Assessment of the general condition of the patient (the severity of the condition) is carried out on the basis of objective and subjective research methods. The severity of the general condition is determined depending on the presence and severity of decompensation of vital body functions. Depending on the severity of the condition, the doctor decides on the urgency and the necessary volume of diagnostic and therapeutic measures, determines the indications for hospitalization, the patient's transportability and the likely outcome (prognosis) of the disease.
In clinical practice, there are several gradations of the general condition:
Ø Satisfactory
Ø Moderate
Ø Heavy
Ø Extremely heavy (pre-agonal)
Ø Terminal (agonal)
Ø State of clinical death
General condition satisfactory If the vital functions of the body are not impaired, many symptoms of the disease may appear, but they are mild and do not prevent the patient from being active. Consciousness is clear, position in bed is active, nutrition is not disturbed, body temperature is normal or subfebrile. The patient can take care of himself. A satisfactory condition occurs in mild forms of the course of the disease or in the period of convalescence (recovery).
In a state of moderate severity the functions of vital organs are impaired, but do not pose an immediate danger to the life of the patient. The patient's consciousness is clear, but the facial expression is painful. Moderately expressed symptoms of the underlying disease are determined: pain of various localization, weakness, fever, shortness of breath, and so on. The motor activity of patients is limited: most of the time they spend in bed. Active actions increase the general weakness and painful symptoms, but they are able to serve themselves.
In severe condition decompensation of the functions of vital organs poses an immediate danger to the life of the patient, or can lead to disability. The position of the patient in bed is passive or forced, various degrees of oppression of consciousness are possible. Complaints and symptoms of the disease are significantly expressed: unbearable pain, indomitable vomiting, severe shortness of breath at rest, etc. Often the patient groans, asks for help, the expression on his face is suffering. All patients in serious condition require urgent hospitalization.
Extremely severe (predagonal) condition characterized by a sharp violation of the basic vital functions of the body and without urgent and intensive therapeutic measures, the patient may die within the next hours or minutes. Consciousness is oppressed up to a coma. The position is passive. Symptoms of damage to the respiratory system, cardiovascular system and other organs and systems are expressed: pathological types of breathing, the pulse is weak in the carotid arteries, barely palpable, convulsions, etc. The treatment is carried out in the intensive care unit.
In the terminal (agonal) state there is a complete extinction of consciousness, the muscles are relaxed, there are no reflexes. The cornea becomes cloudy, the lower jaw droops. The pulse is not palpable even on the carotid arteries, blood pressure is not detected, heart sounds are not heard, however, the electrical activity of the myocardium is still recorded on the electrocardiogram. Rare periodic respiratory movements are noted according to the type of Biot's breathing. The agony can last for minutes or hours.
The appearance on the electrocardiogram of an isoelectric line or fibrillation waves and the cessation of breathing indicate the onset of clinical death . Immediately before death, the patient may develop convulsions, involuntary urination and defecation. The duration of the state of clinical death is only a few minutes, however, promptly initiated resuscitation can bring a person back to life.
State of consciousness
The patient may develop various degrees of disorder of consciousness, which is manifested by its oppression (stupor, stupor, coma) or excitation of the central nervous system (delusions, hallucinations).
clear mind- complete preservation of consciousness, active wakefulness, adequate perception of oneself and the environment. The patient is fully oriented in the environment, clearly answers the questions posed.
Stupor (moderate stun)- partial depression of consciousness. The patient is poorly oriented in time and space, but the orientation in his own personality, surrounding persons is preserved. Characterized by increased exhaustion, lethargy, some depletion of facial expressions, drowsiness. The motor reaction to the pain caused is active and purposeful. Speech contact is maintained; upon hearing speech, he opens his eyes, but answers questions slowly, in monosyllables, sometimes not to the point. Control over the functions of the pelvic organs is preserved.
Sopor- deep stupefaction of consciousness. The patient is in a state of "hibernation": indifferent, eyes closed, speech contact is impossible, does not follow commands, is motionless. Only in response to a loud cry, painful impact (prick, pinches, etc.) do coordinated protective movements of the limbs aimed at eliminating them appear, the patient turns to the other side, and may moan. A short-term exit from the state of pathological drowsiness is possible. Control over the functions of the pelvic organs is impaired. Vital functions are preserved or moderately changed in one parameter.
