SHN’s critical care team provides expert care to patients with complex conditions. We know that spending time in critical care can be stressful, and our expert team is dedicated to providing you and your loved ones exemplary and compassionate care every day.
As family members, you play a very important role in your loved one’s healing process. You are an essential part of the health-care team, particularly during the critical phase of their illness. At SHN, we are committed to providing exceptional patient and family-centered care, and will involve you in your loved one’s care as much as possible.
We understand that communication is vital, and we are committed to making sure that patients’ families are kept informed. The bedside nurse responsible for the care of your loved one is your best contact person. We encourage you to ask them any questions you may have about your loved one’s care, treatment, and progress. Meetings and family updates with doctors and your loved one’s broader care team can be arranged through the nurse.
It is best to have one family member be designated as the spokesperson to gather information and pass it on to the rest of the family. This person is encouraged to get updates in person or call the unit directly.
Visitors are now allowed moderate access to the hospital, under the following circumstances:
- All visitors must be noted on the visitor list
- No more than 10 visitors on the unit at any one time
- Visitors who have COVID-19 or symptoms of COVID-19 may not visit, as they must follow Public Health Guidelines
- Hospital visiting hours are 1300-1900h – we can allow visiting from 1000-1900h for up to 2h
- For end of life – 24h access to people of importance (immediate family); only 2 individuals in the room at any given time
All other circumstances/exceptions should be brought to the unit manager’s attention for approval. Also, please ensure families are aware that our exceptions may not be supported on other units.
We invite patients’ immediate family members or the assigned substitute decision makers to join the care team at bedside rounds. Bedside rounds are daily meetings when doctors, nurses and other health-care providers come together as a team to plan, discuss, and coordinate care for each patient in the unit. Bedside rounds happen every day between 9 and 10 a.m.
If you plan to attend rounds, please speak with your loved one’s primary nurse. Please be aware that rounds may be interrupted for emergency situations, new patients being admitted to the unit, or for other reasons. We appreciate your understanding and patience in these situations.
Bedside rounds are an excellent opportunity to be involved your loved one’s daily care and decision-making, but they are not the only time you can talk to the care team. If you would like to have a more in-depth discussion, we can set up a family meeting.
Birchmount Intensive Care: 416-495-2400 ext. 2626
Centenary Intensive Care, 2nd floor Phone: 416-284-8131 ext. 4038
General Intensive Care, west wing 3rd floor Phone: 416-431-8200 ext. 3315
SHN’s intensive care units (ICUs) care for patients with extremely complex conditions. We care for intensive care patients across our health network at ICUs at each of our three hospitals.
Coronary (heart) Care
Coronary care units (CCUs) provide specialized care for patients who are critically-ill due to heart disease. Coronary care units at each of our hospitals support patients who have had heart attacks, or have conditions such as unstable angina, cardiac dysrhythmia, and other conditions that need continuous monitoring and treatment.
At Centenary hospital, the CCU is located next to the regional cardiac care centre, which sees more than 6,500 patients a year from communities along the 401-east corridor. The CCU is a key support, caring for many patients who have received life-saving treatments at the cardiac centre.
Critical Resource Team
The Critical Care Resource Team (CCRT) is made up of ICU staff (including nurses, doctors, and respiratory therapists) who respond to calls from around the hospital about patients who are very sick and getting worse. When a patient becomes so sick that their nurses and doctors can no longer help them on their own, the CCRT can be called to help try and help the patient get better. The CCRT can provide extra treatments and decide if the patient can stay on their current unit, or if they need to be sent to the ICU. The CCRT will also follow a patient for a short period of time after they have left the ICU and gone to another unit in the hospital.
- ICU orientation sheet
- Participation in bedside round fact sheet
- Who Am I questionnaire
Specialized equipment and procedures in critical care
A lot of advanced equipment is used in critical care. This equipment helps us to closely monitor patients and provide specialized treatment. Here is a list to help you become more familiar with some of this equipment.
