Critical Care

These are usually the first people you speak to. They assist you when you wish to visit or communicate with any of the health care team. They also provide clerical duties for the unit.

Critically ill patients receive direct, hands-on care from nurses with specialized training in critical care. This care includes everything from meeting basic needs to managing complex medications and life-sustaining equipment.

Respiratory Therapists are specialists in managing breathing therapies. Care provided by RTs includes breathing treatments and tests, management of artificial airways and artificial ventilation (breathing machines).

Maintaining strength and conditioning is an important part of getting better. Physiotherapists are here to help our patients do that. They will assist with exercises and breathing better.

The clinical pharmacist works with the team to ensure that all medications are reviewed and monitored.

Social Workers offer supportive counselling to families at difficult times of uncertainty, grief and loss. They attend family/team meetings, clarify information and can assist with financial, employment, legal or other practical matters.

In critical care, Speech-language pathologists (SLPs) play an important role in the management of patients' swallowing abilities. There is a high incidence of dysphagia (swallowing difficulty) in critical care related to acute critical illness, prolonged intubation, and tracheostomy tubes. SLPs asses and treat dysphagia to determine swallowing ability and safety of intake by mouth. Consultation for patients with communication impairments in critical care can also be provided. SLPs work closely with the interprofessional team to enhance patient safety and quality of life

Patients in the ICU have higher than normal (and different) nutritional needs. Dietitians calculate the individual needs for the patient and monitor their nutritional intake.

Ethicists are available when there is uncertainty as to what to do next. They can help make sure everyone has the right information to make the best decision possible and honor patient wishes related to treatment options.

The PSR/SA has special training to provide cleaning within hospitals (to prevent the spread of infection) and to assist with the transport of patients.

The PSW has special training to assist the RN with patient personal care, patient repositioning, and mobility.

The AIRVO system is a humidified high-flow oxygen delivery device designed to provide heated, humidified air/oxygen mixtures at flow rates up to 60 L/min. It delivers precise oxygen concentrations (FiO₂) via nasal cannula or tracheostomy interface, supporting patients with hypoxemic respiratory failure or those requiring high levels of oxygen therapy.

The system provides:

• Heated and humidified gas to optimize mucociliary clearance, improve secretion mobilization, and enhance patient comfort.
• Adjustable FiO₂ (21%–100%) and flow rates, allowing for individualized titration of oxygen therapy.
• Nasal high-flow interface that reduces the need for tight-fitting masks, enabling eating, drinking, and communication.
• Flow-dependent positive airway pressure effect, which can help reduce work of breathing and improve oxygenation.

Clinical Uses:

• Acute hypoxemic respiratory failure (e.g., pneumonia, COVID-19, ARDS, pulmonary edema).
• Post-extubation support.
• Patients with high oxygen demands not adequately managed by conventional oxygen therapy.

The bedside cardiac monitor allows the team to view different waveforms depending on the needs of the patient. This can include any combination of the following: heart rate and rhythm, blood pressure, respiratory rate and rhythm, oxygen saturation, and heart pressures.

An intravenous catheter may be inserted into a blood vessel to allow the team to give fluids and drugs. A peripheral line is a small catheter in the hand or arm. Many critical-care patients require a larger catheter known as a central line, which is inserted into one of the bigger veins in the neck, chest, or groin. These lines are used for fluids or blood pressure support medications. These fluids and medications are controlled by an infusion pump.

If patients are having trouble with breathing a ventilator may be used for support. This can be done through a tight fitting mask (BiPAP); or more commonly, a tube called an endotracheal (ET) tube is placed through the mouth into the trachea (windpipe) and connected to the breathing machine. In the ICU at Rouge Valley Centenary, if support is needed for a longer period of time the doctor may discuss a tracheostomy where the breathing tube is inserted through the neck into the trachea. This is considered more comfortable for long term use.

Sometimes a catheter is inserted into an artery (usually in the wrist or groin) and connected to the bedside monitor. This allows the team to monitor the blood pressure at all times and also will allow for frequent taking of blood samples for tests.

When patients are very sick, they may not be able to eat or drink enough nutrition to help them heal. Some patients are not able to eat or drink. To provide the needed nutrition, a tube is placed in the stomach through the mouth or nose and the patient can be given tube feeds. If the stomach needs to be rested then parenteral nutrition (PN) may be given directly into the blood stream through an intravenous.