SICU is where your loved one will be cared for immediately after surgery or trauma. Due to the serious injuries, your loved one will be monitored very closely for any changes including many wires and tubing. Do not be alarmed by all the equipment. It is routine in this environment.
The Injured Brain
When the brain is injured, many things can happen. Swelling. When tissues are damaged, they swell - as in a bruised leg or arm. Unlike the arm and leg, the brain is enclosed within the skull and has very little room to swell. Therefore, as the brain swells, the pressure (ICP) increases. This can cause several physical and mental changes as seen in one-sided weakness, changes in the pupils of the eyes, slurred speech, seizures, infection, and even stopping blood flow to the brain, killing brain cells, or even herniation of the brain (the swelling pushes the brain out of its normal space and damages the brain stem, causing death).
What Happens First?
When a patient comes into the Emergency Room with a head injury, the patient is evaluated, treated, and sent for a CT (CAT) scan of the head to look for swelling and bleeding. Note: The patient will be wearing a rigid collar that fits tightly around the neck and kept straight in case he or she has a fracture in the neck or back that may cause damage to the spinal cord. This is known as spinal precautions and is routine care for all severe head injury patients. This must be worn at all times until the doctors determine there are no fractures or swelling to the neck and back that would endanger the spinal cord and cause the patient not to move again.
Also Note: If the patient is fighting or moving a lot, it may be necessary to restrain the
patient, sedate, and possibly even chemically paralyze the patient to keep them from moving and causing more injury. It may be necessary to place a tube into the mouth that goes to the lungs and place on a breathing machine to help them breath or to control their breathing. It is essential to maintain good breathing so that the patient gets enough oxygen to their brain.
The Next Step
After the scan of the brain, then the patient is moved to SICU and if necessary a Neurosurgeon will be consulted by the Trauma team. The brain scan can show several things. The doctors are looking for signs of bleeding, swelling, or changes in the structures of the brain. If the brain scan is positive for any of these, several options are provided. A bolt may be placedinto the head for monitoring the pressures to the brain. A tube may be placed to drain any excess fluid or blood in the brain. If it is serious enough, the patient may go to surgery to remove the blood to help reduce the pressures in the brain. But, with some brain injuries the bleeding may be spread out so that surgery would not be helpful. For example, if you were pinched on the arm very hard, you would get bruising and swelling. You could not take a needle and withdraw the blood because it is not pooled in your arm. It is a lot of little vessels spread out over the area. This may be the case with the damage to the brain and may not be helpful.
The Waiting Process
When in the SICU, several things will take place while you wait in the waiting area. The following steps may take place anytime the doctors determine the patient needs additional monitoring or treatment.
1. We place several lines into the patient to monitor, the heart, lungs, and fluids, monitoring the brain and the kidneys.
2. If there’s a need for it, we will start our program for severe brain injury. We would start several IV
medications and drips that will give the patient the best possible means to recover. (It is common to see many IVs and cords hanging around the patient to treat and monitor).
3.Monitoring and treating changes as they occur. The first several days to weeks are crucial to see how the body will respond. It may take from days up to several months of treatment for the patient to respond if they will respond. Outcomes may vary from complete recovery, changes in behavior, speech, chronic coma, or even death.
Items to be aware of:
While in bed, the patient is a risk for infection in the lungs (pneumonia), blood clots in the legs, and high temperatures due to the brain injury. We have in place many items that will try to prevent this from happening, but many times it will still occur due to the severe injuries. Alarms will sound and numbers will change, but we are watching for changes that last not just numbers changing after suctioning or during some activity.
This may be a very long process or may be very quick with many people telling you to be patient and wait. Many times we don’t know the outcome until it happens. And, we know this is frustrating and difficult. It is very important to start gathering information and support. Ask questions; seek out spiritual and family help. Our own Chaplain Services and Care Coordination Services will assist you in this process. At any time, things may change
We will need a phone number to contact you at all times. If things do change, we may do more tests. We will call you with these changes. Feel free to call insert phone # herefor a report. Families, please designate one person to call and receive information, so we can give more time to care for your loved one. We know this is difficult, and we want to help you and your loved one through this as best as possible.
Visiting Hours
You may be asked to wait in the waiting area for up to 45 minutes or more, while we get the patient settled. We ask that all family members come in together during the first visit with a limit of two family members on each visit afterwards. The immediate family may visit for up to 1 hour beginning at:
Insert Times Here
If more than two family members want to visit, please take turns with other family members.
Our phone number to the SICU is insert phone number here. A waiting room for family’s use is located near the SICU. We ask that non-family members call the family for information. The waiting room number is: insert phone number here.
Please Note: if you are calling about information regarding a patient, you must have the pass code in order to receive information on the patient. This is designed to protect every person’s privacy.
We have a 1-800 number to have family members call for report to the nurse in SICU. This number cannot be transferred to the waiting area or be used for family to family calls. Insert 800 # here.
We care about you and your loved one and want to make your stay as pleasant as possible.
When the brain is injured, many things can happen. Swelling. When tissues are damaged, they swell - as in a bruised leg or arm. Unlike the arm and leg, the brain is enclosed within the skull and has very little room to swell. Therefore, as the brain swells, the pressure (ICP) increases. This can cause several physical and mental changes as seen in one-sided weakness, changes in the pupils of the eyes, slurred speech, seizures, infection, and even stopping blood flow to the brain, killing brain cells, or even herniation of the brain (the swelling pushes the brain out of its normal space and damages the brain stem, causing death).