The bedside cardiac monitor allows the care team to view different waveforms depending on the needs of the patient. This can include any combination of the following: heart rate and rhythm, blood pressure, respiratory rate and rhythm, oxygen saturation, and heart pressures.
An intravenous (IV) catheter – or tube – may be inserted into a blood vessel to allow the team to give patients fluids and drugs. A peripheral line is a small catheter in the hand or arm. Many critical-care patients require a larger catheter known as a central line, which is inserted into one of the bigger veins in the neck, chest, or groin. These lines are used for fluids or blood pressure support medications. These fluids and medications are controlled by an infusion pump.
Sometimes a catheter is inserted into an artery (usually in the wrist or groin) and connected to the bedside monitor. This allows the team to monitor the blood pressure at all times and also allows makes it easier to take frequent blood samples for tests.
If patients are having trouble breathing, they may need to use a ventilator for support. Patients can breathe with a ventilator by wearing a tight fitting mask (BiPAP); but, more commonly, an endotracheal (ET) tube is placed through the patient’s mouth into the trachea (windpipe) and connected to the breathing machine. In the ICU at Centenary, if support is needed for a longer period of time the doctor may discuss a tracheostomy where the breathing tube is inserted through the neck into the trachea. If a patient will be using a ventilator for long-term use, ET tubes are more comfortable.
When patients are very sick, they may not be able to eat or drink enough to help them heal. To make sure patients get the nutrition they need, the care team may feed them by placing a tube through their mouth or nose and into their stomach. Patients can then receive highly nutritious liquid food through the tube. If a patient’s stomach cannot process food or needs rest, the patient may receive parenteral nutrition directly into the blood stream through an IV.
Some critical care patients have poorly functioning kidneys and need help to filter toxins out of their blood. The care team may use a dialysis machine to run the patients’ blood through a filter to clean the blood and help the kidneys. A catheter is placed in a large blood vessel (either the neck or the groin) and connected to the dialysis machine.
A balloon pump helps the heart pump more blood around the body and deliver more oxygen to the heart. The pump is connected to a catheter placed in a large blood vessel in the patients’ groin. The pump rhythmically inflates and deflates, pushing blood around the body and into the arteries of the heart.
There are many reasons a patient in critical care may feel uncomfortable, anxious or confused. The health-care team is committed to helping your loved one feel as comfortable as possible. Pain medicine, sedatives, and medications for confusion are common. Please talk to the doctor or the nurse if you have any questions about the medication your loved one is receiving.
We use isolation precautions to help stop infections from spreading between people. We want to protect everyone: patients, staff and visitors. There are three types of isolation precautions: contact isolation, droplet isolation, and airborne isolation. If a patient needs isolation precautions, the care team will place a sign outside their room to notify staff and family members what precautions are necessary. The nurse will explain how you can properly protect yourself and your loved one, including how to put on and remove gloves, gown, and a mask if needed. Wearing a mask is required when visiting patients. Unfortunately, visiting patients who are currently positive for COVID-19 is not an option at this time.
Remember: always wash your hands or use alcohol hand sanitizer before entering or leaving a patient room.
Meet the members of the health-care team
The patient’s RN spends the most time with the patient. This includes basic care (such as with bathing, feeding, and moving in bed), assessing the patient’s condition (carefully looking and listening to the patient’s body and associated machinery for any changes), giving medications, and many other tasks that involve handling the patient directly. Nurses also update the rest of the patient’s team on the patient’s condition, and can make the rest team aware of any issues the family or patient may have.
Critical Care Physicians lead the health care team by deciding on the patient’s treatment plan. This includes ordering and interpreting the results of those tests, prescribing medications, managing consultations from other specialized physicians, and many more tasks. Physicians will call a patient’s family about major changes in condition or the treatment plan, and they also make an effort to call families on a regular basis, but the ICU is an extremely busy unit and they are often unable to do so.