8/14/2019 Medical intensive care unit
1/120
Hdukdvh|k Fbsk
[dhu
8/14/2019 Medical intensive care unit
2/120
8/14/2019 Medical intensive care unit
3/120
8/14/2019 Medical intensive care unit
4/120
Hdukdvh|k Fbsk [dhu hv b mgvphub` lbfh`hux lgs fbsk glfshuhfb``x h`` pbuhkduv bu b igsk hdukdvh|k `k|k` umbd hvdkkeke cx gumks pbuhkduv$ Vubllke cx vpkfhb`hqkepksvgddk`$
HF[ fbsk skr{hskv b i{`uhehvfhp`hdbsx ukbi umbu fgdvhvuvgl c{u hv dgu `hihuke ug hdukdvh|hvuv -f`hdhfhbdv ~mgvpkfhb`hqk hd fshuhfb` h``dkvv fbsk$ Umkx ~h`` psg|hekuskbuikdu ibdbnkikdu, ehbndgvhv, hduks|kduhgdv, bdehdeh|he{b`hqke fbsk lgs kbfm pbuhkdu skfg|kshdn lsgi
vk|ksk h``dkvv$
8/14/2019 Medical intensive care unit
5/120
8/14/2019 Medical intensive care unit
6/120
_{spgvk gl HF[
8/14/2019 Medical intensive care unit
7/120
Umk p{spgvk gl umk hdukdvh|k fbsk {dhu -HF[( hv vhip`k k|kdumg{nm umk psbfuhfk hv fgip`k}$ Mkb`umfbsk psglkvvhgdb`v~mg ~gsj hd umk HF[ gs sgubuk umsg{nm hu e{shdn umkhsusbhdhdn psg|hek bsg{de)umk)f`gfj hdukdvh|k igdhugshdn bdeuskbuikdu gl pbuhkduv vk|kd ebxv b ~kkj$
^mkd pbuhkduv bsk usbdvlksske ug umk HF[ lsgi bdgumksmgvphub` ekpbsuikdu, uskbuikdu gseksv bde p`bddhdn i{vuck sk|hk~ke bde dk~ uskbuikdu p`bdv ~shuukd lgs umkpbuhkdu.v f{sskdu vubu{v$ Lgs k}bip`k, b fmsgdhfb``x h``hdpbuhkdu ibx nsg~ ibsjke`x ~gsvk ~humhd b lk~ mg{sv bdeibx ck usbdvlksske ug umk HF[, ~mksk umk vubll i{vuskk|b`{buk gseksv lgs mhv gs mks fbsk$
8/14/2019 Medical intensive care unit
8/120
Ekvfshpuhgd gl
HF[
8/14/2019 Medical intensive care unit
9/120
HF[v bsk mhnm`x skn{`buke ekpbsuikduv, uxphfb``x `hihuhdnumk d{icks gl |hvhugsv ug umk pbuhkdu.v hiikehbuk lbih`xk|kd e{shdn |hvhuhdn mg{sv$
Hd beehuhgd ug umk hdukdvh|hvu.v sg`k hd ehskfu pbuhkdu fbsk,mk gs vmk hv {v{b``x umk `kbe pmxvhfhbd ~mkd i{`uhp`k
fgdv{`ubduv bsk hd|g`|ke hd bd hdukdvh|k fbsk psgnsbi$Umk hdukdvh|hvu fggsehdbukv umk fbsk psg|heke cx umkfgdv{`ubduv, ~mhfm b``g~v lgs bd hduknsbuke uskbuikdubppsgbfm ug umk pbuhkdu$
Umk d{svk.v sg`k {v{b``x hdf`{ekv f`hdhfb` bvvkvvikdu,
ehbndgvhv, bde bd hdeh|he{b`hqke p`bd gl k}pkfukeuskbuikdu g{ufgikv lgs kbfm pbuhkdu
8/14/2019 Medical intensive care unit
10/120
Umk pbuhkdu {v{b``x mbv vk|ksb`
igdhugsv buubfmke ug |bshg{v pbsuv
gl mhv gs mks cgex lgs skb`)uhikk|b`{buhgd gl ikehfb` vubch`hux$
8/14/2019 Medical intensive care unit
11/120
Umk hdukdvh|hvu ~h`` ibjk pkshgehfbvvkvvikduv gl umk pbuhkdu.v fbsehbfvubu{v, cskbumhdn sbuk, {shdbsx g{up{u,bde c`gge `k|k`v lgs d{ushuhgdb` bde
mgsigdb` psgc`kiv umbu ibx bshvk bdeskr{hsk {snkdu buukduhgd gs uskbuikdu$
8/14/2019 Medical intensive care unit
12/120
Mhvugsx gl HF[
8/14/2019 Medical intensive care unit
13/120
Hd 2=;5, L`gskdfk Dhnmuhdnb`k `klu lgs umk Fshikbd ^bs, ~mksk umkdkfkvvhux ug vkpbsbuk vkshg{v`x ~g{deke vg`ehksv lsgi `kvv)vkshg{v`x
~g{deke ~bv gcvks|ke$ Dhnmuhdnb`k ske{fke igsub`hux lsgi 5?+ ug 3+gd umk cbuu`klhk`e, fskbuhdn umk fgdfkpu gl hdukdvh|k fbsk$
Hd 28;?, bdkvumkvhg`gnhvu _kuks Vblbs kvubc`hvmke umk fgdfkpu gl#Be|bdfke V{ppgsu gl @hlk,# jkkphdn pbuhkduv vkebuke bde |kduh`buke hdbd hdukdvh|k fbsk kd|hsgdikdu$ Vblbs hv fgdvhekske umk lhsvu hdukdvh|hvu$
Hd skvpgdvk ug b pg`hg kphekihf -~mksk ibdx pbuhkduv skr{hske fgdvubdu|kduh`buhgd bde v{s|kh``bdfk(, Casd Hcvkd kvubc`hvmke umk lhsvu hdukdvh|kfbsk {dhu hd Fgpkdmbnkd hd 28;6$Umk lhsvu bpp`hfbuhgd gl umhv hekb hd umk[dhuke Vubukv ~bv phgdkkske cx Es$ ^h``hbi Igvkdumb`, b v{snkgd bu umkEbsuig{um)Mhufmfgfj Ikehfb` Fkduks$ Hd umk 28
8/14/2019 Medical intensive care unit
14/120
_BUHKDUV HD UMK HF[
8/14/2019 Medical intensive care unit
15/120
UX_KV GL _BUHKDUV _buhkduv fgik hdug umk IHF[ lsgi b |bshkux gl p`bfkv1 umk
l`ggsv, umk KS, bv usbdvlksv lsgi gumks mgvphub`v, bvpgvugpv, bv cgbseksv lsgi gumks vks|hfkv, bde vgikuhikvbv ehskfu beihuv, cxpbvvhdn umk KS$ Umk hdukskvuhdn umhdnbcg{u umk IHF[ hv umbu ~k `huksb``x vkk b chu gl bcvg`{uk`x
k|ksxumhdn, {d`hjk umk vpkfhb`ux HF[v$ Hl xg{ ~gsj mksk`gdn kdg{nm, xg{`` vkk pbuhkduv umbu ~g{`e dgsib``x ck hdk|ksx gumks HF[ kd|hsgdikdu -k}fkpu ibxck lskvm pgvugpfbsehgumgsbfhf pbuhkduv umbu HF[ ~h`` c{ip igsk vubc`kpbuhkduv g{u ug ibjk sggi($ ^k vkk fbsehbf pbuhkduv,vgikuhikv ~hum hdusb)bgsuhf cb``ggd p{ipv: ~k vkk dk{sg
pbuhkduv, gffbvhgdb``x ~hum igdhugske cg`uv hd p`bfk, ~k|kegdk be{`u KFIG b lk~ uhikv, bde ~k k|kd vgikuhikvnku nkdksb`)v{sn pgvugp fbvkv$$
8/14/2019 Medical intensive care unit