Coma- complete loss of consciousness. The patient does not respond to pain and sound stimuli, there are no reflexes. It is characterized by a violation of the depth and frequency of breathing, a decrease in blood pressure, a violation of the rhythm of cardiac activity, a violation of temperature regulation. The pupils are constricted, there is no reaction to light. Coma indicates a significant severity of the disease, develops as a result of deep inhibition in the cerebral cortex due to acute circulatory disorders in the brain, head injuries, inflammation (with encephalitis, meningitis, malaria), as well as as a result of poisoning (with barbiturates, carbon monoxide, etc.). ), with diabetes mellitus, uremia, hepatitis (uremic, hepatic coma).
Rave- this is a false, absolutely uncorrected judgment, accompanied by a disorder of thinking, incoherent speech. May occur in somatic patients with elevated body temperature (for example, with infectious diseases), more often with mental disorders. Distinguish between quiet and violent delirium. In violent delirium, patients are extremely agitated, jump out of bed, and in this state can harm both themselves and others. An individual nursing post is organized for the care and observation of these patients.
hallucinations- a false perception of what is not in reality. Hallucinations are auditory, visual, olfactory, tactile. With auditory hallucinations, the patient talks to himself or to an imaginary interlocutor. With visual hallucinations, patients see something that is not really there. This kind of hallucination often occurs in patients suffering from chronic alcoholism. Olfactory hallucinations are accompanied in the patient by a sensation of unpleasant odors, a change in taste. Tactile hallucinations are the sensation of insects, microbes, etc. crawling over the body.
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The system for assessing the severity of the patient's condition determines in the short term potentially possible actions for complex therapy or resuscitation of a person. What are the evaluation criteria? How accurate are modern domestic prognostic methods? What are the characteristics of the intensive care unit? You will read about this and much more in our article.
The severity of the patient's condition
The general condition of the patient and its types includes definitions of 5 stages:
- Satisfactory condition. The vital functions of the human body are not disturbed;
- Condition of moderate severity. There are slight violations of vital functions with the obligatory presence of clear symptoms, indicating a linear course of the disease, pathological process, syndrome;
- Severe condition. Moderate impairment of vital functions on several basic indicators;
- Extremely serious condition. Serious violation of vital functions on a number of basic indicators;
- Terminal state. Critical violation of vital functions, in the vast majority of cases leading to death.
In modern medical practice, there is no single mechanism for classifying the severity of a patient.
So, within the framework of nursing practice, the need for hospitalization of a patient without a short-term forecast of the dynamics of the process is assessed. Resuscitation includes in the gradation a lot of specific parameters, including those diagnosed by express methods of laboratory and instrumental research methods.
Satisfactory
A satisfactory condition of the patient means that the functions of important organs are relatively compensated and it is usually observed in the presence of mild forms of the course of the disease.
- Clear consciousness and active posture;
- Blood pressure - 110-140 / 60-90 millimeters of mercury;
- Respiratory rate - From 16 to 20 DD for 1 minute;
- Normal or subfebrile temperature, only symptoms of the underlying disease are observed;
- The epidermis and subcutaneous tissue are within normal limits;
- Heart rate - 60-90 per minute;
- Functions of vital organs are compensated;
- The nature of the disease is stable with a mild or moderate course of the disease and the presence of general indications for hospitalization in a hospital.
Condition of moderate severity
The state of moderate severity means that this condition does not pose an immediate danger to the life of the patient. The main criteria are as follows:
- The work of the nervous system. The patient is conscious, may be partially disoriented in space/time. There is lethargy, adynamic and some difficulty in speech contact;
- Functionality. Forced or active position in bed while maintaining the ability to self-service;
- Skin covers. There is swelling, severe pallor or cyanosis of moderate severity;
- Temperature indicator. Body temperature - low or high, there is a fever;
- Parameters of the cardiovascular system. They are in the stage of compensated insufficiency. There are moderate signs of microcirculation disorders, pastosity of the lower extremities. There is bradycardia or tachycardia, low or high blood pressure within 10-15% of normal;
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- Breathing functions. Tachypnea is determined with a frequency of 21-30 DD/minute or bradypnea with a frequency of 11-8 DD/minute. For breathing, the patient from time to time uses auxiliary muscles, basic respiratory support is required. Indicators of the gas composition of the blood are compensated;
- General state internal organs. Part of the function is decompensated, but does not pose an immediate danger to basic vital signs;
- secondary symptoms. In addition to the signs of the underlying disease, pronounced dyspeptic disorders are observed, signs of gastrointestinal bleeding are formed, and the risks of developing acute complications increase;
- medical tactics. The patient is requesting emergency care and general hospitalization.
