The oxygen plant and ICU at Vihiga County Referral Hospital (VCRH) was commissioned in May of 2021. The facility serves as the primary HDU/ICU unit for patients needing intensive care at the level 5 hospital, other referrals and those referred from sub-county hospitals, health centers and dispensaries in Vihiga County, Kenya. This guide will help you find care at the ICU, VCRH.
Bed Capacity
The ICU at Vihiga County Referral Hospital (VCRH) had 5 beds. A typical ICU/HDU bed at VCRH includes:
- a ICU bed,
- working monitor,
- resuscitation trolley with incubation equipment, suction machine and defibrillator.
Each bed is manned according to internal practice with a nurse to patient ratio of 1:1 to 1:1:5 at any given point.
Admission
This section covers which patients get admitted to the critical care unit at Vihiga County Referral Hospital and the process one undergoes during admission.
Who gets admitted to ICU? VCRH Admission criteria
The ICU at Vihiga County Referral Hospital (VCRH) provides specialist care for patients who are ill in such a way that their normal, healthy body functions are damaged, but who with medical help, maybe able to regain normal, healthy functions i.e. patients with reversible physiological impairment. Some of the health conditions that may lead to one being admitted to ICU in VCRH are:
- Severe infection of the blood (sepsis) that requires support for one’s blood circulating and breathing system i.e. hemodynamic and respiratory support
- Patients suffering from shock as a result of blood loss (hemorrhagic shock), severe infection (septic shock), severe allergic reaction (anaphylactic shock) and poorly functioning heart (cardiogenic shock) who need support for their blood circulating system i.e. requiring hemodynamic monitoring and inotropic support
- Those in need for breathing using a ventilator such as patients with respiratory failure, brain or nerve damage (neurological impairment).
- Patients who need support for their blood circulating and breathing systems (cardio respiratory support) after suffering trauma that leads to a head injury.
- Those in need for medical care after suffering heart attack (post cardiac arrest care) when Return Of Spontaneous Circulation (ROSC) is achieved.
- Elder or very young patients with multiple organ dysfunction and injuries to many body parts and organ systems (polytrauma).
- Patients with acid/ base impairment requiring treatment and cardiopulmonary monitoring.
- Reversible metabolic impairments that require cardio respiratory monitoring and support.
- Post operative care for head, heart, liver, renal surgery.
- Post operative care in patient with severe infections involving the abdomen (peritonisis) that needs support for the blood. circulating system and nutrition i.e. hemodynamic support and total parenteral nutrition.
VCRH ICU Admission Process
Once the patient meets the eligibility criteria for admission; bed availability will be confirmed by the team leader in the ICU and plans to admit the patient instituted.
Patients from outside the hospital shall receive a communication through the Nurse covering mobile number +254720295739 who shall then confirm bed availability with the ICU team leader.
The intensivist/anesthesiologist shall be notified by the ICU leader/Clinician of admission of sensitive patients and post-operative patients.
Care at Vihiga County Referral Hospital ICU
Before admission patients to HDU/ICU patients must have the following investigations done;
- CT Scan head for head injury and patients with suspected injuries to the Central Nervous System (CNS)
- Blood clotting tests (coagulation profile) for patients with suspected bleeding problems (coagulopathies).
- A complete blood count (CBC) also known as full hemogram (FHG).
During the admission these tests shall be done concurrently
- Kidney function tests i.e. blood tests for urea, electrolytes and creatinine (UEC)
- Liver function tests (LFTs) i.e. blood tests for liver enzymes, liver proteins etc.
- Blood Sugar
- Chest x-ray (CXR)
- Arterial blood gas analysis (ABGA or ABG)
What care to expect at VCRH HDU/ICU
- The admitting doctor or clinician will take a detailed medical history of the patients and consult with the doctor consultant in charge as necessary.
- Initial medical assessments will include a severity score
- The patient will have a urinary catheter inserted. Catheterization is helpful in monitoring the urine output of very ill patients
- A feeding tube (nasogastric tube -NGT) placement will be done by ICU staff. This tube helps carry food and medicine to the stomach through the nose. Remember that patients in ICU are often unconscious or often slip into coma. This means that they will require help to safely feed and taking medicines.
- Thereafter, an intubation chest x-ray (CXR) will be done to ensure that the endotracheal tube (ETT) is properly placed. The ETT or intubation tube is a special tube the keeps the patient’s breathing tube (trachea) open so that air can be delivered to the lungs. The tube can connect to a machine, ventilator, that delivers air or oxygen to the lungs.
- Most patients will be given medicines, anticoagulant medicines, to help prevent blood in their deep veins from clotting (DVT prophylaxis). Most patients will also be given drugs, antiulcer medicines, to help prevent peptic ulcer disease.
- The doctor will also undertake blood, urine, stool and radiological tests if need be to screen for infections. The exact tests done in this group of medical tests known as the septic screen will depend on the patients history and the clinical assessment of the patient by the doctor.
Patient Family Rights
- Right to counseling in the pre-admission period
- Right to information, prognostication and counseling through family conferencing
- Right to receive daily accrued bills.
Kindly note that Euthanasia is NOT practiced in this hospital in accordance with the constitution of Kenya.
Patient Family Obligations
- The family shall disclose bonafide next of kin and a family spokesman to be duly documented in file.
- Honor occurred bills.
- Provide specimen signatures of the next of kin.
ICU Charges at Vihiga County Referral Hospital
To know ICU charges at VCRH, kindly contact the hospital. Vihiga County Referral Hospital (VCRH) is also accredited by NHIF (hospital code 4442780) to provide inpatient and outpatient to the public. Contact the Vihiga NHIF Office to get information on details of what your NHIF cover affords you and your dependents when seeking crtical care services at VCRH HDU/ICU.
