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Intensive Care Unit

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This is a background article. See Psychological aspects of intensive care

An Intensive Care Unit (ICU) or Critical Care Unit (CCU) is a specialised facility in a hospital that provides intensive care medicine. The first application of this idea in the US was pioneered by Dr. William Mosenthal, a surgeon at the Dartmouth-Hitchcock Medical Center.[1]

Many hospitals also have designated intensive care areas for certain specialities of medicine, as dictated by the needs and available resources of each hospital. The naming is not rigidly standardized.

Specialized types of ICUs include:

  • Neonatal intensive care unit (NICU)
  • Special Care Baby unit (SCBU)
  • Pediatric Intensive Care Unit (PICU)
  • Psychiatric Intensive Care Unit (PICU)
  • Coronary Care Unit (CCU) for heart disease
  • Medical Intensive Care Unit (MICU)
  • Surgical Intensive Care Unit (SICU)
  • Cardiac Surgery Intensive Care Unit (CSICU)
  • Neuroscience Critical Care Unit (NCCU)
  • Overnight Intensive Recovery (OIR)
  • Neuro Intensive Care Unit (NICU)
  • Burn Wounds Intensive Care Unit
  • Trauma Intensive care Unit (TICU)

Equipment and systemsEdit

Common equipment in an ICU includes mechanical ventilator to assist breathing through an endotracheal tube or a tracheotomy opening; dialysis equipment for renal problems; equipment for the constant monitoring of bodily functions; a web of intravenous lines, feeding tubes, nasogastric tubes, suction pumps, drains and catheters; and a wide array of drugs to treat the main condition(s), induce sedation, reduce pain, and prevent secondary infections.

Quality of careEdit

Medicine suggests a relation between ICU volume and quality of care for mechanically ventilated patients. [2] After adjustment for severity of illness, demographic variables, and characteristics of the ICUs (including staffing by intensivists), higher ICU volume was significantly associated with lower ICU and hospital mortality rates. For example, adjusted ICU mortality (for a patient at average predicted risk for ICU death) was 21.2% in hospitals with 87 to 150 mechanically ventilated patients annually, and 14.5% in hospitals with 401 to 617 mechanically ventilated patients annually.

StaffEdit

Medical staff typically includes intensivists with training in internal medicine, surgery, or anesthesia. Many Nurse Practitioners and Physician Assistants with specialized training are also now part of the staff that provide continuity of care for patients. Staff typically includes specially trained critical care Registered Nurses, Registered Respiratory Therapists, Nutritionists, Physical Therapists, etc.

Staff supportEdit

ReferencesEdit

  1. Remembering Dr. William Mosenthal: A simple idea from a special surgeon. Dartmouth Medicine. URL accessed on 2007-04-10.
  2. Kahn JM, Goss CH, Heagerty PJ, Kramer AA, O'Brien CR, Rubenfeld GD. (2006). Hospital volume and the outcomes of mechanical ventilation.. New England Journal of Medicine 355 (1): 41-50.
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