Required skills of intensive care medical staff Management

Senior intensive care medical staff, assisted by senior nursing and pharmacy colleagues, command the primary responsibility for the financial management of the intensive care unit. It is through their actions that treatment of the critically ill is initiated and perpetuated; they are ultimately responsible for the activity of the unit and patient outcome.

Decision making

In the ICU most decisions are ultimately made by team consensus. Clinical decisions in the intensive care unit can be thought of under three categories: (i) decisions relating to common or routine problems for which a unit policy exists; (ii) decisions relating to uncommon problems requiring discussion with all ICU and non-ICU staff currently involved and (iii) decisions of an urgent nature taken by intensive care staff without delay.

Practical skills

Expertise in the management of complex equipment, monitoring procedures and performance of invasive procedures are required.

Clinical experience

Medical staff require experience in the recognition, prevention and management of critical illness, infection control, anaesthesia and organ support.

Technical knowledge

The intensive care specialist has an important role in the choice of equipment used in the intensive care unit.

Pharmacological knowledge

Drug therapy regimens are clearly open to the problems of drug interactions and, in addition, pharmacokinetics are often severely altered by the effects of major organ system dysfunction, particularly involving the liver and kidneys.

Teaching and training

The modern intensive care specialist has acquired a number of skills that cannot be gained outside the intensive care unit. It is therefore necessary to be able to provide this education to junior doctors in training for intensive care.

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