Enfº Flávio Dias

Nurse Responsible for ICU
Intensive Care Unit

Intensive Care Unit

What is its purpose in a hospital environment?

HPA Magazine 19

Historically, it was during the Crimean war (1854 by Florence Nightingale) that the concept emerged of grouping the wounded according to the severity of the injury and degree of dependence, and placing those in the most critical condition close to the nurses’ stations and treatment preparation areas, where health professionals remained for longer periods, thus increasing surveillance and reducing the time lapse in emergency situations.
Later, Intensive Care Units emerged from post-anaesthetic Operating Theatre Recovery Rooms where patients were continuously monitored during the first hours after surgery, to guaranteed an immediate response when necessary, increasing the patient's surgical success rate and well-being throughout his hospital stay.

Over the years, the structure and organization of hospital services has evolved. 
Nowadays, it is indisputable that patients with greater hemodynamic instability need permanent and continuous surveillance, sometimes emergency medical care, specialized health care, procedures, techniques and treatments that are often more invasive. 
Of utmost importance is also the comfort and safety provided by a specialized and trained multidisciplinary team, who are always available to do more and better. All this is provided by an Intensive Care Units.
An Intensive Care Unit is a complex and specialized hospital service. The main objectives of an ICU are diagnosis, monitoring and treatment of potentially reversible acute diseases, where there is failure or risk of failure of one or more vital organs. A Hospital’s ICU is of enormous importance in the differentiation and development of a hospital unit for three main reasons:
> An ICU permits highly complex surgeries with a greater associated risk to take place, allowing for close monitoring and intervention in the event of any postoperative complications;
> Excellent care is provided for the critically ill patient in a controlled environment;
> Provides a safe hospital environment for everyone in the hospital (patients, visitors and employees), through the Intra-Hospital Medical Emergency Team. This team consists of a Doctor and an Emergency Nurse experienced and trained to act in an emergency, able to respond to any intercurrence or collapse that might occur within the hospital unit. In our hospital, this team is based in the Intensive Care Unit and is activated through an internal emergency phone extension number.
In a hospital with an Intensive Care Unit, all serious, sudden and unexpected clinical cases or those with a considerable and known epidemiological percentage for triggering intercurrences, can remain and be treated in the hospital, without the need for a hospital transfer as an only solution. Due to its complexity and specificity, the Intensive Care Unit is a hospital service with highly specialized management requirements, not only of medical equipment and infrastructures, but also of human resources. Due to life-threatening situations, a high level of professionalism and maturity is required from the multidisciplinary team.

An example of this is the Intensive Care Unit of the Hospital in Gambelas-Faro, inaugurated in 2009. This service has evolved over the years, always following the challenges proposed by the Administration, and also as a response to the growing number of patients who daily seek our medical services, as well as the need of the HPA Health Group to serve its community.  An example of one of these challenges is Cardiac Surgery, a complex surgical intervention that, south of Lisbon, is only performed in our hospital unit, filling this gap in the regions of the Algarve and Alentejo.
Our ICU has the capacity for 8 patients, for whom we provide medical care with professionalism, availability and safety. We have a whole set of differentiated means that allow, among other things, mechanical ventilation (invasive and non-invasive), high-flow oxygen therapy, hemodiafiltration (renal replacement), central venous pressure monitoring, intra-abdominal pressure, intracranial pressure in the neurocritical patient and continuous cardiac monitoring.
We take care of patients in the postoperative period after major surgery in medical specialties such as General Surgery, Neurosurgery, Cardiac and Thoracic Surgery, as well as patients in a serious condition due to a medical emergency who have sought medical care through our Emergency Unit available 24/7. With patients already hospitalized in one of our In-Patient Units, an Emergency situation may sometimes also be triggered due to a set of comorbidities and the patient’s clinical condition may deteriorate.  
However, admission to the Intensive Care Unit is not always synonymous of a serious clinical situation. Patients are sometimes admitted for close monitoring and surveillance in the initial   postoperative period.
The Specialized Team of professionals working in the Intensive Care Unit is committed and motivated to do better each day. The small turnover of professionals, the continuous training often together with ICU Nurses and Medical Assistants, the constant revision of action protocols and the enormous dedication of all its professionals, have all led to excellent final results together with the excellent feedback from our patients and families and on Clinical Accreditation of international prestige, granted by Joint Commission International. A heartfelt thank you to our team!