Critical care has been defined as the provision of sophisticated life support system, with appropriate medications for a wide variety of patients, in a setting of close monitoring.
Intensive care unit is a nursing unit specially designed, equipped and staffed to manage critically-ill patients with potentially reversible lesions, requiring constant observation, irrespective of age, sex and diagnosis, and requiring extraordinary nursing care.
It is a nursing unit where intensive monitoring, active life support, specific therapy and specialised nursing care are provided, where technical expertise and sophisticated equipment are concentrated for critically-ill patients.
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The aim is to support life in a crisis, prevent life-threatening conditions, and then try to remove the cause of dysfunction by specialised treatment and skilled nursing.
Contrary to popular belief, ICU is a place and not a form of treatment, as many lay persons tend to believe.
At present intensive care facilities are not available in all hospitals. Very few of even the Government district level hospitals have a proper ICU. However, the need for an ICU in all hospitals has been realised by clinicians and administrators alike.
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Where it is not possible to provide a modicum of reasonable care for critical illness in medium sized intermediate level hospitals, say up to a district hospital level, then it can be achieved by providing a better staffed and better equipped high-dependency ward in every district hospital.
These wards would not qualify as critical care units but could offer better care, with improved results at smaller cost.
Reason demands that well-equipped critical care units should be confined to medium and large hospitals which have the infrastructure to support such units. It would also be wiser and profitable to organise general all-purpose intensive care units in different specialties and subspecialties.
A multidisciplinary ICU permits concentration of meagre resources with regard to staffing, equipment and technical expertise.
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Above all, it encourages a more holistic approach, so that problems in the critically-ill are considered in an overall perspective rather than in terms of disease affecting isolated organ systems.
An intensive care unit has its own advantages and disadvantages. The chief advantage is that it provides better and more organised care. The main disadvantage is of a holistic environment contributing to anxiety, emotional stress, loneliness, fear, and a greater risk of developing nosocomial infections.
Crises in ICU arise mainly because many people presume that every medical problem has a solution and the expectation from the hospital to do everything possible, which unnecessarily raises the cost of ICU care.