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You may have many questions during your stay in the intensive care unit (ICU). These are some frequently asked questions.
Any illness that threatens life requires critical care. Poisoning, surgical problems, and premature birth are a few causes of critical illness. Critical illness includes:
Illness that affects the heart and all of the vessels that carry blood to the body, such as:
Illness that affects the lungs and the muscles used for breathing, such as:
Illness that affects the kidneys, such as:
Illness that affects the mouth, esophagus, stomach, intestines, and other parts of the body that carry food, such as:
Illness that affects the brain and the spinal cord and nerves that connect the brain to the arms, legs, and other organs, such as:
Infection caused by a virus, bacteria, or fungus, such as:
A serious injury also requires critical care, whether the result of:
The intensive care unit (ICU) is a special part of the hospital that provides care to patients with severe, life-threatening injuries or illnesses. ICUs have higher nurse-to-patient ratios than other parts of the hospital. They also can provide specialized treatments, such as life support.
Critical care is the long-term treatment of patients who have an illness that threatens their life. Emergency medicine is the short-term treatment of those patients; it is also the treatment of patients who have a minor injury (for example, sprained ankle, broken arm).
In the emergency department, doctors and nurses stabilize patients and then transport them to the intensive care unit (ICU) or another area of the hospital for further treatment.
Your family doctor is an important link between the care team and you.
The family doctor has a complete medical history of the patient, is often trusted by the family, and may be aware of the patient’s values, attitudes and healthcare preferences. The care team often works closely with the family doctor to determine pre-existing illness, allergies, use of medications, and other factors which may influence the health of the patient.
Your local hospital and personal doctor are likely to have advance directives, living wills, and other documents available. A national organization, Choice in Dying, can also provide you with the forms. To contact them, call +1 800 989-WILL.
Telemedicine, or Tele-ICU, is the use of electronic communication to examine a patient from a place far away from the bedside. Telemedicine links doctors to patients, doctors to doctors, doctors to bedside caregivers and doctors to medical information.
Telemedicine will not replace your doctor at the bedside. It is a “second set of eyes” that will allow your doctor to give you complete care, even when he or she is helping another patient. Telemedicine improves patient safety and moves the care team to the bedside when the patient most needs them.
Telemedicine improves critical care because it allows the doctor to:
Many Different Types of Telemedicine
Telemedicine may be as simple as using the telephone. Normally, telemedicine involves more advanced means of sharing information, including:
Uses for Telemedicine
The doctor may use telemedicine to:
When using telemedicine, the care team will take the appropriate actions to guarantee your confidentiality and privacy.
With the use of telemedicine, a qualified doctor specially trained in critical care can be at your bedside virtually 24 hours a day, 7 days a week.
Life support refers to various therapies that help keep patients alive when vital organs are failing.
Most often, when people say “life support,” they are referring to a mechanical ventilator, which is also known as a “breathing machine.” Mechanical ventilation helps patients breathe by pushing air into their lungs. The mechanical ventilator is connected to the patient by a tube that goes through the mouth and into the windpipe. Patients who need less lung support than mechanical ventilation may simply have a mask over their mouths and nose to deliver oxygen.
Dialysis is another form of life support; it filters toxins from the blood when kidneys are failing.
There are many reasons that patients may be treated in the ICU. The most common ones are shock, respiratory failure and sepsis.
Shock is a condition in which vital organs are not getting enough oxygen because of low blood pressure. Shock can be caused by many medical conditions, such as heart attack, massive blood loss, severe trauma or sepsis.
Respiratory failure is lung failure that results in dangerously low levels of oxygen or dangerously high levels of carbon dioxide, which is a waste gas. Respiratory failure can result from lung conditions such as pneumonia, emphysema, or smoke inhalation. Respiratory failure can also be caused by conditions affecting the nerves and muscles that control breathing, such as drug and alcohol overdoses.
Sepsis is an infection that results in organ damage. When patients develop an infection, their bodies release chemicals to fight off the infection, but sometimes these chemicals can also damage vital organs, such as kidneys and lungs. When organs are damaged as a result of infection, this is known as sepsis. Any infection can lead to sepsis, but most commonly sepsis results from pneumonia, an abdominal infection (appendicitis or gall bladder infection), or a skin infection (for example, a cut that gets infected).
