• D50 50 500mg/ml (50%)
 • Digibind 40mg/vial
• Verapamil
• Diltiazem
• Vasopressin
• Na Nitroprusside
• Naloxone HCL
• Ipecac Syrup
• Activated Charcoal
• Flumazenil
• Glucagon
• Albuterol
• Diphenhydramine HCL

Paraphernalia: (to be checked at the start of duty)

• penlight
• bandage scissors
• disposable facemask
• sterile gloves
• clean gloves
• calculator
• Isolation gown (2 per duty)
• K95 face mask
• Cap, shoe cover
• Uniform (scrub suit, white rubber shoes, smock gown)

Clinical Duty Requirements:

• 1st day (MMMC): Assessment/Drug study reporting
• 2nd day (MMMC): Reporting of the patient’s assessment/Identify problem
• 3rd day (MMMC): Partial NCP reporting with Evaluation
• 4th day (AUP): NCP reporting/Quiz

ICU Grading system:

• Clinical Performance Evaluation – 40%
• Case presentation (NCP) – 30%
• Worksheet and Quizzes – 30%
• TOTAL – 100%