A patient whose condition is extremely serious, possibly life-threatening, is often taken to an Intensive Care Unit which provides constant observation and treatment from specially trained staff qualified to use specialised equipment.
Some admissions to the Intensive Care Unit are planned, usually after major surgery or in order for specialist treatments to be performed. In such cases it may be possible to visit the unit beforehand or receive an information book. This can help you and your relative or friend by showing you the environment of an Intensive Care Unit in advance. However, most admissions are in emergency situations.
You may also hear the unit referred to as ITU—that stands for Intensive Therapy Unit or Critical Care Unit. It means the same as ICU (Intensive Care Unit). In Southport and Ormskirk NHS Trust our unit is a combined ICU and High Dependency Unit (HDU). HDUs are for patients who require less monitoring or treatment than is normally provided in an ICU.
Due to clinical need, men and women are nursed next to each other on the unit—the staff will endeavour to maintain your relative’s or friend’s dignity at all times. When your relative or friend is discharged they will either go to a sideroom or a single sex bay on a ward.
Medical Equipment on ICU/HDU
The Intensive Care Unit uses machines, which can look frightening when seen for the first time. These machines help us to monitor and support a patient’s normal body functions.
Each patient is attached to a machine called a cardiac monitor. Small, sticky pads are placed on the patient’s chest and are connected to a machine. The machine picks up electrical impulses from a patient’s heart and can detect any abnormalities. The monitor can also show a patient’s blood pressure and oxygen saturation.
It is normal for the numbers on the monitor to keep changing. A patient who is not strong enough to breathe on their own will be connected to a ventilator (breathing machine). This is attached to a tube passing through the nose or mouth into the windpipe. The tube, which is known as an endotracheal tube, is connected to a machine that blows air and extra oxygen in and out of the lungs. The machine can ‘breathe’ completely for a patient or it can be set to assist a patient’s own breathing. A patient can be gradually weaned off a ventilator when their condition improves.
If a patient is likely to remain on a ventilator for more than a few days, the endotracheal tube is sometimes replaced with a tracheostomy. In this case an operation is carried out to insert a tube into a hole made in the throat. Although this can look quite strange, it is actually more comfortable for the patient than having a tube in their mouth. Please remember that, although unable to speak, your relative or friend may be able to hear you. By all means do talk to them, but questions should be put so that they can be answered with a nod or shake of their head.
Patients are often attached to drips or infusions.
These allow liquids to be passed through tubes into veins, usually in the side of the neck, arm or hand. There are various substances commonly used in drips. Fluids can be used for various reasons including re-hydration and maintenance of blood pressure. Infusion pump or syringe driver is attached to the drip to administer the drugs at the correct rate.
Food in the form of liquid containing essential nutrients can be given either through the nose via a tube called nasogastric tube which goes down into the stomach, or by using a drip.
Your relative or friend will have a urinary catheter in order to empty their bladder. We measure the urine every hour so that we can assess how the kidneys are working.
Many of the machines have alarms and flashing lights. They go off quite often for a variety of reasons. Please do not be frightened by the lights or noises. The alarms are to attract the attention of the staff. The nurse will be happy to explain the equipment to you. Please ask questions if you don’t understand something or would like to know more. Always ask for clarification if jargon or technical terms are used. Staff working on the unit are used to this language and we sometimes forget how baffling and frightening it can be for other people.
Can I help?
Some of the drugs will keep a patient deeply asleep. However, you should always assume that the patient can hear you and understand everything that you are saying.Whenever you are in the room with your patient, try to speak in a calm, clear manner. Make short positive statements. For instance, many family members assume because their loved one is on a ventilator they cannot hear. Most of the time the patient can indeed hear you.
Do not discuss any unpleasant matters in your loved one’s room. If your loved one’s condition is critical, discuss this or other problems outside the room. For example, do not discuss financial matters, or family disagreements, etc.
Do feel free to talk to your relative or friend. Do not be afraid to touch your relative or friend. It may be comforting for both of you.
Be sure that you have washed or sanitized your hands prior to ever touching the patient and insist that anyone entering the room wash or sanitize their hands, even if they do not intend to touch the patient. Hand hygiene is the NUMBER ONE way to help prevent your patient from acquiring a potentially life threatening infection while in the ICU.
While your relative or friend is in intensive care you may want to help with the care being given. This would be done under the supervision of a nurse. The nurse will be able to advise and discuss this with you.