Also called intensive therapy departments or critical care units, an intensive care unit (ICU) is a specific hospital unit providing in-depth, ongoing care to patients. In other words, patients suffering from life-threatening or severe diseases and injuries; and who require close, constant support and monitoring are placed in an ICU. Victims of heart attacks, fire accidents, or patients with multiple organ failure are stationed in an ICU and their vital bodily functions such as breathing and heartbeat are constantly monitored.

Image credit: Flickr
Image credit: Flickr

History

An ICU is probably a hospital’s most expensive, resource-intensive, and high-technology area. The need for ICUs and other specialized treatment wards came up in 1952 during the Copenhagen polio epidemic, wherein patients experienced bulbar and respiratory failure. The first proper intensive care unit was set up in 1953 by Bjorn Ibsen, an anaesthetist.

An ICU in 1965. Image credit: Flickr
An ICU in 1965. Image credit: Flickr

Since then hospitals have started accommodating ICUs within their buildings. However, ICUs are not mandatory and therefore not all hospitals have intensive care units, especially the ones located in towns and villages. The bigger, city-based hospitals are most likely to have ICUs.

Medical Team

Image credit: Flickr
Image credit: Flickr

An ICU is usually managed by highly experienced doctors and nurses, who specialize in dealing with serious medical conditions. The medical team also comprises clinical nurse specialists, respiratory therapists, intensivists, physical therapists, pharmacists, physician assistants, nurse practitioners, dietitians, chaplains and social workers. At any given time, a patient in an ICU will be closely monitored by a nurse.

Admission Requirements

Not every patient with a serious medical conditions finds space in an ICU. Generally, only those patients with potentially reversible ailments or who are likely to survive with ICU support are given berth. However, recovery is not guaranteed and patients dying when in ICU care is not rare. 

Patients are usually moved out of an ICU when special therapies or close monitoring are not required. In other words, patients move out when they are in a stable condition. The remainder of the recovery happens in another ward, such as a high dependency unit (HDU) or a general ward.

Infrastructure and Environment

At first glance, an ICU environment may seem overwhelming, comprising medical equipment for monitoring the patient’s heart and respiratory rate, and blood pressure. Some ICUs may have special equipment, based on the patient’s unique condition and requirements. These equipment usually help an ICU patient perform normal activities, such as breathing, which the patient cannot currently do by himself.

Intensive care unit at a children's hospital. Image credit: Flickr
Intensive care unit at a children’s hospital. Image credit: Flickr

Generally, an ICU can be pictured with a bed-ridden patient who has been connected to various medical equipment through cables, tubes and wires. Most patients are likely to feel uncomfortable putting up with such equipment and are therefore prescribed sedatives and painkillers. Most ICUs also have an alarm system, which the medical team or patient may use as needed. An alarm doesn’t always indicate an emergency. In some cases, it may be the patient requiring minor help with something.

Decision-Makers

An ICU patient, when awake, is informed about the medical procedures that’ll be performed on him. In case he is heavily sedated or not conscious, the patient’s blood relative can make decisions on the patient’s behalf. ICU patients can also designate in writing specific family member(s) or any other individual to take care of the medical formalities or proceedings if the patient cannot make those decisions by self. In case of emergencies, the medical team begins treatment without waiting for anyone’s approval.

Specialization

As aforementioned, ICUs exist to cater to the seriously ill or injured patient. Generally, an ICU is sufficiently equipped to treat a range of conditions. However, there are ICUs that may specialize in taking care of certain diseases or patient groups. The specializations could be for heart conditions, nerve disorders, babies or children born with major conditions such as heart defects, to name a few.

Visitors

ICU patients can have a visitor or two at a particular time. Generally, visitors aren’t allowed in the unit for a longer time period. And those having infectious conditions such as cold are prevented from entering an ICU. Visiting hours are typically during the day. Some units may also have a ‘quiet period” or “no-visitor” period.

Visitors are advised to maintain the unit’s decorum and stick to a clear, calm speech. Generally, ICU patients on ventilators can hear things but may not be able to speak. Therefore, as a visitor, one must not interrogate the patient. But if the questions cannot be avoided, those should be answerable by the patient through gestures, such as finger gestures or nodding of the head.

ICU patients are usually frustrated, angry and not in the mood to communicate. Therefore, one needs to be patient throughout the interaction. Some hospitals therefore also provide a board for patients to write on.