Stably heavy
A stable serious condition in intensive care, as a rule, means that there is no improvement, but no deterioration either, that is, the absence of dynamics, any changes. AT given state the patient in the intensive care unit is constantly monitored by doctors and nurses, both visually and with the help of diagnostic equipment.
In most cases, the prognosis for a patient in this condition with timely emergency treatment is favorable. You can understand a stable serious condition by next main criteria:
- The work of the nervous system. Deficiency or oppression of consciousness, complete apathy and drowsiness. Low mobility with partial preservation of basic coordinated defense reactions;
- Functionality. Psychomotor agitation with passive or forced position. Lack of self-service and the need for constant third-party care;
- Skin covers. Strong pallor of the epidermis and pronounced cyanosis in a state of complete rest;
- Temperature indicators. Severe hypothermia or hyperthermia;
- There is a significant increase or decrease in pressure (Ps less than 40 or more than 120, systolic blood pressure - 79-60), the patient requires cardiotropic support against the background of acute circulatory failure and pronounced signs of impaired microcirculation of the systemic blood flow;
- Breathing functions. There are prerequisites for transferring a person to artificial lung ventilation. There is tachypnea more than 35 DD/minute or bradypnea less than 8 DD/minute;
- Explicit decompensation disrupts the functioning of vital functions and in the medium term can lead to profound disability;
- secondary symptoms. Severe complications, often associated with intractable vomiting, profuse diarrhea, peritonitis, massive bleeding in the gastrointestinal tract against the background of the main signs of the disease.
Extremely serious condition
In an extremely serious condition, resuscitation is performed without delay, since violations of the basic vital functions of the body without emergency and intensive measures can lead the patient to death. The prognosis for an extremely serious condition in intensive care depends on how long the condition lasts. The main criteria are as follows:
- The work of the nervous system. The absence of signs of mental activity against the background of a blackout of consciousness. Deep ancestral coma or coma;
- Functionality. Most often passive or absent. In some cases, convulsions and general motor decoordinated excitation are observed;
- Skin covers. Chalky pallor of the skin, deep cyanosis, deathly pale face with pointed features, covered with cold sweat;
- Parameters of the cardiovascular system. Blood pressure is not determined, the pulse is detected exclusively on the carotid arteries. With active cardiotropic and vasopressor support, Ps values are less than 40 or more than 120, systolic blood pressure is less than 60;
- Breathing functions. Intermittent, rare, does not stabilize against the background of the use of mechanical ventilation. Tachypnea reaches 60 DD/minute. Bradypnea - 5 or less DD / minute;
- General condition of internal organs. Severe violations of the basic vital functions of the body, in the short term leading to disability;
- secondary symptoms. Severe dyspeptic disorders with systemic intense bleeding, total pulmonary edema, other manifestations against the background of partial failure of the internal organs;
- medical tactics. Immediate therapy in the intensive care unit.
Terminal degree
The main criteria are as follows:
- Central nervous system. There is an areflexia, partial or complete death of the brain;
- The cardiovascular system. There are no signs of cardiac activity, self-recovery is impossible - resuscitation and auxiliary blood circulation are necessary;
- Breath. Spontaneous breathing is absent. IVL with pure oxygen in the maximum functional mode of the device does not stabilize the performance - PaO2 becomes less than 70 mm Hg, and PaCO2 more than 55 mm Hg;
- General condition and medical tactics. The terminal degree causes critical impairment of vital functions with the highest possible risks of developing a rapid lethal outcome. The medical tactic is to try to stabilize vital signs.
Unconscious state
In the conditions of the intensive care unit, the term unconscious state of the patient means the transition of a person into a coma. It has 3 main stages:
- Stage 1 There is cardiac and respiratory activity with stable indicators. Saved photoreaction pupils, cough, gag and corneal reflexes. The overall prognosis is conditionally favorable;
- Stage 2 There is hyperthermia, hyporeflexia with the preservation of part of the functions without bilateral mydriasis. Background develops bradypnea or tachypnea, bradycardia or tachycardia. The overall prognosis is conditionally unfavorable;
- Stage 3 Areflexia, critical violations of vital functions and parameters, bilateral mydriasis. The prognosis is unfavorable, with high risks of death.
