Essential Care in Intensive Care
This page describes a number of essential cares treatments for someone who is seriously ill and in intensive care. The extent of care given will depend on how unwell the person is.
Washing and bathing
Usually a bath in bed is given daily, as well as when needed. It may be possible to take some people to a shower or a bath instead of them being bathed in bed. Also, hair washes and facial shaves are given if necessary.
Oral (mouth) care
If a person is unable to eat or drink, nurses will usually clean their mouth and teeth every two to three hours. Mouth care can include brushing the person’s teeth, rinsing their mouth with water and/or an antiseptic mouth rinse, and applying moisturiser to their lips.
Some people may also need their mouth and throat suctioned of saliva if they have trouble swallowing or have a breathing tube in their throat. This may cause some brief discomfort, but it is important to remove any extra saliva, as it can interfere with breathing.
If a person is unconscious or receiving medicines that make them sleepy, their eyelids may not close properly. This may cause their eyes to become dry, which can increase their risk of developing sores on their cornea (the protective, transparent layer on the front part of the eyeball).
To help keep the eyes moist and clean, nurses will clean the person’s eyes regularly and apply moisturising eye drops or ointment. Some people may also need their eyelids to be taped closed. And if there is a very high risk of eye infections or problems, then a moisture chamber may be created.
Preventing pressure injuries
When a person is lying down for long periods, as they can be when in intensive care, a pressure injury or ‘bedsore’ may develop. This is when the skin and the underlying skin tissue become damaged due to the constant pressure or friction from the body pressing against the bed. The most common areas for bedsores are the bottom, the heels and the hips.
Pressure injuries can arise due to number of reasons, including:
- the inability to move freely and frequently
- poor blood circulation because of low blood pressure or swollen limbs
- low oxygen levels
- inadequate nutrition because of the inability to eat enough food
- being extremely thin or overweight.
Depending on a person’s level of risk of developing pressure injuries, their care may include:
- lying on special beds or mattresses that reduce pressure (see the Equipment page for more detail on beds)
- being regularly turned by a team of healthcare staff if they are unable to move themselves.
Research has shown that those who are seriously ill will improve more quickly and have fewer complications if they are given therapy to maximise their physical activity. This therapy can include exercises while in bed or sitting in a chair, and even walking while on a ventilator, where possible. Nurses and physiotherapists work together to provide such care.
Essential care in intensive care, version 1, 2015. Kaye Rolls, CPO, ICCMU.
The information on this page is general in nature and cannot reflect individual patient variation. It reflects Australian intensive care practice, which may differ from that in other countries. It is intended as a supplement to the more specific information provided by the doctors and nurses caring for your loved one. ICNSW attests to the accuracy of the information contained here but takes no responsibility for how it may apply to an individual patient. Please refer to the full disclaimer.