Understanding the ICU: What It Is and How It Works

• Intensive care refers to the special treatment given to patients who are critically ill and require 24-hour strict care. An intensive care unit i.e. ICU, provides critical care and life support to extremely ill and critically injured patients.
• Unless you are admitted for an emergency service, you will need to be referred by your doctor or specialist to be admitted to the ICU. Many different types of patients are admitted to the ICU.
• Some patients come directly from the emergency department, while others come from other wards within the hospital due to complications in their illness. There are many types of patients in the ICU, but they all require the same thing – constant observation and specialized care.
• The ICU cares for people whose lives are at risk due to serious illness or injury in an accident, where they are monitored and kept on life support equipment at all times. This is different from other wards in the hospital – 
• The ICU provides 24-hour care by a highly trained team of specialists.
• There are very few beds here, with a lot of equipment to monitor and care for critically ill patients.
• Very few people are allowed to meet the patient.

When you first come to visit a relative in the ICU, one of the things that may worry you is the number of equipment and machines attached to your family member. There are different types of devices or equipment in the ICU which are as follows -

Ventilator
A ventilator is used when patients are so weak or sick that they cannot breathe on their own. When your family member or friend is on a ventilator, they will not be able to talk to you. If you have to talk to them, you should ask them simple questions that can be answered by nodding yes or no. Patients are often heavily sedated to keep them comfortable, so they may be sleepy and therefore may not always respond to you.

Heart Monitor
A heart monitor looks like a television with colored lines running across the screen. These lines measure the activity of the patient's heart. The heart monitor is attached to the patient's skin by sticky pads. The beeps and other noises are alerts given by electronic machines to let the nurse know that something needs attention.

Feeding Tubes
If a patient is unable to eat normally, food is given through a tube into the nose, through a small cut in the abdomen, or into a vein.

Drains And Catheters
Drains are tubes used to remove any build-up of blood or fluid from the body. Catheters are thin tubes inserted into the bladder to drain urine. These machines and monitors help make intensive care as safe and effective as possible.

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If someone is critically ill and needs intensive treatment and close monitoring or if someone has undergone surgery and intensive care can help them, then the patient needs to be kept in the ICU. There are many different conditions and circumstances in which someone may need to be kept in the ICU. Some common reasons include -

• Having undergone a major surgery. 
• For treatment after a serious accident (such as a car accident, severe burns).
• If there is any type of serious illness (for example heart failure, kidney failure, stroke or heart attack). 
• For treatment during a serious infection (for example pneumonia, sepsis).
• If a baby is born prematurely or is born with a serious illness. There is usually a special ICU for children called the Neonatal Intensive Care Unit or NICU.

• Patients in the ICU are closely monitored by a team of ICU staff and are connected to the equipment by many tubes, wires and cables. There is usually one nurse for every one or two patients.
• Although patients in the ICU may be connected to a wide range of machines, the most common machines are heart monitors and artificial ventilators (for when patients cannot breathe on their own).
• Many ICU machines make beeping sounds and noises to attract the attention of staff and sound alarms if there is a change in the patient's condition.
• There is also the possibility of having many tubes attached to give fluids and nutrients or other fluids to patients who are unable to feed themselves.
• The ICU has many trained staff. Each patient usually has a dedicated specialist nurse, who regularly checks the equipment and any life support systems.
• The ICU healthcare team understands how distressing it can be to be in the ICU and so they are available to support the immediate family.

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• Every patient in the ICU is extremely unwell so every hospital has a policy for visitors. Visitors are usually limited to family. You should turn off your mobile phone. You may also be prohibited from bringing gifts for the patient. If you are feeling unwell for any reason, you should not visit the patient.
• Visiting hours - Visiting hours are usually very flexible, but there may be times when visiting is not allowed, so you should check this before coming to visit. The number of people allowed to visit around the person's bed may be limited.
• Hygiene rules - To reduce the risk of spreading infection, you will be asked to clean your hands when entering and leaving the ICU and you may be prevented from bringing certain things such as flowers.
• How the patient may look and behave - The person you are visiting may be sleepy and seem confused. They may also have some swelling or injuries such as bruises or wounds. This may be upsetting to see, but don't worry as the ICU staff will make sure the patient is as comfortable as possible.
• You will usually be free to touch the person, talk to them in a comforting way. This may help them to hear and recognise familiar voices, even if they are not in a position to respond.
• You can tell them about your day or read a book or newspaper to them. You may be able to bring some things to make them more comfortable, but ask the staff first if you want to bring anything.
• ICU staff will be nearby during your visit to answer any questions you may have. Only family members can be given information about the patient. Confidentiality is always maintained while the patient is being cared for.
• Patients are usually moved from here to another ward when they no longer require such constant attention or help.
• Once a person is well enough to go home, they are usually discharged with medications and instructions for home care. They may need to visit the hospital, clinic or their doctor for further care.

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More than 80% of patients have to pay for healthcare services out of their own pockets due to the absence of comprehensive insurance cover. Therefore, the cost of any treatment automatically becomes an important topic for us. The cost of ICU depends on the procedures required for the patient, the time spent in the ICU, and the special care required.

An inpatient stay in an ICU at a private hospital in India can cost anywhere between Rs 30,000 to Rs 50,000 per day. Such a huge cost is one of the main reasons why people are opting for ICU services at home. The same cost at home comes to a mere Rs 7,500 to Rs 12,500 per day.

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The ICU (Intensive Care Unit) is a specialized medical facility where critically ill or injured patients are given continuous monitoring and advanced treatment. The ICU is equipped with modern medical equipment such as ventilators, heart monitors, dialysis machines, and infusion pumps, which play a vital role in saving the patient's life. A team of trained doctors, nurses, and specialists are available here 24 hours a day.

The patient is kept in the ICU when his condition is critical, such as heart attack, brain injury, multiple organ failure, or after major surgery. Continuous care and complex medical procedures are required to keep the patient's condition stable and ensure the effectiveness of treatment. This facility proves to be life-saving, but treatment in it can be expensive and it is used only when it is extremely necessary.