16/120
8/14/2019 Medical intensive care unit
17/120
IHF[ Kr{hpikduv
8/14/2019 Medical intensive care unit
18/120
2$( Ikfmbdhfb`\kduh`bugs
8/14/2019 Medical intensive care unit
19/120
Eklhdhuhgdhv b ikumge ug ikfmbdhfb``x bvvhvu gs
skp`bfk vpgdubdkg{v cskbumhdn$
fhsf{ivubdfkv lgs ~mhfm |kduh`buhgd hvskr{hske umkd beehuhgdb` ikbv{skv bsk
glukd skr{hske ug #vkf{sk# umk bhs~bxe{shdn pgvhuh|k pskvv{sk |kduh`buhgd ug b``g~{dhipkeke pbvvbnk gl bhs hdug umk usbfmkbbde b|ghe bhs pbvvhdn hdug umk kvgpmbn{v
bde vugibfm$
8/14/2019 Medical intensive care unit
20/120
8/14/2019 Medical intensive care unit
21/120
umsg{nm bd bsuhlhfhb` gpkdhdn hdumk dkfj$
8/14/2019 Medical intensive care unit
22/120
8/14/2019 Medical intensive care unit
23/120
Hdehfbuhgdv1Ikfmbdhfb` |kduh`buhgd hv hdehfbuke ~mkd
umk pbuhkdu.v vpgdubdkg{v |kduh`buhgd hvhdbekr{buk ug ibhdubhd `hlk$
b`vg hdehfbuke bv psgpmx`b}hv lgs hiihdkdu
fg``bpvk gl gumks pmxvhg`gnhf l{dfuhgdv, gshdkllkfuh|k nbv k}fmbdnk hd umk `{dnv
8/14/2019 Medical intensive care unit
24/120
Fgiigd ikehfb` hdehfbuhgdv lgs{vk hdf`{ek1
Bf{uk `{dn hda{sx -hdf`{ehdn BSEV, usb{ib(Bpdkb ~hum skvphsbugsx bsskvu, hdf`{ehdn fbvkv lsgi hdug}hfbuhgdFmsgdhf gcvus{fuh|k p{`igdbsx ehvkbvk -FG_E(
Bf{uk skvphsbugsx bfhegvhv ~hum pbsuhb` pskvv{sk gl fbscgd ehg}hek -pFG3( 4;? iiMn bde pM 0 >$3;, ~mhfm ibx ck e{k ug pbsb`xvhv gl umk ehbpmsbnie{k ug N{h``bhd)Cbss vxdesgik, Ixbvumkdhb Nsb|hv, vphdb` fgse hda{sx, gsumk kllkfu gl bdbkvumkuhf bde i{vf`k sk`b}bdu es{nv
Hdfskbvke ~gsj gl cskbumhdn bv k|hekdfke cx vhndhlhfbdu ubfmxpdkb,skusbfuhgdv, bde gumks pmxvhfb` vhndv gl skvphsbugsx ehvuskvv
Mxpg}kihb ~hum bsukshb` pbsuhb` pskvv{sk gl g}xnkd -_bG3( ~humv{pp`kikdub` lsbfuhgd gl hdvphske g}xnkd -LhG3( 0 ;;ii Mn
Mxpgukdvhgd hdf`{ehdn vkpvhv, vmgfj, fgdnkvuh|k mkbsu lbh`{skDk{sg`gnhfb` ehvkbvkv v{fm bv I{vf{`bs Exvusgpmx Bixgusgpmhf @buksb`
Vf`ksgvhv
8/14/2019 Medical intensive care unit
25/120
Ckfb{vk ikfmbdhfb` |kduh`buhgd gd`x vks|kvug psg|hek bvvhvubdfk lgs cskbumhdn bdeegkv dgu f{sk b ehvkbvk, umk pbuhkdu.v{deks`xhdn fgdehuhgd vmg{`e ck fgsskfubc`k
bde vmg{`e skvg`|k g|ks uhik$
8/14/2019 Medical intensive care unit
26/120
3$( KFN
8/14/2019 Medical intensive care unit
27/120
K`kfusgfbsehgnsbpmx -KFN gs KJN( hv b
usbdvumgsbfhf hdukspskubuhgd gl umk k`kfushfb`bfuh|hux gl umk mkbsu g|ks uhik fbpu{ske bdek}uksdb``x skfgseke cx vjhd k`kfusgekv$
Hu hv b dgdhd|bvh|k skfgsehdn psge{fke cx bd
k`kfusgfbsehgnsbpmhf ek|hfk$Umk kuxig`gnx gl umk ~gse hv eksh|ke lsgik`kfusg, ckfb{vk hu hv sk`buke ug k`kfushfb`bfuh|hux, fbsehg, Nskkj lgs mkbsu, bde nsbpm,
b Nskkj sggu ikbdhdn #ug ~shuk#$
8/14/2019 Medical intensive care unit
28/120
hv umk igvu fgiigd`x pkslgsike fbsehbfukvu
Umhv hv ckfb{vk umk KFN hv b {vkl{`vfskkdhdn ugg` lgs b |bshkux gl fbsehbf
bcdgsib`huhkv$KFN ibfmhdkv bsk skbeh`x b|bh`bc`k hd igvu
ikehfb` lbfh`huhkv: bde umk ukvu hv vhip`k ugpkslgsi, shvj)lskk bde hdk}pkdvh|k$
8/14/2019 Medical intensive care unit
29/120
^mbu hdlgsibuhgd fbd cknbhdke lsgi umk KFN7
umk mkbsu sbukumk mkbsu smxumi
~mkumks umksk bsk fgde{fuhgd bcdgsib`huhkv-bcdgsib`huhkv hd mg~ umk k`kfushfb` hip{`vk
vpskbev bfsgvv umk mkbsu(~mkumks umksk mbv ckkd b pshgs mkbsu buubfj
~mkumks umksk ibx ck fgsgdbsx bsuksx ehvkbvk
~mkumks umk mkbsu i{vf`k mbv ckfgik
bcdgsib``x umhfjkdke
8/14/2019 Medical intensive care unit
30/120
Mg~ hv umk KFN pkslgsike7
Xg{ ~h`` `hk gd bd k}bihdbuhgd ubc`k, bde 2?k`kfusgekv -gs `kbev( bsk buubfmke ug xg{sbsiv, `knv, bde fmkvu$
Umk k`kfusgekv ekukfu umk k`kfushfb` hip{`vkv
nkdksbuke cx xg{s mkbsu, bde usbdvihu umkiug umk KFN ibfmhdk$
Umk KFN ibfmhdk psge{fkv b nsbpm -umk KFNusbfhdn( gl umgvk fbsehbf k`kfushfb` hip{`vkv$
Umk k`kfusgekv bsk umkd skig|ke$ Umk ukvuubjkv `kvv umbd ; ihd{ukv ug pkslgsi$
8/14/2019 Medical intensive care unit
31/120
SB gd umk shnmu bsi, b|ghehdn cgdxpsgihdkdfkv$
@B hd umk vbik `gfbuhgd umbu SB ~bv p`bfke,
c{u gd umk `klu bsi umhv uhik$S@gd umk shnmu `kn, b|ghehdn cgdx
psgihdkdfkv$
@@ hd umk vbik `gfbuhgd umbu S@ ~bv p`bfke,c{u gd umk `klu `kn umhv uhik$
23 K`kfusgek _`bfkikdu
8/14/2019 Medical intensive care unit
32/120
\2hd umk lg{sum hduksfgvub` vpbfk -cku~kkd shcv 5 ;(a{vu ug umk shnmugl umk vuksd{i -cskbvucgdk($\3hd umk lg{sum hduksfgvub` vpbfk -cku~kkd shcv 5 ;(
a{vu ug umk `klugl umk vuksd{i$\6 cku~kkd `kbev \3 bde \5$\5hd umk lhlum hduksfgvub` vpbfk -cku~kkd shcv ;
