Intensive Care Phase
The Burn ICU manages patients after burn injuries. Visiting hours are flexible in this Unit, depending on the patient's condition, how busy the unit is at the time, and the needs of the family.
Medical Treatment in the ICU
Burn patients are monitored closely in the ICU. Patients may be attached to equipment that monitors their heart rate, blood pressure, oxygenation, and the pressure inside the head (intracranial pressure). Patients may have several tubes, wires, and intravenous lines to help the staff assess and treat them. A patient's body may appear swollen due to all of the fluids required for treatment, but this is normal.
The staff may give oxygen via a face mask, nasal prongs, or breathing tube. If a breathing tube is in place, it will be attached to a respirator to help the patient breathe. Patients cannot speak while the tube is in place. The staff closely follows blood gases and chest x-rays to help decide when the breathing tube can be removed. Patients are gradually removed from the ventilator so that they can breathe on their own.
A number of intravenous lines may be placed so that the patient can receive fluids, blood products, and medications, if necessary. Blood transfusions may be needed if the patient shows signs of bleeding. Drugs may also be given to keep the patient's heart rate and blood pressure normal. A patient usually needs to stay in the ICU until the heart rate, blood pressure, and blood tests are stable.
A patient may also have a tube in the nose or mouth that extends down into the stomach. Burns and other medical conditions often cause the stomach not to work properly for several days. The tube keeps the stomach empty until it starts working normally. If surgery has been performed on the abdomen, the patient may also have drains in place. In general, these drains will come out when they stop draining fluid.
Nutritional needs are addressed early in a patient's hospitalization. Feedings may be given through a tube in the mouth or nose until the patient is ready to start eating. Sometimes, however, a person's stomach may not be able to digest food due to the injuries. If this happens, the patient may receive what is referred to as "TPN" for nutrition through an intravenous line.
Patients in the ICU are frequently given medicines to help control pain. These medicines often make patients groggy and confused. Many do not remember their stay in the ICU once they recover and move into a general care burn bed on Bigelow 13.
The burn team visits patients each day between 6:00 and 7:30 am (and as needed) to review progress and plan the daily care. Each day, the team will evaluate each ICU patient and assess whether they’re ready to transition out of ICU care and into a general care burn bed.