health

Intensive care

Generality

Intensive care, or intensive care unit, is the hospital ward assigned to the hospitalization of individuals in serious health conditions, who need continuous assistance, to maintain their vital functions in the normal way.

Specifically, intensive care is indicated in cases of: ARDS, severe physical traumas (especially cerebral), multiple organic insufficiency and sepsis. Moreover, it is the place reserved for those who are in a coma or pharmacological coma.

The organization of intensive care is very special: each bed must be equipped with a specific instrumentation (respirator for mechanical ventilation, manual defibrillator, etc.); the medical staff must have an ad hoc preparation; the availability of drugs must be wide and satisfy the needs of patients in very different conditions; finally, the physical space must be such as to guarantee rapid medical interventions, in case of emergency.

Intensive care includes various specialties, including for example: neonatal intensive care, pediatric intensive care, intensive coronary therapy, intensive neurological therapy and intensive psychiatric therapy.

What is intensive care?

Intensive care, or intensive care unit, is the hospital ward reserved for the hospitalization of patients in serious health conditions, who need continuous treatment, monitoring and support, in order to maintain their vital functions normally.

In common jargon, intensive care also means an extreme treatment method, implemented to treat people in danger of life or in critical condition. In fact, this second interpretation of the term "intensive care" is not so different from the more precise definition given a few lines above.

PERSONNEL OF INTENSIVE THERAPY

To work in intensive care, you need to have a specific preparation . Therefore, doctors and nurses of intensive care in 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, clearly, complete the so-called Specialization Schools in Anesthesia, Resuscitation and Intensive Care or similar post-graduate courses .

INTENSIVE THERAPY AND RESCUE

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 utility of creating a hospital ward for the most serious patients 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, from which it turned out that separating the seriously ill from the less serious patients and dedicating them priority care had led to a reduction in mortality from 40% to 2%.

Despite this, the birth of what is now called intensive therapy dates back almost a century, to be precise to 1950 . In fact, this year, an Austrian anesthesiologist named Peter Safar established the concept of "Advanced Life Support", based on the idea of ​​having to resort to intensive and continuous care, to keep patients sedated and ventilated 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 in many countries of the world: for example, in 1953, it was the turn of Denmark, by a certain Bjorn Aage Ibsen; in 1955, it was the United States' turn, on the input of Dr. William Mosenthal; and so on.

Indications

Intensive care is indicated, specifically, for people who are victims of:

  • ARDS, an acronym for a serious health condition known as Acute Respiratory Distress Syndrome ;
  • Serious physical traumas, especially cerebral ones;
  • Multiple organic insufficiency, also known as multi-organ dysfunction syndrome . It is a morbid condition that compromises the functionality of different organs of the individual concerned. May result from an infection, severe trauma, etc .;
  • Sepsis (or septicemia ). It is a potentially lethal complication of a bacterial infection, which induced an exaggerated systemic inflammatory response.

    In other words, sepsis occurs as a result of a bacterial infection, which has triggered a widespread inflammatory response 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, that is the state of unconsciousness resulting from a serious health condition, and to people in a state of pharmacological coma, that is the temporary state of unconsciousness induced voluntarily by doctors, for 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 multiparameter monitor for continuous monitoring of vital functions (eg heart rate, blood pressure, etc.), a manual defibrillator, pumps infusions, nasogastric probes, catheters and a suction / drainage system. Furthermore, it guarantees specialized nursing assistance equal to one unit for every two beds (NB: in the other departments, it is equal to one unit for every 4-5 beds) and the supervision of patients, by an anesthesiologist-resuscitator .

For obvious reasons, the physical space, designed for intensive care, is suitable for immediate and sudden medical interventions.

Please note: the hospital dispositions 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, the basic rule is that a nurse is needed for every two patients; however, if the conditions of a patient are really 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 the medical staff to deal with a large number of circumstances / conditions.

The list of medicines present canonically in intensive care also includes: drugs to induce pharmacological coma, all kinds of sedatives, analgesics of all sorts and antibiotics.

Branches and specialties

Modern intensive therapy includes numerous specialties, each of which is responsible for the care of a certain category of patients.

Among the specialties of modern intensive care, they include:

  • Neonatal intensive care . It deals with premature babies or those born in the world with serious congenital diseases, which absolutely cannot leave the hospital and deprive themselves of adequate medical care.
  • Pediatric intensive care . It deals with patients in pediatric age, who risk their lives because of: a severe form of asthma, a severe flu, a form of diabetic ketoacidosis, a severe brain trauma, etc.
  • Intensive psychiatric therapy . He is mainly caring for patients with mental problems that tend to self-harm. Generally, it is a "sealed" department, from which the patients have no chance of escape.
  • Coronary intensive care . It takes care of subjects with serious congenital heart defects or of subjects affected by acute and life-threatening heart conditions, such as cardiac arrest.
  • Neurological intensive care . He deals with individuals who are victims of cerebral aneurysms, brain tumors and strokes, and of those who have recently undergone surgery on the brain or spinal cord.

    In addition, neurological intensive care also takes care of people who have been bitten by a rattlesnake.

  • Intensive trauma therapy . It treats people who are victims of trauma that endanger their survival. It is an intensive care specialty present only in some hospitals.
  • Post-anesthetic intensive care . It deals with subjects who have recently undergone major surgery, for which general anesthesia was provided.

    Very often, admission to post-anesthetic intensive care is reserved for people who suspect a possible adverse reaction to sedative and anesthetic practices.

  • Post-transplant intensive care . He is treating those who have just undergone an organ transplant.