Field Trips  

Visits to Critical care units in denmark
before and/or after the conference invited by FSAIO.:

Visit a Critical Care Unit in Denmark

 

It is a pleasure of the International Organising Committee to invite delegates to visit Critical Care Units in Denmark. Several hospitals in Copenhagen have agreed to receive visitors Saturday afternoon after closing the congress.

 

The visits will take place Saturday afternoon from 14.00 until 17.00 and will be guided. If you wish to participate, please register at the information desk at the congress centre.

 

The visits are free of charge, and transportation will be arranged. For further information, look for the notice at the information desk when you register for the congress.

 

Distribution of the number of participants will be after: first some first served.

 

Presentation of the Critical Care Units can be seen below:

 

 

             

Copenhagen University Hospital, Rigshospitalet (RH)

Trauma Centre 3193                                                          

 


 

The Trauma Centre is the Acute Coordination Centre of the Capital Region. It receives patients from

The Capital Region, Eastern Denmark, Faeroe Island and Greenland and has the following functions: 

 

  • Trauma resuscitation area
  • ED  medical patients
  • ED injured patients with referral
  • Receiving area and primary treatment of patients with burning injuries
  • CT scanner and digital radiology suite
  • 24 hours OR
  • Patients for pressure chamber treatment from whole country

     

                                                                             

The Centre is also Acute Medical Coordination Centre

 

  • Charge of planning, coordination and management
  • Medical responsibility from the scene of accident to hospitals
  • The Trauma Centre is a level 1 centre, meaning that it is a resourse centre with all medical specialities, specially trained nurses, On-call surgeons and anaesthesiologists and equipment and facilities for examination and treatment of the severely injured patient. It is in connection with American College of Surgeons Committee of Trauma 2006

 

The ideology of the Trauma Centre is teamwork consisting of the following areas:

 

  • Anaesthesiology
  • Blood bank
  • Burns
  • Paediatric Surgery
  • Radiology
  • Gynaecology and obstetrics
  • Intensive care (46 beds)
  • vascular Surgery
  • Surgery (liver transplant team)
  • Neurosurgery
  • Ophthalmology
  • Orthopaedic Surgery
  • Plastic Surgery
  • Psychiatry
  • Dentists
  • Thoracic Surgery
  • Pressure chamber and bariatric
  • Urology

 

Injury mechanisms from 2008 is divided on

  • Traffic accident 62%
  • Fall 19%
  • Penetrating violence 12%

 

Trauma Team Activations

  • Year 2000 - near 623
  • Year 2007 – near 965
  • Year 2009 - near 1111    
 
 

Margrethe Lomholt

Clinic head nurse, RN

Traume Center 3193

 
                                           

 

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GLOSTRUP HOSPITAL, part of Copenhagen University Hospital

 

Glostrup Hospital: Intensive Care Unit Y 13

Multidisciplinary ICU

 

The Intensive Care Unit is part of the Surgical- Anesthetic Center “Y” in Glostrup Hospital, one of Copenhagen University Hospitals. 

Glostrup Hospital has approximately 500 beds and has medical disciplines as General Practise, Neurology, Rehabilitation, Referral Centre for Chronically Respiratory Defiance, Ophthalmological Centre and Day Case Surgery.  

Intensive Care Unit Y 13 counts 9 multidisciplinary beds. The patients diagnosed with respiratory and/or hemodynamic and neurological defiance /failures are admitted to intensive care (5 beds). Thrombolytic treatment (3 beds) and observation of epilepsy diagnosed patients are admitted for medicine adjustment (1 bed). 