8/14/2019 Medical intensive care unit
33/120
6$( Dkc{`hqks
8/14/2019 Medical intensive care unit
34/120
ek|hfk {vke ug beihdhvuks ikehfbuhgd ug
pkgp`k hd umk lgsi gl b ihvu hdmb`ke hdugumk `{dnv$ Hu hv fgiigd`x {vke hd uskbuhdnfxvuhf lhcsgvhv, bvumib, bde gumksskvphsbugsx ehvkbvkv$
Dkc{`hqksv bffkpu umkhs ikehfhdk hd umklgsi gl b `hr{he vg`{uhgd, ~mhfm hv glukd`gbeke hdug umk ek|hfk {pgd {vk
8/14/2019 Medical intensive care unit
35/120
Umk skbvgd umkx bsk hdmb`ke hdvukbe glhdnkvuke hv {v{b``x ug ubsnku umkhs kllkfu ugumk skvphsbugsx usbfu, ~mhfm vpkkev gdvku glbfuhgd gl umk ikehfhdk bde ske{fkv vhek
kllkfuv fgipbske ug gumks ikbdv glek`h|kshdn umkvk ikehfhdkv$
8/14/2019 Medical intensive care unit
36/120
ikehfhdk hv hdmb`ke umsg{nm b u{ck)`hjk
ig{umphkfk, vhih`bs ug umbu gl bd hdmb`ks$
8/14/2019 Medical intensive care unit
37/120
mg~k|ks, hv vgikuhikv skp`bfke ~hum b lbfk
ibvj, vhih`bs ug umbu {vke lgs hdmb`kebdbkvumkvhb, lgs kbvk gl {vk ~hum xg{dnfmh`eskd gs umk k`eks`x
8/14/2019 Medical intensive care unit
38/120
5$( Eklhcsh``bugs
8/14/2019 Medical intensive care unit
39/120
uskbuikdu lgs umk `hlk)umskbukdhdn fbsehbfbssmxumihbv, |kdushf{`bs lhcsh``buhgd bdep{`vk`kvv |kdushf{`bs ubfmxfbsehb$ Eklhcsh``buhgdfgdvhvuv gl ek`h|kshdn b umksbpk{uhf egvk glk`kfushfb` kdksnx ug umk bllkfuke mkbsu
Umhv ekpg`bshqkv b fshuhfb` ibvv gl umk mkbsu
i{vf`k, uksihdbukv umk bssmxumihb, bde b``g~vdgsib` vhd{v smxumi ug ck skkvubc`hvmke cx umkcgex.v dbu{sb` pbfkibjks, hd umk vhdgbushb`dgek gl umk mkbsu$
8/14/2019 Medical intensive care unit
40/120
Ibd{b` k}uksdb` eklhcsh``bugs
{vke hd fgda{dfuhgd ~hum -gs igsk glukdmb|k hdc{h`u( k`kfusgfbsehgnsbi skbeksv,~mhfm umk mkb`umfbsk psg|heks {vkv ugehbndgvk b fbsehbf fgdehuhgd
8/14/2019 Medical intensive care unit
41/120
Umk mkb`umfbsk psg|heks ~h`` umkd ekfhek~mbu fmbsnk -hd ag{`kv( ug {vk, cbvke gdpsg|kd n{hek`hdkv bde k}pkshkdfk, bde~h`` ek`h|ks umk vmgfj umsg{nm pbee`kv gspbev gd umk pbuhkdu.vfmkvu$
8/14/2019 Medical intensive care unit
42/120
;$( _{`vk G}hikuks
8/14/2019 Medical intensive care unit
43/120
Hu hv b ikehfb` ek|hfk umbu hdehskfu`xikbv{skv umk g}xnkd vbu{sbuhgd gl b
pbuhkdu.v c`gge bde fmbdnkv hd c`gge|g`{ik hd umk vjhd, psge{fhdn bpmgugp`kumxvignsbpm
Hu hv b ikehfb` ek|hfk umbu hdehskfu`x
ikbv{skv umk g}xnkd vbu{sbuhgd gl bpbuhkdu.v c`gge bde fmbdnkv hd c`gge|g`{ik hd umk vjhd, psge{fhdn bpmgugp`kumxvignsbpm
Hu hv b ikehfb` ek|hfk umbu hdehskfu`xikbv{skv umk g}xnkd vbu{sbuhgd gl bpbuhkdu.v c`gge bde fmbdnkv hd c`gge|g`{ik hd umk vjhd, psge{fhdn b
pmgugp`kumxvignsbpm
8/14/2019 Medical intensive care unit
44/120
8/14/2019 Medical intensive care unit
45/120
L{dfuhgdEhvp`bxv umk pksfkdubnk gl bsukshb` mkign`gchd hd
umk g}xmkign`gchd fgdlhn{sbuhgd$ Bffkpubc`kdgsib` sbdnkv bsk lsgi 8; ug 2?? pksfkdu,
b`umg{nm |b`{kv eg~d ug 8?+ bsk fgiigd
8/14/2019 Medical intensive care unit
46/120
Uxphfb``x hu mbv b pbhs gl vib`` `hnmu)kihuuhdnehgekv -@KEv( lbfhdn b pmgugehgek umsg{nm busbdv`{fkdu pbsu gl umk pbuhkdu.v cgex, {v{b``x b
lhdnksuhp gs bd kbs`gck$ Gdk @KE hv ske, ~hum~b|k`kdnum gl
8/14/2019 Medical intensive care unit
47/120
Be|bdubnkvp{`vk g}hikuks hv {vkl{` hd bdx
vkuuhdn ~mksk b pbuhkdu.vg}xnkdbuhgd hv {dvubc`k, hdf`{ehdn
hdukdvh|k fbsk, gpksbuhdn, skfg|ksx,kiksnkdfx bde mgvphub` ~bsevkuuhdnv, ph`guv hd {dpskvv{shqkebhsfsblu, lgs bvvkvvikdu gl bdx
pbuhkdu.v g}xnkdbuhgd, bdeekuksihdhdn umk kllkfuh|kdkvv gl gsdkke lgs v{pp`kikdub` g}xnkd$
8/14/2019 Medical intensive care unit
48/120
@hihubuhgdv bde
Be|bdfkikduv
G}hikusx hv dgu b fgip`kuk ikbv{sk gl skvphsbugsxv{llhfhkdfx$ B pbuhkdu v{llkshdn lsgimxpg|kduh`buhgd -pggs nbv k}fmbdnk hd umk `{dnv(nh|kd 2??+ g}xnkd fbd mb|k k}fk``kdu c`ggeg}xnkd `k|k`v ~mh`k vuh`` v{llkshdn lsgi skvphsbugsxbfhegvhv e{k ug k}fkvvh|k fbscgd ehg}hek$
G}hikusx hv dgu b fgip`kuk ikbv{sk gl skvphsbugsxv{llhfhkdfx$ B pbuhkdu v{llkshdn lsgimxpg|kduh`buhgd -pggs nbv k}fmbdnk hd umk `{dnv(nh|kd 2??+ g}xnkd fbd mb|k k}fk``kdu c`ggeg}xnkd `k|k`v ~mh`k vuh`` v{llkshdn lsgi skvphsbugsxbfhegvhv e{k ug k}fkvvh|k fbscgd ehg}hek$
8/14/2019 Medical intensive care unit
49/120
8/14/2019 Medical intensive care unit
50/120
V{fuhgd{vke ug f`kbs umk bhs~bx gl c`gge, vb`h|b,
|gihu, gs gumks vkfskuhgdv vg umbu bpbuhkdu ibx cskbumk$
psk|kdu p{`igdbsx bvphsbuhgd, ~mhfmfbd `kbe ug `{dn hdlkfuhgdv
{vke ug skig|k l`{hev lsgi umkbhs~bxv lbfh`hubuk cskbumhdn bde psk|kdu
