Intensive Care Unit

Hospital facility for care of critically ill patients at a more intensive level than is
needed by other patients. Staffed by specialized personnel, the intensive care unit
contains a complex assortment of monitors and life-support equipment that can sustain
life in once-fatal situations, including adult respiratory distress syndrome, kidney failure,
multiple organ failure, and sepsis.
ICU care requires a multidisciplinary team that consists of but is not limited to
intensivists (clinicians who specialize in critical illness care); pharmacists and nurses;
respiratory care therapists; and other medical consultants from a broad range of
specialties including surgery, pediatrics, and anesthesiology. The ideal ICU will have a
team representing as many as 31 different health care professionals and practitioners
who assist in patient evaluation and treatment. The intensivist will provide treatment
management, diagnosis, interventions, and individualized care for each patient
recovering from severe illness.

Purpose
The purpose of the intensive care unit (ICU) is simple even though the practice is
complex. Healthcare professionals who work in the ICU or rotate through it during their
training provide around-the-clock intensive monitoring and treatment of patients seven
days a week. Patients are generally admitted to an ICU if they are likely to benefit from
the level of care provided. Intensive care has been shown to benefit patients who are
severely ill and medically unstablethat is, they have a potentially life-threatening
disease or disorder.
When patients are transferred to the ICU from another hospital department,
treatment orders and planning must be reviewed and new treatment plans written for
the patient's current status. For example, a chronically ill inpatient may grow markedly
worse within a few hours and may be transferred to the ICU, where the staff must
reevaluate orders for his or her care.

Description
ICUs are highly regulated departments, typically limiting the number of visitors to
the patient's immediate family even during visiting hours. The patient usually has
several monitors attached to various parts of his or her body for real-time evaluation of
medical stability. The intensivist will make periodic assessments of the patient's cardiac
status, breathing rate, urinary output, and blood levels for nutritional and hormonal
problems that may arise and require urgent attention or treatment. Patients who are
admitted to the ICU for observation after surgery may have special requirements for
monitoring. These patients may have catheters placed to detect hemodynamic (blood
pressure) changes, or require endotracheal intubation to help their breathing, with the
breathing tube connected to a mechanical ventilator.

In addition to the intensivist's role in direct patient care, he or she is usually the
lead physician when multiple consultants are involved in an intensive care program. The
intensivist coordinates the care provided by the consultants, which allows for an
integrated treatment approach to the patient.
Nursing care has an important role in an intensive care unit. The nurse's role
usually includes clinical assessment, diagnosis, and an individualized plan of expected
treatment outcomes for each patient (implementation of treatment and patient
evaluation of results). The ICU pharmacist evaluates all drug therapy, including dosage,
route of administration, and monitoring for signs of allergic reactions. In addition to
checking and supervising all levels of medication administration, the ICU pharmacist is
also responsible for enteral and parenteral nutrition (tube feeding) for patients who
cannot eat on their own. ICUs also have respiratory care therapists with specialized
training in cardiorespiratory (heart and lung) care for critically ill patients. Respiratory
therapists generally provide medications to help patients breathe as well as the care
and support of mechanical ventilators. Respiratory therapists also evaluate all
respiratory therapy procedures to maximize efficiency and cost-effectiveness.

History
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), Bjrn Ibsen established the first intensive care unit in
Copenhagen in 1953.[1] The first application of this idea in the United States was
pioneered by Dr. William Mosenthal, a surgeon at the Dartmouth-Hitchcock Medical
Center.[2] 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.

Ref:
http://en.wikipedia.org/wiki/Intensive_care_unit
http://www.answers.com/topic/intensive-care-medicine
http://www.cpmc.org/learning/documents/icu-ws.html#What%20is%20the%20ICU
%20%28Intensive%20Care%20Unit%29