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What is an Intensive Care Unit (ICU)?

Intensive Care Unit and what treatments and support can be provided in each. Charge
JOHN WILSON: We previously spoke about one of the components of our critical care unit, the high-dependency unit. Now we’ll take a look at the intensive care unit and talk about which patients we would treat there. The intensive care unit provides level 3 care. This means that those who are admitted to intensive care will require support for a minimum of two organs unless they are receiving advanced respiratory support in the form of being intubated and ventilated alone. In this case, they would be admitted to the intensive care unit regardless of whether they had other organs requiring support or not. This is a typical bed in our intensive care unit. As you can see, there are some differences compared to HDU.
This is one of our ventilators, which would be used to prevent respiratory support. There are a range of different settings which can be used to give, for example, either pressure or volume support while the patient is ventilated. There is also the option to provide support while encouraging the patient to breathe by themselves. A typical patient in ICU will also have a few infusion pumps to provide a range of drugs, from sedatives and analgesics to inotropes, antibiotics, and others. Patients are ideally awake, calm, and pain-free. This requires a lot of skill to achieve. That is one of the reasons why there is a 1 to 1 nursing ratio in ICU, compared to a 1 to 2 nursing ratio in HDU.
Another reason for the high nursing ratio is that patients may require other organ support, such as renal replacement therapy, or have extra monitoring, such as cardiac output monitoring. Attention to all organ systems is given, including the gut. Patients are mostly fed through a nasogastric tube, but TPN is sometimes needed if the gut is not functioning well.

There are clear differences between a High Dependency Unit and an Intensive Care Unit in terms of the various treatments and levels of support which can be provided. Charge Nurse John Wilson returns to explain what we mean by an Intensive Care Unit and shows how this differs from the High Dependency Unit.

During this week you will be asked to reflect on this and decide where you think your patient should be managed; in a ward, a High Dependency Unit or the Intensive Care Unit. Look out for the poll with the associated comments section to see what others think too.

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Introduction to Critical Care Medicine

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