The nursing staff represents 48 nurses, approximately 80% experienced and specialist trained intensive care nurses and 5 nurse assistants.  Five of the nurses work within administration, clinical supervision  and specialists in intensive care and teaching.  Collaboration within the different staff members of medical-, secretary- , nursing and health care workers have high priority as well as introduction of new staff members. Development of unique learning and work environment is important to every staff member, coherently to the aim of Centre Y:  “Patients needs – our responsibility”

At the moment nursing activities and medical research projects are:

  • Diary writing for patients in long term stay in ICU
  • Follow-up of ICU patients  after discharge 
  • CAM-ICU scoring in every shift
  • Project: Monitoring quality of sleep
  • Inter professional learning and collaboration , patients diagnosed COLD, admitted to ICU/ returning to ward
  • Focused round wards
  • Techniques used in changes in patient positions
  • Patient Safety
  • Part in Hospital Accreditations Scheme by Joint Commission in 2011
 
 
Contact person:
Lisbeth Rudiengaard Wolpold
Clinical Critical Nurse Educator
 

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COPENHAGEN UNIVERSITY HOSPITAL

    

 
ICU Department of Hepatology,
Copenhagen University Hospital 2010

 

Department of Hepatology is the oldest Department of Medicine in Denmark. It was established in 1757, and is now a National liver failure unit and part of the liver transplantation centre at Copenhagen University Hospital. Accordingly the department of Hepatology has an obligation to admit and take care of patients with severe liver disease from other hospitals in Denmark, the Faroe Islands and Greenland for evaluation, prognostication and treatment with liver assist devices (plasmaferesis and albumin dialysis (MARS® and Prometheus®), TIPS and/or transplantation.

 

The department of Hepatology employs 8 medical doctors, 40 nurses, 1 service assistant and 4 secretaries. Beside that, the department of Hepatology has an outpatient clinic and a laboratory. The department has 19 beds, including 4 liver ICU beds, where the systemic and cerebral hemodynamic and metabolic conditions can be monitored. Furthermore, the patients can be treated with mechanical ventilation, continuous hemodiafiltration, plasma exchange, and albumin dialysis.


Patients with acute liver failure

At an annual basis Department of Hepatology receives approximately 130 patients from all of Denmark with severe acute liver disease, some for assessment for liver transplantation, and some for treatment with liver assist devices, plasmaferesis and albumin dialysis mechanical ventilation, dialysis, hemofiltration, monitoring and treatment of hemodynamic failure, monitoring and treatment of hepatic encephalopathy and brain oedema.

 

Patients with Chronic liver disease including acute aggravation

Department of Hepatology receives patients with different etiological end-stage liver disease. Relevant and different complications are mapped with the intension to establish the prognosis and start relevant treatment. Out of this group of patients approximately 45 undergoes a liver transplant annually. Until now more than 600 patients in Denmark has undergone liver transplantation.

 

In 2003 approximately half of the capacity in the unit was used for handling patients with complications to liver cirrhosis and acute liver failure. This has now raised to more than 90 %. This illustrates that the weight of the tasks have become larger and now often include albumin dialysis, plasmaferesis, TIPS, cancer-treatment and transplantation..

 

Teaching - Pregraduate

Currently Department of Hepatology teaches medical students, medical secretaries and nurse students at all levels. We intend to provide challenges at a high professional level, which matches the individual students’ needs. As a University Hospital department we teach medical students in internal medicine, hepatology and squeals from poisoning.

 

Teaching - Postgraduate

At an annual basis we educate 2-3 intensive care nurses. Due to the high degree of specialization our ICU nurse students take practice in another ICU for 12 weeks and for 6 weeks at a postoperative care unit during their two-year education. Likewise we receive ICU nurse students for practice from ICU´s situated in other hospitals.

 

Research and Approach:

  • Patophysiological processes following acute liver failure and new treatments.
  • Improving treatment for patients with liver failure due to chronic liver disease.
  • Development and evaluation of liver assist devices to patients with liver failure.
  • Treatment for patients with acute and chronic hepatitis type A, B and C.
  • Nurse interventions and care to the patients above.

Department of Hepatology has its own experimental facilities for scientific research in liver failure. In this way the department has established liver failure models. Both within these experimental research areas as well as with regard to clinical research Department of Hepatology cooperate with several large foreign Centres, among them Centres in London, Birmingham, Barcelona, Helsinki and Montreal.

 

 

Contact person:

Jenny Hcau-Tin Woo

Headnurse, MPA, Coach

 

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COPENHAGEN UNIVERSITY HOSPITAL

 

 

Visit PACU 2042, Rigshospitalet

 

During your visit to Post-Anesthesia Care Unit (PACU) 2042 at Copenhagen University Hospital you will be shown around the department, be able to speak with the PACU nurses and observe monitoring methods used.

