An intensive care unit (ICU), critical care unit (CCU), intensive therapy unit or intensive treatment unit (ITU) is a specialized department used in many countries' hospitals that provides intensive care medicine. Many hospitals also have designated intensive care areas for certain specialities of medicine, as dictated by the needs and available resources of each hospital. The naming is not rigidly standardized.
In 1854, Florence Nightingale left for the Crimean War, where the necessity to separate seriously wounded soldiers from less-seriously wounded was observed. Nightingale reduced mortality from 40% to 2% on the battlefield, creating the concept of intensive care
In 1950, anesthesiologist Peter Safar established the concept of "Advanced Support of Life," keeping patients sedated and ventilated in an intensive care environment. Safar is considered the first intensivist.
In response to a polio epidemic (where many patients required constant ventilation and surveillance), Bjørn Ibsen established the first intensive care unit in Copenhagen in 1953. The first application of this idea in the United States was pioneered by Dr. William Mosenthal, a surgeon at the Dartmouth-Hitchcock Medical Center. In the 1960s, the importance of cardiac arrhythmias as a source of morbidity and mortality in myocardial infarctions (heart attacks) was recognized. This led to the routine use of cardiac monitoring in ICUs, especially in the post-MI setting.
Specialized types of ICUs include:
Common equipment in an ICU includes mechanical ventilator to assist breathing through an endotracheal tube or a tracheotomy opening; cardiac monitors including telemetry, external pacemakers, and defibrillators; dialysis equipment for renal problems; equipment for the constant monitoring of bodily functions; a web of intravenous lines, feeding tubes, nasogastric tubes, suction pumps, drains and catheters; and a wide array of drugs to treat the main condition(s). Medically induced comas, analgesics, and induced sedation reduce pain and prevent secondary infections.
Medicine suggests a relation between ICU volume and quality of care for mechanically ventilated patients. After adjustment for severity of illness, demographic variables, and characteristics of the ICUs (including staffing by intensivists), higher ICU volume was significantly associated with lower ICU and hospital mortality rates. Typically, patient to nurse ratio is what determines the care. A ratio of 2 patients to 1 nurse is recommended for a medical ICU. This is unlike the ratio of 4:1 or 5:1 ratio on the medical floors.
Medical staff typically includes intensivists with training in internal medicine, surgery, anesthesia, or emergency medicine. Many nurse practitioners and physician assistants with specialized training are also now part of the staff that provide continuity of care for patients. Staff typically includes specially trained critical care registered nurses, registered respiratory therapists, clinical pharmacists, nutritionists, physical therapists, certified nursing assistants, social workers etc.
In the United Kingdom intensive care medicine is an extremely specialised area. In the United States up to 20% of hospital beds can be labelled as intensive care beds, whereas in the United Kingdom intensive care usually will comprise only up to 2% of total beds. This high disparity is attributed to patients in the UK who are admitted to an ICU tending to be only the most severely ill.
Intensive Care is an incredibly expensive healthcare service. In the United Kingdom the average cost of funding an intensive care unit is:
An intensive care unit (ICU), critical care unit (CCU), intensive therapy unit (ITU), or intensive treatment unit (ITU) is a special part of a hospital. Usually, people that are very sick are sent there. They need to be looked at by a nurse or doctor very closely in case they get more sick while at the hospital.
Some ICUs may work with only one type of injuries.
In 1854, Florence Nightingale went to the Crimean War. There it was important to separate seriously wounded soldiers from less-seriously wounded. Nightingale reduced death rates from 40% to 2% by creating the concept of intensive care.
Because of a polio epidemic, Bjørn Ibsen established the first intensive care unit in Copenhagen in 1953. Patients with polio require more ventilation than normal; this is why Ibsen set up a special unit for them. The first person to use this idea in the United States was Dr. William Mosenthal, a surgeon at the Dartmouth-Hitchcock Medical Center.