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intensive care unit

Alternative Names
ICU, critical care unit

Definition
Sick or injured people who need very close monitoring are cared for in an area of the hospital called the intensive care unit or the ICU. Smaller community hospitals generally only have one ICU. Larger hospitals or trauma centres may have many different ICUs. These ICUs may include:
  • surgical
  • cardiac
  • neurological
  • paediatric
  • neonatal
  • respiratory
What is the information for this topic?
The ICU is a specialised area where very sick people are treated. Generally, people in the ICU have a life-threatening illness or condition.

In most ICUs, each person is in a separate room. Visitors are limited to allow the person to get the rest he or she needs. Sometimes, doctors wear special masks or gowns when they go into the person's room. This is usually to prevent the spread of infection.

The amount of monitoring done in the ICU can appear overwhelming to a visitor or patient. The person being treated may look totally different than normal. There are often several intravenous, or IV, lines attached to different bags of medication and fluid. These IV lines go into veins in the hand, forearm, elbow, neck, or groin. A cuff is wrapped around the person's arm to take blood pressure readings. Stickers are placed on the chest with wires attached to them to monitor the heart tracing, or electrocardiogram, also called an ECG. A device to measure oxygen in the blood, known as a pulse oximeter, may be placed on a finger.

A person may be getting oxygen through tubes in the nose or a special face mask. Sometimes, a person is hooked up to an artificial breathing machine called a ventilator. This involves putting an endotracheal tube in through the mouth and into the windpipe. People on a ventilator cannot talk. They may even be paralysed and put to sleep with medications.

There may be special stockings or devices wrapped around the legs as well. These devices help prevent a blood clot known as deep venous thrombosis from developing. A tube called a urinary catheter may be placed through the urethra and into the bladder. The urethra is the tube through which urine leaves the body. This kind of catheter is used to collect urine. In many situations, the exact amount of urine is monitored.

It seems as if one or more machines are always beeping in the ICU. Most of the time, this represents a small problem that is more annoying than important. Occasionally, these beeps represent a life-threatening situation. Patients and visitors in the ICU do not need to worry about machines beeping. The staff usually knows when the beeps signal an important problem. However, if a patient is in trouble, he or she should call for the nurse. A beeping machine is not a cause for concern, but a person who is not feeling well is.

The same person does not take care of a patient all the time. Specially trained nurses generally work in 8- or 12-hour shifts. Doctors often work during business hours and are not on call every night. However, there is always a doctor on call in case of an emergency. During shift changes, the staff exchanges information about each patient. The person's medical record is also available to read.

A patient or family member should feel free to ask questions. The doctor may only come by once or twice a day. If a question comes up at other times, it should be asked of the nursing staff or written down.

Doctors often form a treatment plan each morning after seeing patients. They write orders in the chart to be executed throughout the day. A doctor does not need to be there long to know what is going on in many cases. If any problems occur, the nursing staff can call the doctor.

Many different people may be involved in the care of a person in the ICU. Doctors, nurses, respiratory therapists, technical assistants, people who draw blood, and housekeepers may all come into the room at different times. The ICU is not the best place to sleep. These people all work together, however, to provide the best care available in modern medication.

Author: Adam Brochert, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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