nsg~um gl ihfsggsnbdhviv
ibx ck ikfmbdhfb` mbde p{ipv gscbuuksx gs k`kfushfb``x gpksbukeikfmbdhviv
8/14/2019 Medical intensive care unit
51/120
8/14/2019 Medical intensive care unit
52/120
>$( Fbsehbf Igdhugs
8/14/2019 Medical intensive care unit
53/120
Fbsehbf Igdhugsek|hfk umbu vmg~v umk k`kfushfb` bde
pskvv{sk ~b|klgsiv gl umk fbsehg|bvf{`bs
vxvuki lgs ikbv{skikdu bde uskbuikdu
k`kfushfb` fgddkfuhgdv bsk ibekcku~kkd umk fbsehbf igdhugs bde umk
pbuhkdu, hu hv jkpu bu umk pbuhkdu.vckevhek
8/14/2019 Medical intensive care unit
54/120
8/14/2019 Medical intensive care unit
55/120
_{spgvkfgduhd{g{v`x ehvp`bxv umk fbsehbf
k`kfusgfbsehgnsbi -KJN( usbfhdn
Beehuhgdb` igdhugshdn fgipgdkduvb``g~ fbsehg|bvf{`bs pskvv{skv bdefbsehbf g{up{u ug ck igdhugske bdeehvp`bxke bv skr{hske lgs pbuhkduehbndgvhv bde uskbuikdu
G}xnkd vbu{sbuhgd gl umk bsukshb` c`ggefbd b`vg ck igdhugske fgduhd{g{v`x
Igvu fgiigd`x {vke hd kiksnkdfx sggivbde fshuhfb` fbsk bskbv, ckevhek igdhugsvfbd ck hduksfgddkfuke ug b``g~ lgs
fgduhd{b` gcvks|buhgd gl vk|ksb` pbuhkduvlsgi b fkdusb` ehv `b
8/14/2019 Medical intensive care unit
56/120
8/14/2019 Medical intensive care unit
57/120
ES[N VU[EX
8/14/2019 Medical intensive care unit
58/120
8/14/2019 Medical intensive care unit
59/120
8/14/2019 Medical intensive care unit
60/120
Nkdkshf Dbik ' CsbdeDbik
Ikfmbdhvi gl Bfuhgd Hdehfbuhgdv Fgdusbhdehfbuhgdv Be|ksvk Skbfuhgdv D{svhdn Skvpgdvhch`huhkv
8/14/2019 Medical intensive care unit
61/120
Dbik
Kphskpmhdk`k|gpmke-beskdb`hdk(
C2 bde C3 bngdhvufb{vhdn hdfskbvke`k|k`v gl fxf`hf BI_psge{fhdncsgdfmgeh`buhgd,fbsehbf bde FDV
vuhi{`buhgd: `bsnkegvkv fbd fb{vk|bvgfgdvushfuhgd |hbb`pmb skfkpugsv:vib`` egvk fbd fb{vk|bvgeh`buhgd |hb c3|bvf{`bs skfkpugsv
)bf{uk bvumibbuubfj)mkigvubvhv)csgdfmgvpbvi)bdbpmx`b}hv)b``ksnhf skbfuhgdv
)fbsehbf bsskvu)bea{dfu hdbdkvumkvhb)vmgfj
)mxpksvkdvhuh|huxugvxipmbugihikuhfv)dbssg~)bdn`kn`b{fgib
)gsnbdhf csbhd bdemkbsu ehvkbvkvxdesgik)`gfb` bdkvumkvhbgl fksubhd bskb)`bcgs)fbsehbf eh`buhgd)fgsgdbsxhdv{llhfhkdfx
)fkskcsb`bsukshgvf`ksgvhv
)uskigsv)bd}hkux)pb`phubuhgdv)ubfmxfbsehb)exvsmxumihbv)bdgsk}hb
)exvpdkb
)igdhugsskvphsbugsxl{dfuhgd, KFN ugpsk|kdu fkskcsb`mkigssmbnk)igdhugs lgs
k|hekdfk glb``ksnhf skbfuhgdv,pbsbeg}hfb`csgdfmgvpbvi)hdvus{fu pbuhkduug {vk umhvikehfbuhgd cklgskgumks ikehfbuhgdvbde b``g~ bu `kbvu
; ihdv cku~kkdkbfm, ug psk|kdug|ksvuhi{`buhgd
Vgeh{ichfbscgdbuk
Gsb``x dk{usb`hqkvnbvushf bfhe, ~mhfmlgsiv ~buks, DbF`,FG3, hdfskbvkvp`bvib chfbscgdbuk,~mhfm c{llksv m2 hgdfgdfkdusbuhgd,sk|ksvkv bfhegvhv
)bfhegvhv)fbsehbf bsskvu)b`jb`hdhqbuhgd)nbvushf bfhedk{usb`hqbuhgd'bdubfhe
)mxpksukdvhgd)pkpuhf {`fks)skdb` ehvkbvk)mxpgfb`fkihb
)u~hufmhdn)mxpkskl`k}hb)ck`fmhdn)ehvukduhgd)b`jb`gvhv
)bvvkvvskvphsbugsxl{dfuhgd bde p{`vksbuk, ekpum, `{dnvg{dev)bvvkvv lgs FG3 hdNH usbfu)igdhugs l`{hecb`bdfk,k`kfusg`xukv, c`gge_M, {shdk g{up{u)be|hvk pbuhkdu ugdguhlx IE hlhdehnkvuhgd hvbffgi bdhke ~hum
8/14/2019 Medical intensive care unit
62/120
Nkdkshf Dbik ' CsbdeDbik
Ikfmbdhvi gl Bfuhgd Hdehfbuhgdv Fgdusbhdehfbuhgdv Be|ksvk Skbfuhgdv D{svhdn Skvpgdvhch`huhkv
8/14/2019 Medical intensive care unit
63/120
Ihebqg`bi-egsihf{i(
Ekpskvvkvv{cfgsuhfb` `k|k`v hdFDV: ibx bfu gd`hichf vxvuki,skuhf{`bs lgsibuhgd,
ibx pgukduhbukNBCB cx chdehdn ugvpkfhlhfckdqgehbqkphdkskfkpugs
)psk gp vkebuhgd)nkdksb`bdkvumkvhbhde{fuhgd)vkebuhgd lgs
ehbndgvuhf ukvu)hdu{cbuhgd
)mxpksvkdvhuh|huxugckdqgehbqkphdkv)vmgfj)fgib
)b`fgmg`hdug}hfbuhgd)bf{uk dbssg~bdn`k n`b{fgib
)db{vkb)|gihuhdn)fg{nmhdn)exvpdkb)`gvv gl cb`bdfk
)igdhugs C_, p{`vk)~bufm g{u lgsskvphsbugsxekpskvvhgdkvpkfhb``x ug
k`keks`x pbuhkdu)fb{uhgd pbuhkdu ugb|ghe FDVekpskvvbduvhdf`{ehdn b`fgmg`lgs 35msv bluksubjhdn umhv es{n
Db`g}gdk-Dbsfbd(
Ibx ehvp`bfk gphghebdb`nkvhfv lsgi umkhsskfkpugsv ug ske{fkhuv kllkfuv
)dbsfguhfg|ksegvk)pgvu gp dbsfguhfekpskvvhgd
)skvphsbugsxekpskvvhgd e{k ugdgd)gphghe es{nv
)ubfmxfbsehb)hdfskbvk C_)vkhq{skv)fbsehbf bsskvu)p{`igdbsx
kekib
)bvvkvv fbsehbfvubu{v)igdhugs \V)bvvkvv lgs pbhd,pbuhkdu skvphsbuhgd
)hdvus{fu pbuhkduug skpgsu be|ksvkskbfuhgd
Nkdkshf Dbik 'Csbde Dbik
Ikfmbdhvi glBfuhgd
Hdehfbuhgdv Fgdusbhdehfbuhgdv
Be|ksvkSkbfuhgdv
D{svhdnSkvpgdvhch`huhkv
8/14/2019 Medical intensive care unit
64/120
Csbde Dbik Bfuhgd dv Skbfuhgdv Skvpgdvhch`huhkv
_sgikumbqhdk-_mkdksnbd(
Bfuv gd c`gge|kvvk`v, NH,skvphsbugsx vxvukicx fgipkuhdn ~hummhvubihdk lgs m2