 

Background information:

Post-Anaesthesia Care Unit 2042 is part of the Department of Anaesthesia and Surgery situated in the Abdominal Centre. The Department of Anaesthesia and Surgery provides anaesthesia service and surgical assistance as well as postoperative recovery service for patients undergoing major gastrointestinal, urological surgery and vascular surgery as well as breast cancer surgery.

 

PACU 2042 

  • PACU 2042 is largest PACU at Copenhagen University Hospital with 18 fully monitored beds. On a yearly basis PACU 2042 delivers post anesthesia recovery service to more than 8000 patients from 13 surgical specialties, 4 within the Abdominal Center and 9 from other centers.  Approximately 700 patients are under 15 years of age.

 

In addition, PACU closely collaborates with the multidisciplinary Intensive Care Unit (ICU) 4131. Approximately 50 patients a year are referred from the Multidisciplinary ICU 4131. These include trauma patients, patients with a complex perioperative course needing intensive monitoring, care and treatment in the postoperative phase, as well as other patients needing close monitoring and treatment. PACU 2042 does not deliver care for patients, who will need mechanical ventilation.

 

Quality assessment and development within such areas as pain management, PONV and Postanaestehetic urinary retention (PUR) are continuously monitored.

 

PACU 2042 Patient Classification:

PACU 2042 realizes the importance of the appropriate level of nursing service provided each patient. To ensure this level, a patient classification has been developed, according to the patient’s need for monitoring, care and treatment.

 

Upon entering PACU, patients are categorized into 3 levels based on the individual patient’s need for monitoring, care and treatment.

 

Classification:

 

  • Level 1 includes the stable patient with a complication-free post anesthesia period, who receives PACU’s routine monitoring, care and treatment.

 

  • Level 2 includes the less stable patient, who is at risk of complications needing treatment intervention. This patient needs extended monitoring, care and treatment.

 

  • Level 3 includes the unstable patient needing extensive monitoring, care and treatment.

 

  • We are looking forward to meet you.

 

 

Contact person: Lara Henningsen

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Intensive Care Unit 4131, Rigshospitalet

 

 

ICU 4131:

The ICU is a multidisciplinary intensive care unit, providing critical care to medical and surgical patients, most in need of ventilator treatment and cardiovascular stabilization. The unit offers spezialised critical care including invasive monitoring, diagnostic procedures, ventilator treatment, cardiovascular support and contineus dialysis.

 

The unit has 18 beds, organized in 3 teams, and provides critical care to patients, both adults and children, from the Capital Region, and to patients with specialized and complicated acute critical care problems from the rest of Denmark, including Greenland and Farrow Islands.

 

 

Patients:

Patientes are refered to the unit, from al medical and surgical departments of the Hospital, from the HospitalsTrauma Centre and from other intensive care units in Denmark.

The most common reasons for being refered to ICU 4131 are:

 

        • Severe pneumonia
        • Severe sepsis
        • Multi Organ Dysfunction Syndrome
        • Multitrauma
        • Severe burns and inhalation injury
        • Necrotising fasciitis to be treated with hyberbaric oxygenation (HBO)
        • Postoperative monitoring and stabilization after liver transplantation
        • Complications due to immunosupressive treatment i.e. neoplastic drugs or bone marrow transplantation.
        • Infectionus diseases i.e. malaria
        • Need of ventilator treatment in the postoperative period after major surgery

 

Staff:
The Medical Head of department and the Nursing Head of Department manage the clinic. The clinic is organized in 3 teams, each lead by a Senior Consultant and a Nursing Head of Unit.
Medical staff: 1. Head of Department, 7 Senior Consultant, 10 Junior Consultant, 4 resident and 8 doctors in training. The majority of the Medical staff are Medical Specialists in Intensive Care.

Nursing staff: 1. Nursing head of Department, 3 Nurisng Head of Unit, 1 Clinical Nurse specialist, 3 Nurse Educational Specialist, 130 Registered Nurses and 9 Nurse Aids. More than 60% of the Nursing Staff has graduated as Critical Care Nurse.