[hollyberry678]

Hi, I work in a very high acuity step down unit. Many comments from co-workers are that we are a 'mini-ICU' because we apparently get pts who should be in ICU. We send ppl to ICU if they are crashing.

I just wanted to get a better sense of what the criteria for ICU is, and what the criteria for d/c FROM ICU is.

Hope you can understand what I am trying to ask. TIA for answering!! (as you can tell, I am new)

[meandragonbrett]

Our criteria includes: Mechanical Ventilation, Vasoactive Drips that require titration and there are many other pieces to the puzzle. Are you in a generalized ICU or a specialty ICU? There should be a clearly defined set of criteria for your unit in your hospital's P&P manual.

[Bluehair]

Originally Posted by meandragonbrett

Our criteria includes: Mechanical Ventilation, Vasoactive Drips that require titration and there are many other pieces to the puzzle. Are you in a generalized ICU or a specialty ICU? There should be a clearly defined set of criteria for your unit in your hospital's P&P manual.

Really and truely, it can vary a bit from hospital to hospital. Invasive monitoring such as arterial lines, ICP, etc. also qualify ICU admit where I am now. Some fresh MI's go to stepdown if stable, then start to crash and need to go to ICU. I have worked in some places as you describe, where the patients stepdown receives should be in ICU - but the patients in ICU are even sicker, and no one has figured out the whole bunk-bed thing that I know of. Sometimes they just do the best they can with the number of beds available. Our hopital has been VERY VERY busy the last few weeks - no holiday slow down this year, the whole house has been jumpin'! Some places try to leave one ICU bed open in case of bad trauma/cardiac arrest, etc., not sure if that applies where you are? Makes some sense since that is not when you want to be trying to shuffle beds to make room in the unit.
:Santa2:

[traumaRUs]

I actually am on staff at a hospical with the "one-bed" concept. They have a unit which is comprised of 50 beds (ind rooms) and all beds have the availability to be either ICU or step-down beds. Every room can handle anything from a vent to mulitple gtts, to an LVAD, balloon pump, etc.

I think this is the wave of the future.