Features of the intensive care unit
The intensive care unit at large hospitals is a separate structure designed to provide emergency medical care. Branches of this type are specialized or general.
In the ICU, one resuscitator manages several (from 2 to 4) patients. Specific differences from regular branches:
- Round-the-clock work of specialized specialists;
- The maximum possible technical and preparation equipment;
- An established system of care with operational channels for transporting and servicing patients.
A person is not in intensive care for a long time - the task of specialized specialists is to stabilize the patient's condition to an average or moderate stage with the subsequent transfer of a person to specialized general departments.
APPENDIX 3
METHODOLOGICAL DEVELOPMENT FOR TEACHERS AND STUDENTS
TO THE TOPIC "GENERAL EXAMINATION OF THE PATIENT"
Criteria for assessing the general condition
2. Indications for emergency hospitalization, as well as the urgency and scope of therapeutic measures.
3. Nearest forecast.
The severity of the condition is determined by a complete examination of the patient.
1. during questioning and general examination (complaints, consciousness, position, skin color, swelling ...);
2. when examining systems (respiratory rate, heart rate, blood pressure, ascites, bronchial breathing or the absence of breath sounds over the lung area ...);
3. after additional methods (blasts in the blood test and thrombocytopenia, heart attack on the ECG, bleeding stomach ulcer on FGDS ...).
There are: a satisfactory condition, a moderate condition, a serious condition and an extremely serious condition.
Satisfactory condition
Functions of vital organs are compensated.
No need for emergency hospitalization.
There is no threat to life.
Does not need care (care for a patient due to functional insufficiency of the musculoskeletal system is not the basis for determining the severity of the condition).
A satisfactory condition occurs in many chronic diseases with relative compensation of vital organs and systems (clear consciousness, active position, normal or subfebrile temperature, no hemodynamic disturbances ...), or with a stable loss of function from the cardiovascular system, respiratory system, liver, kidneys, musculoskeletal system , nervous system but without progression, or with a tumor, but without significant dysfunction of organs and systems.
Wherein:
The functions of vital organs are compensated,
There is no immediate adverse prognosis for life,
There is no need for urgent therapeutic measures (receives planned therapy),
The patient serves himself (although there may be a limitation due to the pathology of the musculoskeletal system and diseases of the nervous system).
Moderate condition
2. There is a need for urgent hospitalization and medical measures.
3. There is no immediate threat to life, but there is a possibility of progression and development of life-threatening complications.
4. Motor activity is often limited (active position in bed, forced), but they can serve themselves.
Examples of symptoms detected in a patient with a moderate condition:
Complaints: intense pain, severe weakness, shortness of breath, dizziness;
Objectively: consciousness is clear or stunned, high fever, severe edema, cyanosis, hemorrhagic rashes, bright jaundice, HR over 100 or under 40, RR over 20, impaired bronchial patency, local peritonitis, repeated vomiting, severe diarrhea, moderate intestinal bleeding, ascites ;
Additionally: heart attack on the ECG, high transaminases, blasts and thrombocytopenia less than 30 thousand / µl in an. blood (may be a state of moderate severity even without clinical manifestations).
serious condition
2. There is a need for emergency hospitalization and therapeutic measures (treatment in an intensive care unit).
3. There is an immediate threat to life.
4. Motor activity is often limited (active position in bed, forced, passive), they cannot take care of themselves, they need care.
Examples of symptoms seen in a severely ill patient:
Complaints: unbearable prolonged pain in the heart or abdomen, severe shortness of breath, severe weakness;
Objectively: consciousness may be impaired (depression, agitation), anasarca, severe pallor or diffuse cyanosis, high fever or hypothermia, thready pulse, severe arterial hypertension or hypotension, shortness of breath over 40, prolonged attack of bronchial asthma, incipient pulmonary edema, indomitable vomiting, diffuse peritonitis, massive bleeding.
