Intro to critical care &EM

Dr. Ko 644

Acuity

• complexity and severity of patient’s medical condition

High acuity

• more severely ill, could be based on many factors:

  • Abnormal lab values

  • Unstable vital signs

  • Requires close cardiac or neurological monitoring

  • Multiple medications or interventions needed (complex treatment plans)

  • Comorbidities

Triage

• Patients are triaged based on their acuity

  • Triage: determine how quickly a patient needs care

  • ED patients are seen/examined in order of acuity NOT order of arrival

Hospital units: lowest to highest level of care

• note where intubated patients are

Acute care

• care that is provided in a hospital setting

• urgent or emergent

• umbrella term which also includes critical care

Critical care

• Highest acuity, most unstable patients

• Without immediate action & resources, patient could decompensate and/or code

• Requires many personnel to assist; many interventions happening at once

Role of EM/ICU Pharmacist

• Rapid assessment & critical thinking with sometimes minimal information (ED setting)

• Ensure effective medications are ordered and administered safely

• Quickly gather relevant information from patient (weight/height, allergies, medication history)

• Ensure medications are dosed correctly (especially pediatrics!) in fast-paced environment

• Recommend appropriate therapies

• Prepare medications at the bedside using rapid IV compounding & labeling

• Programming of IV infusion pump

• Answering drug info questions (IV compatibility, monitoring, adverse effects)

• Educate providers, nurses, and patients

Practical skills of EM/ICU Pharmacists

• Teamwork & communication

• Patient advocacy

• Know your resources

• Streamline/tailor your recommendations and education to the audience & pace

• Ability to triage and ask for help

• Resiliency & willingness to seek resources to cope with tragedy