skfkpugs vhuk:ekfskbvkv b``ksnhfskvpgdvk cx c`gfjhdnmhvubihdk: b`vg bfuvgd fmkig skfkpugsushnnks qgdk ugekfskbvk |gihuhdn:hdfskbvkv FDVvuhi{`buhgd: mbv
bduhfmg`hdksnhfskvpgdvk
)iguhgd vhfjdkvv)smhdhuhv)b``ksnx skvpgdvk)vkebuhgd)db{vkb
)psk gp bde pgvugp vkebuhgd)
)mxpksvkdvhuh|huxug m2 skfkpugsbdubngdhvu)v{`lhuk b``ksnx)fmh`e 03xs
)bf{uk bvumibbuubfj
)ehqqhdkvv)esg~vhdkvv)fgdvuhpbuhgd){shdbsx skukduhgd
)bvvkvvskvphsbugsx vubu{v,H bde G)nh|k 2ms cklgskbde 3msv bluks
ikb`v ug ekfskbvkNH {pvku)fb{uhgd pbuhkdudgu ug k}fkkeskfgiikdekeegvk:exvsmxumihb ibxgff{s
Mxesgfgsuhvgdk-vg`{)fgsukl(
N`{fgfgsuhfghe ~humbduh hdl`biibugsxkllkfu ckfb{vk gl huvbch`hux ug hdmhchupsgvubn`bdehdvxdumkvhv, hdmhchuihnsbuhgd glibfsgpmbnkv,`k{fgfxukv bdelhcsgc`bvuv bu vhukv glhdl`biibuhgdpmbngfxugvhv bde`xvgib` kdqxiksk`kbvk$ Hu fbd b`vgfb{vk umk sk|ksvb` gl
hdfskbvke fbph``bsxpksikbch`hux
)b``ksnhf bdehdl`biibugsxgpmumb`ihfpsgfkvvkv)NH ehvkbvk{`fksbuhf fg`huhv)i{`uhp`k vf`ksgvhv)uskbuikdu glvxdg|huhv glgvukgbsumshuhv)uskbuikdu gljk`ghev)sk`hkl glehvfgilgsubvvgfhbuke ~hum
mkigssmghevpkshdkb` hufmhdn gs
)vxvukihf l{dnb`hdlkfuhgd)bf{ukn`{iks{`gdkpsmhuhv)bigkchbvhv)BHEV))UC)dgdbvumibuhfcsgdfmhb` evk$
)ekpskvvhgd)l`{vmhdn)v~kbuhdn)mkbebfmk)igge fmbdnkv)mxpksukdvhgd)ehbssmkb)db{vkb)|gihuhdn)mkigssmbnk
)igdhugs pbuhkduv~khnmu, C_$N`{fgvk bdek`kfusg`xuk `k|k`v$)bvvkvv lgsvxvukihfbcvgspuhgd bdehsshubuhgd)be|hvk pbuhkdu ugk}ksfhvk bde ubjk|hu$ E bde fb`fh{iv{pp`kikduv
Nkdkshf Dbik 'Csbde Dbik
Ikfmbdhvi glBfuhgd
Hdehfbuhgdv Fgdusbhdehfbuhgdv
Be|ksvkSkbfuhgdv
D{svhdnSkvpgdvhch`huhkv
8/14/2019 Medical intensive care unit
65/120
Csbde Dbik Bfuhgd dv Skbfuhgdv Skvpgdvhch`huhkv
Ek}bikumbvgdk-Ekfbesgd(
Vxdumkuhfn`{fgfgsuhfghe ~humibsjke bduh)hdl`biibugsx kllkfuckfb{vk gl huv bch`hux
ug hdmhchupsgvubn`bdehdvxdumkvhv, hdmhchuihnsbuhgd glibfsgpmbnkv,`k{jgfxukv bdelhcsgc`bvuv bu vhukv glhdl`biibuhgd,pmbngfxugvhv bde
`xvgvgib` kdqxiksk`kbvk
)hdl`biibuhgd)b``ksnhkv)dkgp`bviv)fkskcsb` kekib)vkpuhf vmgfj
)fg``bnkdehvgseksv
)pvxfmgvhv)mxpksvkdvhuh|hux)hehgpbumhfumsgicgfxugpkdhb)bigkchbvhv
dgdbvumibuhfcsgdfmhb` evk$
)ekpskvvhgd)l`{vmhdn)v~kbuhdn)mxpksukvhgd)ehbssmkb
)db{vkb)|gihuhdn)bcegihdb`ehvukduhgd)hdfskbvkebppkuhuk
)bvvkvv hdlkfuhgd:lk|ks, pgubvvh{iekp`kuhgd, ikdub`vubu{v)igdhugs ~khnmu
ebh`x)hdvus{fu pbuhkduug skpgsu vhndv glbe|ksvk skbfuhgdv)be|hvk pbuhkdu ugb|ghe k}pgv{sk ugpksvgdv ~humhdlkfuhgd
Uksc{ub`hdk-cshfbdx`(
Sk`b}kv csgdfmhb`vdggum i{vf`k cxehskfu bfuhgd gd C3beskdksnhf skfkpugsvumsg{nmbff{i{`buhgd glfBI_ bu C)beskdksnhfskfkpugs vhukv:skv{`uv bskcsgdfmgeh`buhgd,eh{skvhv bde FDv,mkbsu vuhi{`buhgd:sk`b}kv {ukshdkviggum i{vf`k$
)csgdfmgvpbvi )mxpksvkdvhuh|huxugvxipmbugihikuhfv)dbssg~)bdn`kn`b{fgib)ubfmxexvsmxumihbv
)uskigsv)hdvgidhb)mkbebfmk)ehqqhdkvv)pb`phubuhgdv)d{bvkb)|gihuhdn
)igdhugsskvphsbugsxl{dfuhgd)ekuksihdk umbupbuhkdu mbv dguskfkh|keumkgpmx``hdkumksbpx cklgsknh|hdn egvk)igdhugs lgsk|hekdfk glb``ksnhf skbfuhgdv)bvvkvv lgspbsbeg}hfb`csgdfmgvpbvi)vmg{`e ck nh|kd~hum ikb`v)
Nkdkshf Dbik 'Csbde Dbik
Ikfmbdhvi glBfuhgd
Hdehfbuhgdv Fgdusbhdehfbuhgdv
Be|ksvkSkbfuhgdv
D{svhdnSkvpgdvhch`huhkv
8/14/2019 Medical intensive care unit
66/120
Csbde Dbik Bfuhgd dv Skbfuhgdv Skvpgdvhch`huhkv
Usbdk}kihf bfhe-Mkigvubd(
Hdmhchuv cskbjeg~dgl lhcshd f`guv$ Hu bfuvpshibsh`x cx c`gfjhdnumk chdehdn glp`bvihdgnkd bde
p`bihd ug lhcshd:ehskfu hdmhchuhgd glp`bvihd bPgff{svgd`x ug b `hihukeeknskk
)uskbuikdu bdepsgpmx`b}hv glmkigssmbnkbvvgfhbuke ~humk}fkvvh|k
lhcshdg`xvhv)psgpmx`b}hv lgsmkskehubsxbdnhgkekib
)mxpksvkdvhuh|hux)vk|ksk skdb`hdv{llhfhkdfx)pbuhkdu ~humihfsgvfgphf
mkibu{shb
)db{vkb)|gihuhdn)mkbebfmk)mxpgukdvhgd
)bvvkvv pbuhkdu hl~hum bfuh|khdusb|bvf{`bsf`guuhdn: gcubhdpsgumsgichd uhik
gl umk pbuhkdu)pkslgsi `h|ksl{dfuhgd ukvu bdec`gge ukvuv)be|hvk pbuhkdu ugskpgsu |hv{b`bcdgsib`huhkv ugumk pmxvhfhbd$
Bihgebsgdk-Fgsebsgdk(
_sg`gdnv bfuhgdpgukduhb` e{sbuhgdbde kllkfuh|ksklsbfugsx pkshge,v`g~v vhd{v sbuk ~humhdfskbvhdn _S bde RUhduks|b`v, dgd)fgipkuhuh|k b`pmbbde ckub beskdksnhfhdmhchuhgd: hdfskbvk_S bde RU hduks|b`v,ekfskbvk vhd{v sbukbde ekfskbvkv _\S
)vk|ksk|kdushf{`bsubfmxfbsehb)v{psb|kdushf{`bsubfmxfbsehb)|kdushf{`bslhcsh``buhgd)bushb` lhcsh``buhgddgu fgdusg``ke cx2vu `hdk bnkduv
)vhd{v dgekexvl{dfuhgd)3de gs 6se eknskkB\ c`gfj)csbexfbsehb)dkgdbukv, hdlbduv
)mkbebfmk)ehqqhdkvv)mxpgukdvhgd
