Intensive Care Unit, a special department of a hospital or health care facility that provides treatment for critically ill patients.
The purpose of the intensive care unit (ICU) is simple even though the practice is complex. Healthcare professionals who work in the ICU or rotate through it during their training provide around the clock intensive monitoring and treatment of patients seven days a week. Patients are generally admitted to an ICU if they are likely to benefit from the level of care provided. Intensive care has been shown to benefit patients who are severely ill and medically unstable that is, they have a potentially life-threatening disease or disorder.
Although the criteria for admission to an ICU are somewhat controversial excluding patients who are either too well or too sick to benefit from intensive care there are four recommended priorities that intensivists (specialists in critical care medicine) use to decide this question.
These priorities include:
• Critically ill patients in a medically unstable state who require an intensive level of care (monitoring and treatment).
• Patients requiring intensive monitoring who may also require emergency interventions.
• Patients who are medically unstable or critically ill and who do not have much chance for recovery due to the severity of their illness or traumatic injury.
• Patients who are generally not eligible for ICU admission because they are not expected to survive. Patients in this fourth category require the approval of the director of the ICU program before admission.
ICU care requires a multidisciplinary team that consists of but is not limited to intensivists (clinicians who specialize in critical illness care); pharmacists and nurses; respiratory care therapists; and other medical consultants from a broad range of specialties including surgery, pediatrics, and anesthesiology. The ideal ICU will have a team representing as many as 31 different health care professionals and practitioners who assist in patient evaluation and treatment. The intensivist will provide treatment management, diagnosis, interventions, and individualized care for each patient recovering from severe illness.
ICUs are highly regulated departments, typically limiting the number of visitors to the patient’s immediate family even during visiting hours. The patient usually has several monitors attached to various parts of his or her body for real-time evaluation of medical stability. The intensivist will make periodic assessments of the patient’s cardiac status, breathing rate, urinary output, and blood levels for nutritional and hormonal problems that may arise and require urgent attention or treatment. Patients who are admitted to the ICU for observation after surgery may have special requirements for monitoring. These patients may have catheters placed to detect hemodynamic (blood pressure) changes, or require endotracheal intubation to help their breathing, with the breathing tube connected to a mechanical ventilator.
In addition to the intensivist role in direct patient care, he or she is usually the lead physician when multiple consultants are involved in an intensive care program. The intensivist coordinates the care provided by the consultants, which allows for an integrated treatment approach to the patient.
Nursing care has an important role in an intensive care unit. The nurse’s role usually includes clinical assessment, diagnosis, and an individualized plan of expected treatment outcomes for Patients.