Generality
The intensive care unit, or intensive care unit, is the hospital ward dedicated to the hospitalization of individuals in serious health conditions, who need continuous assistance, for the maintenance of their vital functions in the norm.
The organization of intensive care is very particular: each bed must be equipped with specific instruments (respirator for mechanical ventilation, manual defibrillator, etc.); medical personnel must have an ad hoc training; the availability of drugs must be wide and meet the needs of patients in very different conditions; finally, the physical space must be such as to guarantee rapid medical interventions in the event of an emergency.
Intensive care includes various specialties, including for example: NICU, Pediatric Intensive Care, Coronary Intensive Care, Neurological Intensive Care and Psychiatric Intensive Care.
What is intensive care?
The intensive care unit, or intensive care unit, is the hospital ward reserved for the hospitalization of patients in serious health conditions, who require continuous treatment, monitoring and support, in order to maintain their vital functions in the normal range.
In common jargon, intensive care also means an extreme treatment method, implemented to treat people in danger of life or in critical conditions. In fact, this second interpretation of the term "intensive care" is not so different from the definition more precise, given a few lines above.
INTENSIVE CARE STAFF
To work in the ICU, it is necessary to have specific training. Hence, doctors and nurses in the ICU of a hospital represent a qualified staff, both in monitoring and in the care of people in serious health conditions.
In order to carry out activities in intensive care, doctors and nurses must attend and, of course, complete the so-called Specialization Schools in Anesthesia, Intensive Care and Intensive Care or similar post-graduate courses.
INTENSIVE CARE AND RESUSCITATION
In most European countries and in North American culture, the terms "intensive care" and "resuscitation" are equivalent in the sense that they refer to the same hospital ward.
HISTORY
The first evidence of the usefulness of creating a hospital ward for the most seriously ill dates back to 1854 and is linked to the name of a British nurse named Florence Nightingale, who in those years assisted the soldiers of her country during the Crimean War. .
Nightingale carried out an "interesting statistical survey, which showed that separating the seriously ill from the less seriously ill and giving them priority care had led to a reduction in mortality from 40% to 2%.
Despite this, the birth of what is now called intensive care dates back to almost a century later, to be precise in 1950. In this year, in fact, an Austrian anesthetist named Peter Safar established the concept of "Advanced Life Support" , based on the idea of the need to resort to intensive and continuous care, to keep sedated and ventilated patients alive.
As stated, Safar is considered the first practitioner of intensive care in the current sense.
From Safar onwards, the application of intensive care as a hospital ward spread to many countries of the world: for example, in 1953, it was the turn of Denmark, thanks to a certain Bjorn Aage Ibsen; in 1955, it was the turn of the United States, at the input of Dr. William Mosenthal; and so on.
Indications
Intensive care is specifically indicated for people who are victims of:
- ARDS, which stands for a serious health condition known as Acute Respiratory Distress Syndrome;
- Severe physical trauma, especially cerebral;
- Multiple organic failure, also known as multiple organ dysfunction syndrome. It is a morbid condition that compromises the functionality of various organs of the individual concerned. It can result from an infection, a serious trauma, etc .;
- Sepsis (or septicemia). It is a life-threatening complication of a "bacterial infection, which induced an" exaggerated systemic inflammatory response.
In other words, sepsis arises as a result of a "bacterial infection, which has triggered an inflammatory response spread throughout the body and so powerful as to cause serious damage to organs and tissues.
Furthermore, intensive care is the place reserved for people in a state of coma, i.e. that state of unconsciousness resulting from a serious health condition, and for people in a pharmacological state of coma, i.e. that temporary state of unconsciousness induced voluntarily by doctors, to safeguard the brain health of the person concerned.
Organization and equipment
A classic intensive care unit has, for each bed unit, an automatic respirator for mechanical ventilation, a multi-parameter monitor for continuous monitoring of vital functions (e.g. heart rate, blood pressure, etc.), a manual defibrillator, pumps infusion devices, nasogastric probes, catheters and an aspiration / drainage system. In addition, it guarantees specialized nursing assistance equal to one "unit for every two beds (NB: in the other departments, it is equal to one" unit every 4-5 places bed) and the supervision of patients by an anesthetist-resuscitator.
For obvious reasons, the physical space, designed for intensive care, is suitable for immediate and sudden medical interventions.
Please note: the hospital provisions of the intensive care unit vary from country to country, based on what the national medical-health community has established.
For example, in the United Kingdom, there is a basic rule that "one nurse is needed for every two patients; however, if the condition of an inpatient is very serious, the circumstances exist to reserve a" personal nurse for the patient in question.
DRUGS
As a rule, the intensive care unit is in possession of a "wide variety of drugs: this allows medical personnel to deal with a large number of circumstances / conditions.
The list of medicines canonically present in intensive care also includes: drugs to induce pharmacological coma, sedatives of all kinds, analgesics of all kinds and antibiotics.
Branches and specialties
Modern intensive care includes numerous specialties, each of which is dedicated to the care of a certain category of patients.
The specialties of modern intensive care include:
- The neonatal intensive care. It takes care of premature babies or babies who have come into the world with serious congenital pathologies, who absolutely cannot leave the hospital and deprive themselves of adequate medical care.
- Pediatric intensive care. It deals with pediatric patients, who risk their lives due to: a severe form of asthma, a severe flu, a form of diabetic ketoacidosis, severe brain trauma, etc.
- The psychiatric intensive care. He mainly cares for patients with mental problems, who tend to self-harm. Generally, it is a “sealed” ward, from which the patients have no possibility of escape.
- Coronary intensive care. It cares for people with severe congenital heart defects or for people with acute and life-threatening heart conditions, such as cardiac arrest.
- Neurological intensive care. It deals with individuals who are victims of brain aneurysms, brain tumors and strokes, and with those who have recently undergone brain or spinal cord surgery.
Neurological intensive care also takes care of people who have been bitten by a rattlesnake. - Trauma Intensive Care. He is treating people who are victims of trauma that jeopardize their survival. It is an intensive care specialty found only in some hospitals.
- The post-anesthetic intensive care. It deals with subjects who have recently undergone major surgery, for which general anesthesia was required.
Most often, admission to post-anesthetic intensive care is reserved for people suspected of having a possible adverse reaction to sedative and anesthetic practices. - Post-transplant intensive care. He is treating those who have just undergone an organ transplant.
