Some hospitals have High Dependency Units (HDUs), also called step-down, progressive and intermediate care units. HDUs are wards for people who need more intensive observation, treatment and nursing care than is possible in a general ward but slightly less than that given in intensive care. The ratio of nurses to patients may be slightly lower than in intensive care but higher than in most general wards. Some hospitals have a combined ICU and HDU or a certain number of beds in ICU given to HDU patients. In these cases, although a person is not moved to another ward, the level of care is slightly reduced as s/he is no longer in such a critical state. People spend varying lengths of time in HDU, depending on the nature of their illness and the demands on the unit. Some hospitals in the UK have no HDUs, and in these cases people are usually transferred directly from intensive care to a general ward.
"Before a patient is discharged from intensive care, s/he should have another health check (called a short clinical assessment) to identify:
• any physical or psychological problems
• the likelihood of any problems developing in the future, and
• their current rehabilitation needs
• If the health check shows that the patient could benefit from more structured support, s/he should be given a more detailed health check (called a comprehensive clinical assessment) to identify their rehabilitation needs."
Intensive care refers to the specialised treatment given to patients who are acutely unwell and require critical medical care.
An intensive care unit (ICU) provides the critical care and life support for acutely ill and injured patients.
Unless you are an emergency admission, you will need a referral from your doctor or specialist to be admitted to ICU.
Who is cared for in ICU?
Patients may have a planned admission following surgery, an unexpected admission after an accident or be admitted because of a sudden and critical deterioration to their health.
ICU teams are multi-disciplinary, made up of highly skilled intensive care nurses, doctors and specialists trained in providing critical care for patients with a variety of medical, surgical and trauma conditions.
Some hospital ICUs specialise in providing care for particular health conditions or injuries including:
• major trauma
• severe burns
• respiratory failure
• organ transplants
• complex spinal surgery
• cardiothoracic surgery.
What to expect in ICU
ICU is one of the most critically functioning operational environments in a hospital.
Every ICU in a hospital has a different environment that will reflect the specialist medical and surgical procedures they perform.
Most ICUs are fairly large sterile areas with a high concentration of specialised, technical and monitoring equipment needed to care for critically ill patients.
The ICU environment can be confronting for some patients and visitors who may find the activity, sounds, machines, tubes and monitors intimidating.
When you visit someone you care about in ICU it can be an uncomfortable experience – you may feel helpless, overwhelmed, frustrated and sad. Your feelings and apprehension are understood by the staff that provide support for the people you care about.
Typically ICU also has a higher ratio of doctors and nurses to patients.