Patients in the ICU are very sick. They are often connected to many monitors that allow healthcare professionals to monitor their vital signs on a minute-to-minute basis. Patients often have intravenous tubes (IVs) in their arms and neck so that medications and fluids can be delivered directly into their veins. They often have a tube placed into the body to drain and collect urine. Some patients are also connected to life support machines, such as breathing machines or dialysis machines. Patients may also have a tube through their nose or mouth to deliver liquid food directly into the stomach. In order to tolerate the tubes, IVs, and life support, many patients receive sedating medications.
Yes, patients often experience difficulty with everyday tasks such as shopping or balancing their checkbook. A recent study demonstrated that more than half of patients had difficulty thinking (also known as cognitive impairment) one year after having a critical illness. One-third of patients had cognitive impairment similar to that of someone who had had a traumatic brain injury, while one-third had cognitive impairment similar to that of someone with Alzheimer’s disease.
Posttraumatic stress disorder is a psychiatric condition that occurs as a reaction to a terrifying and traumatic event. It occurs in 10-20% of patients after critical illness. Patients might be anxious, have nightmares, avoid healthcare settings, and become disengaged.
Depression occurs in one out of three patients after critical illness. Symptoms of depression that might be experienced include prolonged sadness, loss of interest in activities that used to be enjoyable, inability to concentrate, changes in appetite, and changes in sleep.
The critical care team is a group of specially trained caregivers who work in a special area of the hospital known as the intensive care unit, or ICU. They come from many professions and can help very ill patients get better. The care team often teach the patient and family strategies that improve health and well-being.
Members of the team usually include one or more of these caregivers:
A medical doctor who has studied, trained, and tested in caring for very ill patients. The intensivist is often an expert in one of these areas:
A highly skilled nurse who provides all aspects of care for a very ill patient. This nurse helps all of the people involved in that care talk to one another. He or she has close contact with the patient and family and can often uphold the patient's wishes. The critical care nurse becomes an important part of decision-making with the patient, the family and the care team.
A registered nurse (RN) who is certified in critical care is known as a CCRN. CCRNs are certified by the American Association of Critical-Care Nurses.
An expert in drugs who works with the care team to prescribe drugs the patient needs. The pharmacist checks the progress of these drugs during the patient's stay in the hospital.
A caregiver trained and licensed in nutrition and illness. The registered dietitian works with the care team and the family to improve the health of the patient who lacks nutrients. The registered dietitian can lead or perform feedings by mouth, tube or vein.
A caregiver who has special knowledge and practice in healing patients with breathing problems. The respiratory therapist uses lung treatments to help the patient breathe.
A caregiver who helps restore a function of the body that involves the muscles, bones, tissues or nerves. With this help, the patient can better move around in daily life (for example, walking, going up and down the stairs). The physical therapist uses techniques such as stretching and applying heat. These techniques can reduce pain and swelling. They can also prevent permanent physical disability.
A caregiver who helps the patient relearn life skills. Examples of these skills include grooming, feeding, dressing and balancing a checkbook. The occupational therapist helps the patient live as independently as possible.
A clergy member in the hospital who talks with patients, families and staff. The chaplain provides spiritual support and may help find a clergy member of the patient’s faith to better meet the patient’s spiritual needs. Often the chaplain plays an important role in end-of-life care.
A caregiver trained and licensed in clinical services. He or she works in the ICU under the doctor’s lead. Examples of what the physician assistant and nurse practitioner can do include:
They are often the "first responders" to changes in the patient's health.
An expert in child development who works with ill children. The child life specialist provides play and distraction therapy. He or she often works with other experts in the pediatric intensive care unit, or PICU, to improve the health and well-being of very ill children.
The Patient Communicator App by SCCM is designed to improve communication among patients, families, and caregivers. Communication with patients who are unable to speak is often challenging. Mechanical ventilation, hearing or speech limitations, language barriers, and other hurdles may stand in the way of providing optimal patient-centered care.
New and Improved Features!