)igdhugs H bde Gsbuhg, KFN)bvvkvv lgs FDVvxipugiv, vhnmubde |hvhgd)hdvus{fu pbuhkduug skpgsu vhekkllkfuvhiikehbuk`x ugumk pskvfshpugsbde umbu vjhdehvfg`gsbuhgd hv{v{b``x sk|ksvhc`k)be|hvk pbuhkduumbu ebsj n`bvvkvibx ck dkkekelgs pmgugpmgchb)hdvus{fu pbuhkduug {vk v{dvfskkd
Nkdkshf Dbik 'Csbde Dbik
Ikfmbdhvi glBfuhgd
Hdehfbuhgdv Fgdusbhdehfbuhgdv
Be|ksvkSkbfuhgdv
D{svhdnSkvpgdvhch`huhkv
8/14/2019 Medical intensive care unit
67/120
Bihdgpmx``hdk-Us{pmx``hdk(
K}bfu ikfmbdhvi{djdg~d: sk`b}kvviggum i{vf`k glskvphsbugsx vxvukicx c`gfjhdn
pmgvpmgehkvuksbvk~mhfm hdfskbvkvfxf`hf BI_ b`uksvhdusbfk``{`bs fb`fh{ihgd ig|kikduv
)csgdfmhb` bvumib)kipmxvkib)csbexfbsehb
)mxpksvkdvhuh|huxug }bdumhdkv)bfuh|k pkpuhf{`fks ehvkbvk
)ehqqhdkvv)pb`phubuhgdv)vhd{vubfmxfbsehb)db{vkb
)|gihuhdn
)igdhugsumkgpmx``hdk c`gge`k|k`v, H bde G,skvphsbugsx sbuk)hdvus{fu pbuhkdu
ug b|ghembqbseg{vbfuh|huhkv)ukbfm pbuhkdu hlNH {pvku gff{sv,ubjk es{n ~hum=gq gl ~buks)be|hvk pbuhkdu ughdfskbvk l`{he
hdubjk
F`gdhehdk-Fbubpskv(
Hdmhchuv vxipbumkuhf|kPbvgigugs fkdukshd FDV ~mhfm ske{fkhip{`vkv hdvxipbumkuhf dks|g{vvxvuki: C_: p{`vksbuk, FG ekfskbvke:psk|kduv pbhd vhndb`usbdvihvvhgd hd FDVcx b`pmb beskdksnhfskfkpugs vuhi{`buhgdgl umk vphdb` fgse
)ih`e ug igeksbukmxpksukdvhgd
)mxpksvkdvhuh|hux)c`kkehdnehvgseksv)bduhfgbn{`bduv
)esg~vhdkvv)vkebuhgd)mkbebfmk)lbuhn{k)gsumgvubuhfmxpksukdvhgd)dgfu{shb)pb`phubuhgdv)db{vkb)|gihudn)esx ig{um)ib`bhvk
)igdhugs C_'p{`vk)fmkfj lgs kekibhd lkku bde `knvebh`x)igdhugs H bde G)hdvus{fu pbuhkdudgu ug ehvfgduhd{kes{n bcs{pu`x)fb{uhgd pbuhkdu ugfmbdnk pgvhuhgdv`g~`x
Nkdkshf Dbik 'Csbde Dbik
Ikfmbdhvi glBfuhgd
Hdehfbuhgdv Fgdusbhdehfbuhgdv
Be|ksvkSkbfuhgdv
D{svhdnSkvpgdvhch`huhkv
8/14/2019 Medical intensive care unit
68/120
p
Ehng}hd -@bdg}hd( Hdmhchuv vgeh{ipgubvvh{i BU_bvk~mhfm ibjkv igskfb`fh{i b|bh`bc`k lgsfgdusbfuh`k psgukhdv,
skv{`uhdn hdhdfskbvke fbsehbfg{up{u, lgsfk glfgdusbfuhgd:ekfskbvkfgdusbfuhgd,ekfskbvk MS bde B\fgde{fuhgd vpkke
)sbpheehnhub`hqbuhgd hdbf{uk bde fmsgdhfFML)bushb` lhcsh``buhgd
)bushb` l`{uuks)bushb` csbexfbsehb)bushb` ubfmxfbsehb)fbsehgdknhfvmgfj)pbsg}xvib` bushb`ubfmxfbsehb
)mxpksvkdvhuh|huxug ehnhub`hv)|kdushf{`bslhcsh``buhgd)|kdushf{`bs
ubfmxfbsehb)fbsguhe vhd{vvxdesgik)3de gs 6se eknskkc`gfj
)mkbebfmk)esg~vhdkvv)mxpgukdvhgd)db{vkb)|gihuhdn
)bdgsk}hb
)bvvkvv bphfb`p{`vk lgs 2 ihd)igdhugs fbsehbfvubu{v, KFN)be|hvk pbuhkdu ug
ibhdubhd bvgeh{i)skvushfukeehku bv gsekske)ukbfm pbuhkdup{spgvk gl es{n hvug skn{`buk umkmkbsuvl{dfuhgdhdn
\ksbpbih`-Hvgpuhd(
Hdmhchuv fb`fh{i hgdhdl`{} bfsgvv fk``ikicsbdk e{shdnfbsehbfekpg`bshqbuhgd:psge{fkv sk`b}buhgdgl fgsgdbsx |bvf{`bsviggum i{vf`k:pkshpmksb` |bvf{`bsbsukshkv$ Hdfskbvkixgfbsehb` g}xnkdek`h|ksx
)fmsgdhf vubc`k|bvgvpbvuhf){dvubc`k bdnhdb)exvsmxumihbv)mxpksukdvhgd)v{psb|kdushf{`bsubfmxfbsehb)bushb` l`{uuks gslhcsh``buhgd
)vhfj vhd{vvxdesgik)3de gs 6se eknskkmkbsu c`gfj)mxpgukdvhgd)fbsehgnkdhfvmgfj)vk|ksk FML
)mkbebfmk)esg~vhdkvv)kekib)db{vkb)fgdvuhpbuhgd
)bvvkvv l`{he|g`{ik1 H bde Gsbuhg bde skfgse)igdhugs C_ bdep{`vk, p{`igcbsxfbph``bsx ~kenkpskvv{sk)bvvkvv lgsk}usb|bvbuhgd)be|hvk pbuhkdu ughdfskbvk l`{hehdubjk ugfg{duksbfufgdvuhpbuhgd)be|hvk pbuhkdu ugfgip`x ~humikehfb` sknhikd
8/14/2019 Medical intensive care unit
69/120
Nkdkshf Dbik 'Csbde Dbik
Ikfmbdhvi glBfuhgd
Hdehfbuhgdv Fgdusbhdehfbuhgdv
Be|ksvkSkbfuhgdv
D{svhdnSkvpgdvhch`huhkv
8/14/2019 Medical intensive care unit
70/120
Ehpmkdmxesbihdk-ckdbesx`(
Bfuv gd c`gge|kvvk`v, NH,skvphsbugsx vxvuki cxfgipkuhdn ~hummhvubihdk lgs umk
skfkpugs vhuk:ekfskbvkv b``ksnhfskvpgdvk c`gfjhdnmhvubihdk: fb{vkvhdfskbvkMS,|bvgeh`buhg,vkfskuhgd
)b``ksnx vxipugiv)smhdhuhv)iguhgd vhfjdkvv)dhnmuuhikvkebuhgd
)hdlbdu fg`hf)dgd psge{fuh|kfg{nm)bdbpmx`b}hv)dbvb` b``ksnhkv)exvugdhf skbfuhgd)
)mxpksvkdvhuh|huxug M2 skfkpugsbdubngdhvu)bf{uk bvumibbuubfj
)`g~ks skvphsbugsxusbfu ehvkbvk
)ehqqhdkvv)esg~vhdkvv){shdbsx skukduhgd
)bvvkvv skvphsbugsxvubu{v)psg|hek 3@'ebx ugekfskbvkvkfskuhgd
umhfjdkvv)igdhugs HG sbuhg)hdvus{fu _} ug {vkv{dvfskkd ugpsk|kdu pmgugvkdvhuh|hux)k`k|buk vheksbh`vug psgiguk vblkuxvhdfk ehqqhdkvv
ibx gff{s)hdvus{fu _} ugskr{kvu bvvhvubdfk~hum fgip`kuhgd
_mxugdbehgdk
-br{bikpmxugd(
Dkkeke lgs bekr{buk
c`gge f`guuhdn -lbfugsvHH, \HH, H], ](
)|hu$ J
ib`bcvgspuhgd)mxpgpsgumsgichdkihb)psk|kduhgd glmkigssmbnhfehvkbvk gl umakdk~ cgsd
)mxpksvkdvhuh|hux
)vk|ksk mkpbuhfehvkbvk)`bvu lk~ ~kkj glpskndbdfx
)mkbebfmk
db{vkb){uhfbshb
