Intensive care medicine or critical care medicine is concerned with providing greater than ordinary medical care and observation to people in a critical or unstable condition.

People requiring intensive care include those after major surgery, with severe head trauma, life-threatening acute illness, respiratory insufficiency, coma, haemodynamic insufficiency, severe fluid imblance or with the failure of one or more of the major organ systems (life-critical systems or others). A life-critical system or safety-critical system is a system whose failure or malfunction may result in death or serious injury. ...

It is generally the most expensive, high technology and resource intensive area of medical care. In the United States estimates of the 2000 expenditure for critical care medicine ranged from US$15-55 billion. This is about 0.5% of GDP and about 13% of national health care expenditure (Halpen, 2004). 2000 is a leap year starting on Saturday of the Gregorian calendar. ...

Intensive care is only offered to those whose condition is potentially retrievable and who have a good chance of surviving with intensive care aid. Because the outcome of critical illness is difficult to predict, many patients will die in the Intensive Care Unit despite extreme measures to keep them alive and treat their underlying illness. People are not admitted to ICU with the intent that they die there.

Intensive care usually takes a system by system approach to treatment, rather than the SOAP (subjective, objective, analysis, plan) approach of high dependency care. The nine key systems (see below) are each considered on an obervation-intervention-impression basis to produce a daily plan. As well as the key systems Intensive care treatment also raises other issues including psychological health, pressure points, mobilisation and physiotherapy, and secondary infections.

The nine key IC systems are (alphabetically) -- cardiovascular system, central nervous system, endocrine system, gastro-intestinal tract (and nutritional condition), haematology, microbiology (including sepsis status), peripheries (and skin), renal (and metabolic), respiratory system The circulatory system or cardiovascular system is the organ system which circulates blood around the body of most animals. ... The vertebrate central nervous system consists of the brain and spinal cord. ... Major endocrine glands. ... For the Physics term GUT, please refer to Grand unification theory The gastrointestinal or digestive tract, also referred to as the GI tract or the alimentary canal or the gut, is the system of organs within multicellular animals which takes in food, digests it to extract energy and nutrients, and... Hematology is the branch of medicine that is concerned with blood and its disorders. ... Microbiology (in Greek micron = small and biologia = studying life) is the study of microorganisms, including unicellular (single-celled) eukaryotes and prokaryotes, fungi, and viruses. ... Kidneys viewed from behind with spine removed The kidneys are bean-shaped excretory organs in vertebrates. ... The respiratory system is the biological system of any organism that engages in gas exchange. ...

The provision of intensive care is generally administered in a specialized unit of a hospital called the Intensive Care Unit (ICU) or Critical Care Unit (CCU). Many hospitals also have designated intesive care areas for certain specialities of medicine, such as the Coronary Care Unit (CCU) for heart disease, Medical Intesive Care Unit (MICU), Surgical Intensive Care Unit (SICU), Pediatric Intensive Care Unit (PICU), Neuroscience Critical Care (NCCU), Overnight Intensive Revovery (OIR), Neuro/Neonatal Intensive Care Unit (NICU), Neonatal Intensive Care Unit (NICU), and other units, as dictated by the needs and available resources of each hospital. The naming is not rigidly standardized. For a time in the early 1960's it was not clear that specialized intensive care units were needed and intensive care resources (see below) were brough to the room of the patient who needed the additional nursing care and resources. It became rapidly evident, though, that a set location where intensive care resources and personnel were available provided better care than ad hoc provision of intensive care services spread throughout a hospital. The word unit means any of several things: The natural or usual or smallest measure of something, of which there are multiples and of which there may be fractions. ... A hospital today is an institution for professional health care provided by physicians and nurses. ...

Common equipment in an intensive care unit (ICU) includes ventilators to assist breathing through an endotracheal tube or a tracheotomy opening; 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), induce sedation, reduce pain, and prevent secondary infections. A medical ventilator is a device designed to provide mechanical ventilation to a patient. ... Intubation being practiced on a dummy (conventional technique using a laryngoscope) In medicine, intubation is the placement of a tube into an external or internal orifice of the body. ... Tracheotomy is a surgical procedure used to cut a hole in the trachea through which a small tube is inserted. ... In medicine, dialysis is a method for removing waste such as urea from the blood when the kidneys are incapable of this, i. ... Pharmacology (in Greek: pharmacon (φάρμακον) is drug, and logos (λόγος) is science) is the study of how chemical substances interact with living systems. ...

Physicians that practice in an intensive care unit historically have been the same physicians that care for the patient before transferring to the ICU. This is still commonly the case. In some hospitals there is a special group of physicians that staff the ICU, known as Intensivists, which is becoming an speciality. Whether the intensivist becomes the lead doctor or a consultant on a case is a matter of policy in each hospital. The speciality is unusual among the specialties of medicine in that their backgrounds may be Pulmonary, Anesthesiology, Internal Medicine, or other specialties. The reason for the high representation of Pulmonary and Anesthesiology is the need to be familiar with ventilator management.

References

1. Halpern: Crit Care Med, Volume 32(6).June 2004.1254-1259