KATHMANDU: Following the Coronavirus pandemic, the importance of the Intensive Care Unit (ICU) has significantly risen.
Moreover, an increasing number of individuals have developed curiosity about the functioning of ICUs.
Therefore, it is essential to understand the role of ICUs, the types of patients suitable for ICU care, the appropriate stage for admitting a patient to the ICU, the treatment procedures involved, and the rationale behind the restrictions on visiting ICU patients.
Addressing these aspects, Dr. Pravesh Sundar Shrestha sheds light on these matters in an edited excerpt from a conversation:
What is the ICU?
ICU is an abbreviation for Intensive Care Unit. Within the human body, there are numerous organs, and illnesses that impact these organs—such as lung pneumonia, gastrointestinal issues, or neurological complications—often necessitate admission to the ICU.
These illnesses progressively impede the normal functioning of the affected organ, leading to what medical terminology refers to as “progressive failure.”
This condition significantly compromises the patient’s health. To address this, the non-functioning organ requires assistance and support.
Patients afflicted by such conditions are managed within the ICU, which stands for Intensive Care Unit.
Is there a higher risk associated with ICU treatment?
There seems to be a common belief that the risk escalates significantly once a patient enters the ICU.
However, this perception can be simplified. The mere act of entering the ICU doesn’t immediately place a patient in imminent danger.
The decision to admit a patient to the intensive care unit is driven by the severity of their illness.
Within this critical care setting, medical professionals can closely monitor the functioning of the patient’s organs, providing valuable insights into their condition.
This proactive approach allows for the early identification of issues and the potential prevention of further complications.
By promptly detecting any organ dysfunction and promptly providing the necessary support, the patient’s overall prognosis can be vastly improved.
When a patient is admitted to the ICU, they receive the utmost level of care and attention.
This approach has been proven to yield the most favorable outcomes.
The presence of a patient in the ICU contributes to a reduction in the mortality rate associated with various diseases.
Therefore, ICU treatment significantly enhances the quality of care a patient receives and increases their chances of a successful recovery.
How is patient care delivered upon admission to the ICU?
In the modern healthcare landscape, the ICU is staffed with both intensive care physicians and critical care physicians.
An ICU specialist assumes the responsibility of overseeing the care within the ICU environment.
It’s important to acknowledge the vastness of the medical field, where each expert carries their own significance.
Consequently, a collaborative approach is paramount, with the patient benefiting from the collective expertise of the medical team.
Upon a patient’s arrival in the ICU, their treatment journey is tailored to their specific condition.
For instance, if a patient presents with a lung ailment, a pulmonologist takes charge of their care.
Similarly, if gastrointestinal issues are at play, a gastroenterologist steps in.
Furthermore, the ICU doctor coordinates the management of patients requiring assistance from artificial organs.
As medical complexities often intertwine, a multidisciplinary approach is adopted.
If a patient’s initial lung problem gives rise to subsequent kidney complications, a nephrologist becomes part of the team to ensure comprehensive and integrated care.
In this collaborative effort, alongside the ICU physician, the role of the nurse is equally pivotal in providing attentive and well-rounded care to the patient.
What types of ICU treatment should be available in hospitals?
ICUs are categorized into three labels: Label 1, Label 2, and Label 3, each indicating the level of resources, medical personnel, monitoring capabilities, and equipment available within that unit.
This classification helps gauge the ICU’s capacity to provide care.
For instance, in less developed areas, Label 1 ICUs cater to general care, while central hospitals offer the comprehensive services associated with Label 3.
This hierarchical approach ensures that patients receive treatment in line with the resources and expertise available at a particular medical facility.
How many medical staff should attend to patients in the ICU regardless of their condition?
A minimum of two to three doctors should be present in the ICU round the clock to ensure continuous care. If necessary, additional specialists can be consulted for specific treatments. Nursing staff must be available both for patients on ventilators and those who are not. In the case of Label 3 ICUs, each patient is attended to by a dedicated nurse. Furthermore, these units offer an array of services including specialized care, physiotherapy, and nutritional support. Patients are also referred for further treatment as required.
What leads to ICU patients requiring ventilator support?
In the ICU, our primary goal is to sustain adequate oxygen levels within the patient’s body.
However, if oxygen therapy fails to achieve this, and the condition of the patient’s lungs deteriorates to a critical point, the need for artificial ventilation arises.
Ventilator support becomes crucial for patients dealing with severe lung infections, as it assists in maintaining proper lung function.
It’s worth noting that even patients with neurological issues may require ventilator support, regardless of the state of their lungs.
Why are relatives restricted from visiting patients in ICU or on ventilators?
With the growing awareness within society, it’s important to consider the well-being of ICU patients who often have compromised immune systems.
Allowing visits from relatives introduces the risk of potential infections and additional complications, given the patients’ reduced immunity.
Consequently, to prevent the transmission of infections, it becomes necessary to restrict patient visits.
The limitation on meetings in the ICU is imposed to minimize the potential for infections being brought in by external individuals.
It’s recommended to wait until the patient has recovered and been transferred to a general ward before considering visits, in order to ensure their safety and optimal recovery.
What are the expenses associated with ICU admission?
While health insurance provides coverage in many countries, the situation in Nepal differs.
Here, insurance may not fully cover all the expenses incurred during an ICU stay, which can encompass various medical treatments and investigations.
Consequently, the financial burden can be substantial. To address this, we engage in daily counseling sessions, discussing the costs and the necessity of the treatments involved.
It’s important to understand that the expenses can accumulate significantly, underscoring the importance of carefully considering the required treatment options.
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