)igdhugs lgs
c`kkehdn gscs{hvhdn)bvvkvv d{ushuhgdb`vubu{v)ukbfm _}dkfkvvbsx lggevmhnm hd |hu$ J ug ckhde{fke hd ehku)be|hvk _} ug b|ghe
HI hda, uggumcs{vm,l`gvvhdn: {vk
8/14/2019 Medical intensive care unit
71/120
Nkdkshf Dbik 'C e D
Ikfmbdhvi glB uh
Hdehfbuhgdv Fgdusbhdehfbuhgd Be|ksvkS uh
D{svhdnS hch`huh
8/14/2019 Medical intensive care unit
72/120
Csbde Dbik Bfuhgd v Skbfuhgdv Skvpgdvhch`huhkv
egpbihdkBvvkvv hdfskbvk FG,ckub 2 bde b`pmbskfkpugs, fb{vhdn|bvgfgdvushfuhgd, hd
c`gge |kvvk`1 ~mkd`g~ egvkv bskbeihdhvukske fb{vkvskdb` ikvkdukshf|bvgeh`bubuhgd: ckub2vuhi{`buhgd psge{fkhdgusgphf kllkfuv ~humhdfskbvk fbsehbfg{up{u
)vmgfj)ug hdfskbvkpksl{vhgd)mxpgukdvhgd
)mxpksvkdvhuh|hux)|kdushf{`bslhcsh``buhgd)ubfmxexvsxumihbv
)pmkgfmsgigfxugib
)mkbebfmk)pb`phubuhgdv)mxpksukdvhgd)db{vkb
)|gihuhdn)ehbssmkb
)igdhugs KFN, C_,bde p{`vk r; ihdhl C_ esgpv 6?iiMn, vugp
hdl{vhgd, bde fb``pskvfshcks,)fmkfj lgsk}usb|bvbuhgd1fmbdnk vhuk r5=)be|hvk _} ugskpgsu b`` V'K$
Hvgvgschekehdhusbk -hvgjku,hvgseh`(
Sk`b}buhgd gl|bvf{`bs viggumi{vf`k, ~mhfm `kbevug ekfskbvk psk`gbe:bluks`gbe um{v
ekfskbvhdn `klu|kdushf{`bskde,ehbvug`hfpskvv{sk, vxvukihf|bvf{`bs skvhvubdfkbde ske{fhdn fbsehbfg}xnkd ekibde
U} bdepsk|kduhgd glfmsgdhf vubc`kbdnhdb pkfugshv
)mxpksvkdvhuh|hux ugdhusbukv)vk|ksk bdkihb)hdfskbvk HF_)fkskcsb`
mkigssmbnk)bf{uk IH
)|bvf{`bsmkbebfmk)l`{vmhdn)ehqqhdkvv)pgvu{sb`
mxpgukdvhgd
)bvvkv lgs pbhd)igdhugs lgsgsumgvubuhf C_,p{`vk bu cbvk`hdkbde e{shdn U}
)hdlgsi _} umbues{n ibx ckubjkd cklgskvuskvvl{` bfuh|hux)fb{uhgd _} ugfmbdnk pgvhuhgdv`g~`x$
8/14/2019 Medical intensive care unit
73/120
8/14/2019 Medical intensive care unit
74/120
Ikehfbuhgd Vfmke{`kvbf
9 cklgsk ikb`v
RE
9 k|ksx ebx
R BI9 k|ksx igsdhdn
RGE
9 k|ksx gumks ebx
8/14/2019 Medical intensive care unit
75/120
Ikehfbuhgd Vfmke{`kv_SD
9 bv dkkeke'~mkdk|ksdkfkvvbsx
MV
9 mg{s gl v`kkp'bu ckeuhik
IS } 2
9 ibx skpkbu } 2
Vubu
9 bu gdfk
8/14/2019 Medical intensive care unit
76/120
Ikehfbuhgd Vfmke{`kvrm,r2
9 k|ksx mg{s
r3m,r3
9 k|ksx u~g mg{sv
r5m,r59 k|ksx lg{s mg{sv
CHE
9u~hfk b ebx
8/14/2019 Medical intensive care unit
77/120
Ikehfbuhgd Vfmke{`kvUHE
9 umskk uhikv b ebx
RHE
9 lg{s uhikv b ebx
BVB_9 bv vggd bv pgvvhc`k
r mv
9 k|ksx dhnmu bu ckeuhik
8/14/2019 Medical intensive care unit
78/120
_buhkdu Bfuh|hux Uksiv
be `hc9 bv ug`ksbuke
[p be `hc
9 {p bv ug`ksbuke
CS_9 cbumsggi psh|h`knkv
CS
9 ckeskvu
8/14/2019 Medical intensive care unit
79/120
_buhkdu Bfuh|hux Uksiv
FCS9 fgip`kuk ckeskvu
Bei
9beihuuke'beihvvhgd
EF gs e'f9 ehvfgduhd{k'ehvfmbsnk
H E
9Hdfhvhgd esbhdbnk
8/14/2019 Medical intensive care unit
80/120
_buhkdu Bfuh|hux Uksiv
GGC9 g{u gl cke
FF
9fmhkl fgip`bhdu
UFEC9 u{sd, fg{nm, ekkp cskbum
CS f CS_
9 ckeskvu f cbumsggi psh|h`knk
8/14/2019 Medical intensive care unit
81/120
Sg{ukv gl Ikehfbuhgd
8/14/2019 Medical intensive care unit
82/120
Beihdhvusbuhgd
H\ 9 hdusb|kdg{v
HI
9 hdusbi{vf{`bs
VR9 v{cf{ubdkg{v
H\_C
9 hdusb|kdg{v phnnxcbfj
8/14/2019 Medical intensive care unit
83/120
Fgiigd Ehbndgvuhf
8/14/2019 Medical intensive care unit
84/120
UkvuvKJN,KFN
9 K`kfusgfbsehgnsbiKKN9 K`kfusgkdfkpmb`gnsbiF]S
9 Fmkvu ])sbx[NH9 [ppks Nbvusghdukvuhdb`])sbx@NH
9 @g~ks Nbvusghdukvuhdb` ])sbx
Fgiigd Ehbndgvuhf
8/14/2019 Medical intensive care unit
85/120
nUkvuv
ISH9 Ibndkuhf Skvgdbdfk HibnhdnH\_9 Hdusb|kdg{v _xk`gnsbiMfu
9 MkibugfshuC[D9 C`gge [skb Dhusgnkd
Fgiigd Ehbndgvuhf
8/14/2019 Medical intensive care unit
86/120
UkvuvFU9 F`guuhdn UhikNUU9 N`{fgvk Ug`ksbdfk UkvuKIN
9 K`kfusgixgnsbpmx@_9 @{icbs _{dfu{skNC
9 Nb``c`beeks
Fgiigd Ehbndgvuhf
8/14/2019 Medical intensive care unit
87/120
nUkvuv
FBU Vfbd9 Fgip{ukshqke B}hb` Ugignsbpmx
Vfbd[VE9 [`usbvg{de
J[C9 Jhedkx, [skuks, C`beeksMCU9 Mkpbug Ch`hbsx Usbfu
giigd bndgv fUkvuv
8/14/2019 Medical intensive care unit
88/120
UkvuvFCF
9 Fgip`kuk C`gge Fg{duMnc9 Mkign`gchdLCV
9 Lbvuhdn C`gge V{nbsCu9 C`kkehdn Uhik__E
9 _{shlhke _sgukhd Eksh|buh|k
_buhkdu'Mgvphub` Sk`buke
8/14/2019 Medical intensive care unit
89/120
Uksiv
K$S$9 Kiksnkdfx SggiG$S$9 Gpksbuhdn Sggi
_BF[9 _gvu Bdkvumkvhb Fbsk [dhuS$S$9 Skfg|ksx Sggi
Fb9 Fbdfks
_buhkdu'Mgvphub` Sk`buke
8/14/2019 Medical intensive care unit
90/120
Uksiv
FML9 Fgdnkvuh|k mkbsu lbh`{skL[G9 lk|ks gl {djdg~d gshnhd
IH9 Ixgfbsehb` hdlbsfuhgdGCV9 Gsnbdhf Csbhd Vxdesgik
[SH9 [ppks Skvphsbugsx Hdlkfuhgd
_buhkdu'Mgvphub` Sk`buke
8/14/2019 Medical intensive care unit
91/120
Uksiv