Extremely serious condition
1. Severe decompensation of the functions of vital organs and systems
2. There is a need for urgent and intensive therapeutic measures (in intensive care)
3. There is an immediate threat to life in the next minutes or hours
4. Motor activity is significantly limited (the position is often passive)
Examples of symptoms seen in a critically ill patient:
- Objectively: the face is deathly pale, with pointed features, cold sweat, pulse and blood pressure are barely detectable, heart sounds are barely audible, respiratory rate up to 60, alveolar pulmonary edema, "silent lung", pathological Kussmaul or Cheyne-Stokes breathing ...
State examples
It is based on 4 criteria (in the rationale for the examples are indicated by numbers):
2. Indications for emergency hospitalization, as well as the urgency and volume of treatment
events.
3. Forecast.
4. Motor activity and the need for care.
Bilateral coxarthrosis III–IVst. FN 3.
Satisfactory condition (care of the patient due to functional insufficiency of the musculoskeletal system is not the basis for determining the severity of the condition).
Bronchial asthma, attacks 4-5 times a day, stops on its own, dry rales in the lungs.
Satisfactory condition.
Iron deficiency anemia, Hb100g/l.
Satisfactory condition.
IHD: stable angina. Extrasystole. NK II.
Satisfactory condition.
Diabetes mellitus with angiopathy and neuropathy, sugar 13 mmol/L, consciousness is not disturbed, hemodynamics is satisfactory.
Satisfactory condition.
Hypertonic disease. BP 200/100 mmHg But not a crisis. BP decreases with outpatient treatment.
Satisfactory condition.
Acute myocardial infarction without hemodynamic disturbances, according to ECT: ST above the isoline.
Condition of moderate severity (2.3).
Myocardial infarction, without hemodynamic disturbances, subacute period, according to ECG: ST on the isoline.
Satisfactory condition.
Myocardial infarction, subacute period, according to ECG: ST on the isoline, with normal blood pressure, but with a violation of the rhythm.
Moderate condition (2, 3)
Pneumonia, volume - segment, good health, subfebrile temperature, weakness, cough. There is no shortness of breath at rest.
Condition of moderate severity (2, 3).
Pneumonia, volume-lobe, fever, dyspnea at rest. The patient prefers to lie down.
Condition of moderate severity (1,2,4).
Pneumonia, volume - a fraction or more, fever, tachypnea 36 per minute, decreased blood pressure, tachycardia.
The condition is severe (1,2,3,4).
Cirrhosis of the liver. Feeling good. Enlargement of the liver, spleen. No ascites or slight ascites on ultrasound.
Satisfactory condition.
Cirrhosis of the liver. Hepatic encephalopathy, ascites, hypersplenism. The patient walks, serves himself.
Moderate condition (1.3)
Cirrhosis of the liver. Ascites, impaired consciousness and / or hemodynamics. In need of care.
The condition is severe (1,2,3,4).
Wegener's granulomatosis. Fever, lung infiltrates, shortness of breath, weakness, progressive decline in kidney function. Arterial hypertension is medically controlled. Prefers to be in bed but can walk and take care of himself.
Condition of moderate severity (1,2,3,4).
Wegener's granulomatosis. Deviations in blood tests persist, CRF IIst.
Satisfactory condition.
APPENDIX 4
Determination of medical age, significance for diagnosis .
1) Determination of medical age is of no small importance, for example, to forensic practice. A doctor may be asked to determine the age due to the loss of documents. This takes into account that the skin loses elasticity with age, becomes dry, rough, wrinkled, pigmentation, keratinization appears. At the age of about 20 years, frontal and nasolabial wrinkles already appear, about 25 years old - at the outer corner of the eyelids, by 30 years old - under the eyes, at 35 years old - on the neck, about 55 - in the area of the cheeks, chin, around the lips.
On the hands of up to 55 years, the skin, taken in a fold, quickly and well straightens out, at 60 years old it straightens out slowly, and at 65 it no longer straightens out on its own. Teeth with age are erased on the cutting surface, darken, fall out.
By the age of 60, the cornea of the eyes begins to lose transparency, whitishness / arcussenilis / appears along the edges, and by the age of 70 the senile arc is already clearly expressed.
It should be remembered that medical age does not always correspond to metric. There are eternally young subjects, on the other hand - prematurely aged. Patients with increased thyroid function look younger than their years - usually thin, slender, with delicate pink skin, sparkle in the eyes, mobile, emotional. Premature aging is caused by mexedema, malignant tumors and some long-term severe diseases.
