Behind The Scenes Of An Intensive Care Unit - Dr Sanjith Saseedharan, Dr Sandeep Patil

An Intensive Care Unit (ICU) is a specialized area of every hospital where the most severe patients are treated and cared for by trained specialists. If a patient has been admitted to the ICU, there is a high chance that their illness requires constant and careful monitoring. In some places, the ICU is called a critical care unit. In some situations, patients might be on the verge of becoming worse, which is why they need to be constantly monitored so that they are given the necessary care and medication to save their lives in critical moments.

While there is always a generic ICU in all big hospitals, multi-speciality hospitals have a range of ICUs that tackle a specific range of patients. Some of these ICUs include:

• Neonatal ICU (NICU): This type of ICU specializes in caring for young or premature babies.

• Paediatric (PICU): It tackles children requiring intensive care.

• Neurological ICU: A specialized unit designed to care for neurologically unstable patients.

• Cardiac Care Unit (CCU): This unit aims to provide comprehensive care for patients with severe or unstable cardiac issues.

• Surgical ICU (SICU): A unit that cares for patients who are recovering from surgery and still require specialized care.

What are some of the main types of machines in the ICU? Since there are so many machines and tubes in an ICU, the information below tries to demystify them so that patients and their caregivers are not intimidated by them. Let’s find out more about them in detail.

• Ventilator: A medical device, the ventilator helps patients breathe, especially when they cannot do so on their own. It is used on patients suffering from accidents, injuries, or even COVID-19 complications impairing their lung function. To activate a ventilator, a specialist or doctor will pass a small tube called the Endotracheal Tube through the mouth of the patient, which is then connected to a ventilator. When a patient is connected to a ventilator, they cannot speak as the tube passes through the voice box. However, in most cases, patients connected to a ventilator will be able to understand and sense what is happening around them. In such cases, keeping communication active is always recommended. Alternatively, they may be able to communicate with you through writing on a piece of paper. However, keep in mind that in some cases, the nurses and doctors may ask you to maintain silence, as that is vital for the patient’s recovery.

In most cases, a ventilator is connected via a pipe, but in some cases, a mask may be used – in such a case, it is called a ‘non-invasive ventilation method’. Many people are curious about how the patient would eat or go to the toilet on a ventilator. In the case of food, it is fed in semi-solid form through the tube attached to the nose as it goes from the nostril to the stomach. When it comes to going to the toilet, the patient is allowed to pass urine from the bed into a measuring jar, as standing up and going to the bathroom might prove fatal/dangerous for them. In some cases, a ‘catheter’; is passed for the purpose – it is a thin, rubbery pipe placed into the urinary bladder under local anesthesia to minimize discomfort for the patient. Similarly, a receptacle (bedpan) is placed by caregivers to help the patients pass stool while in bed; after each process, the hospital staff assures proper cleanliness and hygiene of the patient & amp; the surroundings.

• Central & Arterial Line: If a patient’s condition worsens in the ICU, the specialists may ask their caregivers to consent to pass the main line through them. The central line helps doctors supply powerful medications to patients, which is impossible through the regular IV lines inserted in them. Although it is like an IV line, the central line is slightly longer and broader. It is generally inserted in the neck or the groin and takes close to 40 minutes. Once this is placed, an X-ray of the patient is taken to ensure it has been set correctly. Additionally, an arterial line is also placed in one of the arteries in the groin or arm to monitor the patient’s blood pressure.

• Tracheostomy Tube: Every human has two pipes; one is the windpipe for breathing, and the second is the food pipe through which food enters the stomach. In many severe cases, patients require help with breathing, especially when admitted for a long duration. Also, they might be so weak that they cannot coordinate swallowing moments, which can increase the risk of food and saliva entering the windpipe. In such a scenario, a tracheostomy tube is inserted into the patient during an operation which is removed when the patient is in a better condition.

• Monitors In ICU: Patients in ICU need continuous monitoring, and a monitor is a device that records, measures, and displays a variety of biometric values, including heart rate, blood pressure, body temperature, SpO2, and others. It can be used to track the health of both infants and adults.

• Dialysis machine: Dialysis is an essential requirement for people whose Kidneys are failing or have failed and is an indispensable part of the ICU.

In conclusion, all machines in the ICU are present with only one goal, which is to improve the lives of the patients admitted there. Also, the specialists who handle them are highly qualified and have all the required knowledge and expertise not just to prevent long-term disability, but also to maximize the recovery process. If you still have any questions, your doctor and medical staff will be happy to explain these devices to you so that you can be an active partner in helping the patient recover and go home as quickly as possible.

Disclaimer: The views expressed in this article are of the authors and not of Medical Dialogues. The Editorial/Content team of Medical Dialogues has not contributed to the writing/editing/packaging of this article.