Monitoring of Patients in the
Intensive Care Unit (ICU)
Presented by: Dr. C. Gunaseelan M.D
Date: 07-03-2025
Introduction
• THE GOAL OF MONITORING • IMPORTANT PARAMETERS SHOULD • DATA IS RECORDED ON THE
PATIENTS IS TO DETECT PROBLEMS BE MONITORED SYSTEMATICALLY AT MONITORING CHART.
EARLY AND MANAGE THEM REGULAR INTERVALS.
PROMPTLY.
Importance of Monitoring
• NEW SYMPTOMS, SIGNS, • CONTINUOUS • SYSTEMATIC ASSESSMENT
OR FINDINGS REQUIRE MONITORING HELPS IMPROVES PATIENT
IMMEDIATE INVESTIGATION. PREVENT COMPLICATIONS. OUTCOMES.
Behaviors of the Patient
• Anxiety, Fear: Response to new • Low PaO2: Check SpO2, patient-
environment or ventilator - Reassure, use ventilator system.
sedatives.
Behavioral Changes
• RESTLESSNESS, AGITATION: • PAIN: ASSESS PAIN • LOW PEAK INSPIRATORY
LOW PAO2 - CHECK SPO2, MEDICATION. FLOW RATE (PIFR).
PATIENT-VENTILATOR SYSTEM.
Mental State Monitoring
• CONFUSION, • USE GCS SCALE FOR • CHECK OXYGENATION,
DISORIENTATION, DECREASED ALERTNESS ASSESSMENT. PERFUSION, AND MEDICATION
RESPONSIVENESS. EFFECTS.
Neurological Signs
• Twitching, Convulsions, Tetany: • Breathlessness: Anxiety, Low PaO2,
Decreased serum levels of Reduced ventilation, Pneumothorax.
anticonvulsants.
Respiratory Monitoring
• ALTERED CHEST WALL MOVEMENTS: • ASYNCHRONOUS THORACIC-
PARADOXICAL MOVEMENT - FLAIL ABDOMINAL MOVEMENT - COPD, POST-
CHEST. SURGERY.
Chest Wall Expansion
• UNILATERAL DECREASE IN EXPANSION: • PAIN-RELATED SPLINTING, PLEURAL
RIGHT MAINSTEM BRONCHUS AIR, ATELECTASIS.
INTUBATION.
Ventilator Monitoring
• ASYNCHRONY WITH VENTILATOR: • TUBE MIGRATION: CHECK PLACEMENT.
ANXIETY, PAIN, AIRWAY OBSTRUCTION.
Vital Signs Monitoring
• Blood Pressure (Every 1-4 Hours): • Hypertension: Anxiety, inadequate
Hypotension - volume depletion, cardiac sedation, increased PaCO2.
failure.
Cardiac Monitoring
• Heart Rate & Rhythm (Hourly): • Causes: Anxiety, drugs, oxygenation
Arrhythmias, tachycardia, bradycardia. changes.
Urinary Output Monitoring
• Hourly
• Normal range:
Monitoring: Low
0.5-1.0 mL/kg/hr
output - Kidney
in adults.
perfusion issues.
Temperature Monitoring
• Fever: Overheated
• Monitor Every 8 humidifier,
Hours. infection, high
metabolic rate.
Respiratory Rate
• Monitor Every 1-4 Hours.
• Unsuccessful weaning leads to
rapid shallow breathing.
Fluid Retention & Edema
• Monitor Daily. • Causes: Heart failure, low
oncotic pressure, sepsis, shock.
Capillary Refill Time
• Check Peripheral Circulation.
• Delayed refill: Vasoconstriction,
low cardiac output.
Oxygen Saturation
• Additional
• Continuous
parameters: End-
Monitoring with
tidal CO2, central
Pulse Oximeter.
venous pressure.
Breath Sounds & Lung Health
• Decreased
• Monitor Every 1- sounds indicate
4 Hours. airway obstruction
or pneumonia.
Skin & Perfusion
• Check for Temperature • Cold, clammy skin =
& Emphysema. Impending shock.
Lab Investigations
• Routine Tests: ABG, Electrolytes, Renal & Liver function, Chest X-ray.
Critical Care Approach
• Timely Response Saves • Provide necessary services
Lives. as quickly as possible.
Summary & Key Takeaways
• Systematic monitoring improves • Early detection &
outcomes. intervention prevent complications.
Thank You!
Questions & Discussions.