Determination of age is also important because certain diseases are characteristic of each age. There is a group of childhood diseases that are studied in the course of pediatrics; on the other hand, gerontology is the science of diseases of the elderly and senile age /75 years and more/.
Age groups /Guide to gerontology, 1978/:
Children's age - up to 11 - 12 years.
Teenage - from 12 - 13 years to 15 - 16 years.
Youth - 16 - 17 years old to 20 - 21 years old.
Young - from 21 - 22 years old to 29 years old.
Mature - from 33 years to 44 years.
Medium - from 45 years to 59 years.
Elderly - from 60 years to 74 years.
Old - from 75 years to 89 years.
Long-livers - from 90 and more.
At a young age, they often suffer from rheumatism, acute nephritis, and pulmonary tuberculosis. In adulthood, the body is most stable, least prone to disease.
The patient's age must also be taken into account due to the fact that it has a significant impact on the course of the disease and the prognosis /outcomes/: at a young age, the disease mostly proceeds rapidly, their prognosis is good; in senile - the reaction of the body is sluggish, and those diseases that end in recovery at a young age, for example, pneumonia, in old people are often the cause of death.
Finally, in certain age periods, there are sharp shifts in both the somatic and neuropsychic spheres:
a) puberty /pubertal period/ - from 14 - 15 years to 18 - 20 years - characterized by increased morbidity, but relatively low mortality;
b) the period of sexual withering / menopause / - from 40 - 45 years to 50 years is marked by a tendency to cardiovascular, metabolic and mental diseases / there are functional disorders of the vasomotor, endocrine-nervous and mental nature /.
c) The period of aging - from 65 years to 70 years - during this period it is difficult to separate the purely age-related phenomena of wear and tear from the symptoms of a particular disease, in particular atherosclerosis.
The doctor determines the correspondence of gender and age to passport data already when questioning the patient, records deviations in the medical history if they are detected, for example: “the patient looks older than his years” or “medical age corresponds to the metric age”.
The degree of the condition of a sick person is calculated taking into account the present indicators of decompensation of important body functions for life. Therapeutic measures that are assigned to a patient who is in a very serious condition are carried out exclusively in the intensive care unit (intensive care unit).
All patients whose health condition is assessed as serious or much worse, extremely serious, should be immediately hospitalized in the nearest future. medical institution. Due to the serious condition of the patients, in the intensive care unit, the patient is constantly monitored by specially trained medical personnel.
Staying in intensive care is a rather difficult situation for people, since in such departments there are no separate rooms for women or men. It is not uncommon for patients to lie in their beds completely naked, with open wounds and injuries of any kind. In addition, the correction of need must be carried out right in the bed.
To conduct constant monitoring of body parameters, many sensors and special medical electronics are attached to the patient. All people staying in the walls of the intensive care unit after the operation have tubes for drainage left for some time.
A stably serious condition in intensive care, involves monitoring with the help of special sensors that record every important indicator for life. Because of these devices, the patient is limited in mobility, so he must comply with strict and undeniable bed rest and all medical prescriptions. Some activity can provoke the departure of important pieces of equipment.
serious condition
Taking into account all the indicators received, the doctor can make adjustments regarding the need for additional diagnostic procedures or a change in the direction of the treatment plan.
"Stably serious condition in intensive care, what does it mean?". According to resuscitation specialists, this expression means the specific position of the patient, due to which the processes of decompensation of vital organs and systems appear, without obvious improvements or deterioration. Such problems are a great threat to human life, and also often leads to disability.
Often, a serious condition in a patient develops in the event of a complication of the present pathology, which is characterized by a vivid course and rapid development. But the biggest threat is an extremely serious condition that requires urgent medical attention.
Patient's stay in intensive care
If a patient is transferred to the intensive care unit, then his health or even life is under great threat. A stably serious condition can last from days to weeks. Unlike a serious condition, a stable one says that the patient has no dynamics and no changes. In such a case, various kinds of violations of the vital functions of the body are observed.
Every person who is preparing for a major surgical intervention, after which a stay in the intensive care unit may be required, should be aware of such features.
