ICU – Myths and Realities
ICU / Critical Care unit is a specialty that involves the management of patients with life-threatening, frequently complex medical and surgical illnesses in a specialized Unit. Each year, Metro Hospital Intensive Care Unit (ICU) treats thousands of severely ill patients using a collaborative, multidisciplinary approach to care, under the leadership of qualified intensivist Dr Vijay Kumar Agrawal. A multidisciplinary team provides the depth and breadth of knowledge and expertise required to care for the wide array of illnesses and complex, multiple conditions seen in the ICU. The Metro Heart Institute with Multispecialty, Faridabad has 119 ICU beds. All beds are equipped with Multichannel physiological monitoring systems allowing close monitoring of patients both from the bedside and the central nursing station. World of ICUs are highly poised by Myths, but facts are different.
Hospitals admit patient to ICU unnecessarily – Every hospital is short of ICU beds, as it is meant for patients who are really sick and very critical so it is insane even to think so. Patients may not appear that sick but patients are admitted not only for treatment alone but for monitoring and observation purposes also.
Ventilators are of no use, they are to make money – Ventilators are used when a patient is unable / has less effort to breathe himself. In fact the real spanner of work towards creating ICUs’ was invention of ventilators. Modern day high end surgeries cannot be done without their support.
Ventilators are used even on dead patients – None of the ICU use ventilator on dead patient. A common myth in our society is considering a brain dead patient as dead patient. Actually brain death is “Irreversible Brain damage” with a functioning heart. In such patients ventilators can’t be removed, as it is legally not allowed, thus giving a false impression among attendants about misuse of ventilators.
All ICUS’ are same – No, lately medical fraternity has realized the need of intensive care. Earlier hospitals use to have one ICU for all patient, but now with better funding and general acceptance of critical care need, multi-specialty hospitals and tertiary care setups have critical care units for different specialties like Medical, surgical, Neurology, Cardiac ICUs etc.
Sudden loss of consciousness/seizure does not require ICU attention- No, it does. Concept of ICU is all about extended monitoring and care, which otherwise, is not possible elsewhere. Both situations, be it loss of consciousness/seizures are severe medical emergencies, which if not monitored properly may lead to permanent brain damage, paralysis or death.
Outcome of a comatose patient can be easily predicted in ICU – Not even God can do that. Our brain is such a complex machine that despite numerous studies and advances, we understand it hardly. A comatose patient can come back to senses either in a day or a week or month or year, no one can guess.
Physical Restrains are the method to control agitating / anxious patients – Restraining means to tie up. This is done to prevent self extubation or any other tubes / instruments may come out or may get damaged or patient may injure himself. Nuances of using physical restrains are higher, person becomes more agitated and might use full force to dismantle restrains. We personally feel physical restrains should be used rarely only when nothing else works.
Loads of similar investigations done daily, unnecessary wastage – Patients are in a critical state in ICUS’. A minute abnormality/disturbance in reports/investigations causes catastrophe, hence to avoid such conditions, tests are conducted repeatedly for correct and quicker treatment.
In the name of Infection, Attendants are allowed to see patient, only once or twice in 24 hours – Critically ill patients are fragile and often immune compromised i.e., susceptible to even slightest infection, hence it is for the patient’s benefit that less or even no contact is allowed.
Psychological support from relatives in ICU, is a waste of time – There are certain conditions, where patients are conscious but cannot be shifted from ICU. These patients may develop ICU Psychosis. To avoid this, attendants are often asked to actively communicate with them, even if they can’t speak, they may be able to write, or point to some objects/letters written on paper. Showing photo of beloved one’s, bringing favorite perfume or music, makes them feel connected and thus help them in faster recovery.