[UH9 [shdbsx Usbfu HdlkfuhgdMKKDU9 mkbe,kbsv, kxkv, dgvk, umsgbu
NH9 Nbvusghdukvuhdb`N[9 Nkdhug){shdbsx
NXD9 Nxdkfg`gnx
_buhkdu'Mgvphub` Sk`buke
8/14/2019 Medical intensive care unit
92/120
Uksiv
GC9 GcvukushfvFGF9,fgduhd{hux gl fbsk
BCG9 Umk ibhd c`gge nsg{pIkev9 ikehfbuhgd
@I_9 `bvu ikdvus{b` pkshge
_buhkdu'Mgvphub` Sk`buke
8/14/2019 Medical intensive care unit
93/120
Uksiv
BSEV9 Be{`u Skvphsbugsx Ehvuskvv
VxdesgikBJB
9 bcg|k jdkk bip{ubuhgdB'VNB9 B|ksbnk'Vib`` Nkvubuhgdb` BnkBVME
9 Bsukshgvf`ksguhf Mkbsu Ehv$
_buhkdu'Mgvphub` Sk`buke
8/14/2019 Medical intensive care unit
94/120
Uksiv
H\L9 Hdusb|kdg{v l`{heF'V9 Fkvbskbd Vkfuhgd
FB_E9 Fgduhd{g{v Bic{`bugsx _kshugdkb`
Ehb`xvhvF_S
9 Fbsehg _{`igdbsx Skv{vfhubuhgd
8/14/2019 Medical intensive care unit
95/120
_buhkdu'Mgvphub` Sk`buke
8/14/2019 Medical intensive care unit
96/120
Uksiv
_SGI9 pskibu{sk s{pu{sk gl ikicsbdk_HE9 _k`|hf Hdl`biibugsx Ehvkbvk
_IH9 pghdu gl ib}hi{i hip{`vk\CBF9 \bnhdb` chsum bluks fkvbskbd vkfuhgd
8/14/2019 Medical intensive care unit
97/120
_buhkdu'Mgvphub` Sk`buke
8/14/2019 Medical intensive care unit
98/120
Uksiv
VGC9 vmgsudkvv gl cskbum
D$_$
9 D{svk _sbfuhuhgdks
BID_9 Be|bdfke Ikehfb` D{svk
_sbfuhuhgdks
MGM
9 mbse gl mkbshdnKfugix
9 skig|b`
_buhkdu'Mgvphub` Sk`buke
8/14/2019 Medical intensive care unit
99/120
Uksiv
huhv9 hdl`biibuhgdGugix9 hdfhvhgd hdug
_K9 p{`igdbsx kicg`hvi_IM9 pbvu ikehfb` mhvugsx_UB9 pshgs ug beihvvhgd
8/14/2019 Medical intensive care unit
100/120
_buhkdu'Mgvphub` Sk`buke
8/14/2019 Medical intensive care unit
101/120
Uksiv
CI9 cg~k` ig|kikduBF@V9 Be|bdfke Fbsehbf @hlk V{ppgsu
BHEV9 Bfr{hske Hii{dk Eklhfhkdfx
Vxdesgikbdkv$9 bdkvumkvhb
_buhkdu'Mgvphub` Sk`buke
8/14/2019 Medical intensive care unit
102/120
Uksiv
B'FSL9 Bf{uk'Fmsgdhf Skdb` Lbh`{skC_M
9 Ckdhnd _sgvubuhf MxpksusgpmxF_E9 Fkpmb`g _k`|hf EhvpsgpgsuhgdFBE9 Fgsgdbsx Bsuksx Ehvkbvk
_buhkdu'Mgvphub` Sk`buke
8/14/2019 Medical intensive care unit
103/120
Uksiv
FDV9 Fkdusb` Dks|g{v VxvukiU_D9 ugub` pbskduksb` d{ushuhgd
F\_9 Fkdusb` \kdg{v _skvv{skNFV9 N`bvng~ Fgib Vfb`kHG_9 hdusbgf{`bs pskvv{sk
_buhkdu'Mgvphub` Sk`buke
U
8/14/2019 Medical intensive care unit
104/120
Uksiv
GSHL9 Gpkd Ske{fuhgd Hduksdb` Lh}buhgd_KK_9 _gvhuh|k Kde K}phsbugsx _skvv{sk
_[E9 _kpuhf [`fks EhvkbvkV\F9 v{pkshgs |kdb fb|b
_buhkdu'Mgvphub` Sk`buke
U
8/14/2019 Medical intensive care unit
105/120
Uksiv
UGL9 Ukusb`gnx gl Lb``guUBMCVG9 Ugub` Bcegihdb` Mxvukskfugix ~'
Ch`buksb` Vb`phdng)ggpmgskfugixU[S_9 usbdv{skumsb` skvkfuhgd gl umk
psgvubuk
N ` U
8/14/2019 Medical intensive care unit
106/120
Nkdksb` Uksivf
9 ~hum
v
9 ~humg{u
b9 cklgsk
p
9 bluks
N ` U
8/14/2019 Medical intensive care unit
107/120
Nkdksb` Uksivbf
9 cklgsk ikb`v
S
9 shnmu
GE9 shnmu kxk -gf{`{v
ek}uks(
L
9 Lbmskdmkhu
N ` U
8/14/2019 Medical intensive care unit
108/120
Nkdksb` UksivF
9 Fk`vh{v, fkduhnsbek
E}
9 Ehbndgvhv
S}9 Uskbuikdu
V}
9 Vks|hfk
N ` U
8/14/2019 Medical intensive care unit
109/120
Nkdksb` UksivU}
9 usbfuhgd, umksbpx
C}
9 chgpvx
L}9 lsbfu{sk
f'f
9 fgip`bhdu gl
N ` U
8/14/2019 Medical intensive care unit
110/120
Nkdksb` Uksiv~'f
9 ~mkk`fmbhsEBU
9 ehku bv ug`ksbuke
biu$
9 big{du
esvn$
9 eskvvhdn
N ` U
8/14/2019 Medical intensive care unit
111/120
Nkdksb` UksivGv
9 ig{um gs gpkdhdnpgvu)gp
9 pgvu gpksbuh|k`x
pskp
9 pskpbsbuhgd
\G
9 |kscb` gseks
Nkdksb` Uksiv
8/14/2019 Medical intensive care unit
112/120
Nkdksb` UksivJ\G
9 jkkp |khd gpkdUcvp
9 ubc`kvpggd
Vv
9 mb`l
Ff
9 f{chf fkduhikuks
Nkdksb` Uksiv
8/14/2019 Medical intensive care unit
113/120
Nkdksb` Uksiv\V
9 \hub` vhndvC_
9 C`gge _skvv{sk
U_S
9 Ukipksbu{sk, _{`vk,Skvphsbuhgd
D_G
9 dgumhdn cx ig{um -dgdpks gv(
Nkdksb` Uksiv
8/14/2019 Medical intensive care unit
114/120
Nkdksb` Uksivpf
9 bluks ikb`v@
9 `klu, `huks
GV
9 `klu kxk -gf{`{v vhdkvuks(
G[
9 cgum kxkv
Nkdksb` Uksiv
8/14/2019 Medical intensive care unit
115/120
Nkdksb` Uksiv
M3?9 ~buks
S'G
9 S{`k G{u
G39 g}xnkd
_u
9 pbuhkdu
8/14/2019 Medical intensive care unit
116/120
8/14/2019 Medical intensive care unit
117/120
Nkdksb` Uksiv
8/14/2019 Medical intensive care unit
118/120
Nkdksb` Uksiv
pks9 cx gs umsg{nm
pskgp
9 pskgpksbuh|k`x
^D@9 ~humhd dgsib` `hihuv
UG
9 uk`kpmgdk gseks
Nkdksb` Uksiv
8/14/2019 Medical intensive care unit
119/120
Nkdksb` Uksiv
^u9 ~khnmu
Uvp
9 ukbvpggd
Fbum$9 fbumkuks
I`
9 ih``hikuks
kde gl
8/14/2019 Medical intensive care unit
120/120
kde glpskvkdubuhgd
UMBDJ XG["