Each hospital should be equipped with a specific unit with a narrow specialty - an intensive care unit or resuscitation. It has strict rules and restrictions, one of which is the restriction of the patient's physical activity.
Medical personnel who serve the intensive care unit must have unrestricted access to the human body, especially if an emergency develops such as cardiac arrest or lack of breathing.
Of great importance are the sensors that are connected to the patient's body. They should capture the functioning of the cardiovascular system, and the frequency of respiration. For each patient, a personal history of the disease is started, in which the dynamics of changes in the state, the prescribed and performed diagnostic and treatment procedures are recorded.
Possible degrees of deterioration
Often, the general condition of the patient can remain quite good, provided that the pathology is mild. Subjective and objective symptoms of pathologies, in this case, are not very pronounced, the person’s consciousness is clear, he behaves actively, eats and defecates normally, body temperature remains within normal limits or subfebrile.
The general condition of a person, which is regarded as moderate, has manifestations of decompensation in the functioning of vital organs, but without a direct threat to life.
A stably serious condition in intensive care, much more serious than those described above, but in this phrase the only pleasant word is stable. The patient has all the indicators of a severe stage of decompensation of organs and systems. Patients are usually unconscious or much worse in a coma, so they require constant monitoring by specialists.
Sometimes, patients have pronounced psychomotor agitation and convulsive seizures. Similar conditions are sometimes observed after major operations, severe injuries after a fall or fight, car accidents, etc.
The severity of the general condition of the patient is determined depending on the presence and severity of decompensation of vital body functions. Treatment of patients in extremely serious general condition is carried out in the intensive care unit. All patients whose general condition is characterized as severe require urgent hospitalization. Due to the severity of the condition of patients in the intensive care unit, round-the-clock monitoring is carried out.
Treatment in intensive care is a very stressful situation for the patient. Indeed, in many intensive care centers there are no separate wards for men and women. Often patients lie naked, with open wounds. Yes, and you have to cope with the need without getting out of bed. The intensive care unit is represented by a highly specialized unit of the hospital.
To determine all these indicators, a lot of special equipment is connected to the patient. Patients who are in the intensive care unit after the operation have temporary drainage tubes. The extremely serious condition of patients means the need to attach to the patient a large amount of special equipment necessary to monitor vital signs. important indicators. All these devices significantly limit the patient's motor activity, he is unable to get out of bed. Excessive activity may cause critical equipment to become disconnected.
serious condition
Depending on these indicators, the doctor prescribes diagnostic and therapeutic measures. A serious condition means a situation in which the patient develops decompensation of the activity of vital systems and organs. The development of this decompensation poses a danger to the patient's life, and can also lead to his deep disability. Usually, a serious condition is observed in case of a complication of the current disease, which is characterized by pronounced, rapidly progressive clinical manifestations.
Intensive Care Unit, or Why is it impossible to visit the seriously ill?
And this means that their treatment is carried out in the intensive care unit. A stably serious condition can last from several days to weeks. It differs from the usual serious condition in the absence of dynamics, any changes. In this condition, there is a sharp violation of all vital functions of the body.
This article will be especially useful for patients preparing for major operations, after which further treatment is expected in the intensive care unit. The intensive care unit is a highly specialized unit of the hospital. All this sharply limits the amount of motor activity of intensive care patients, makes it impossible for them to get out of bed.
Resuscitation medical personnel should always have quick access to the entire body of the patient in case of cardiac or respiratory arrest. In this case, the determination of the functional state of the cardiovascular system and the respiratory system is of particular importance. The description of the objective status in the case history begins with a description of the general condition.
As a rule, the general condition of patients remains satisfactory in mild forms of the disease. Subjective and objective manifestations of the disease are not pronounced, the consciousness of patients is usually clear, the position is active, nutrition is not disturbed, the body temperature is normal or subfebrile. A general state of moderate severity is said if the disease leads to decompensation of the functions of vital organs, but does not pose an immediate danger to the life of the patient.
What is most pleasing about this expression is the stability of the state. All these indicators indicate a very serious condition of the patient. Patients in this condition are under the constant supervision of specialists. All patients with a very serious condition are subject to mandatory hospitalization. In some cases, there are states of psychomotor agitation, general convulsions. Most often, this condition occurs after major operations. The general condition of patients is also satisfactory in the period of convalescence after acute diseases and when exacerbations of chronic processes subside.
