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Being in intensive care
Admission to intensive care is reserved for seriously ill patients who, by virtue of their condition, require invasive treatments to save their lives.
It can take an hour or more following admission to intensive care to start treatment to endeavor stabilise your illness. You might still be recovering from your anaesthetic following surgery or you may have been sedated and put on a breathing machine as the first stage in your treatment.
After this initial period visitors are usually welcome at the bedside and will, in all probability, see various pieces of medical equipment connected to you. There will be a high level of activity around the clock.
Noise levels are likely to be higher than on a general hospital ward. Some of this is down to the equipment which, to promote your safety, may alarm frequently. If you hear an alarm it doesn't necessarily mean anything's wrong, just that there's something the staff need to be aware of or attend to.
Staff will explain the equipment and noises if you are awake and have concerns.
The first few hours on intensive care are often a very unstable time and your condition can change from minute to minute. Even if you are sedated one of the team is likely to summarise what has happened so far and what they are expecting in the next few hours.
If you are awake, or when you come round from the sedation, don't be afraid to ask questions as soon as you feel able.
It is important for your relatives to focus on your needs; they need to be supportive and positive. You may be confused or bewildered because of your condition or the sedative medication. It will reassure you and help your recovery if your family explain what has happened to you.
While sedated, it may be difficult for you to think clearly. Sometimes the medication may change your perception of what is happening and you may seem angry, hostile, or just different. You will find that some days are good and some are bad as your condition changes. Concentrate on the good days and view the bad days as hurdles that can be overcome.
Try not to become discouraged and keep a positive outlook. It is not uncommon for you to feel you are getting worse before you get better.
Hallucinations, delusions and nightmares
Patients vary as to how much they remember of their stay in intensive care. Some remember nothing at all, some remember very little, but most patients can recall the days immediately following the removal of the breathing tube (extubation), although these memories are fragmented. Patients can often remember unreal experiences in detail - particular objects, individual nurses and important emotional experiences.
Some of these experiences may be described at a later date, often based on a misinterpretation of events going on around them at the time. The experience may have been frightening, pleasant or simply very peculiar.
You should not be afraid to discuss these experiences with the nurses and it is very rare that they recur after recovery.
Poor recall and loss of memory are due to a combination of the type and severity of the illness, drug treatment and other factors that are, as yet, not understood completely.
Feeling weak and loss of weight
During your stay in intensive care, you may lose weight and muscle tone. Joints may also be stiff due to the long time spent in bed and there may be some loss of sensitivity in the fingers and other small joints. These problems can be quite distressing, but, as you become more active, muscle weakness and joint stiffness will improve as part of the recovery process.
Muscle weakness and joint stiffness will improve when you recover
Physiotherapy will help you to regain your physical strength and that of your lungs if you have needed a breathing tube.
Even though you are getting better, you may feel anxious and depressed about the effects of being critically ill. This is an understandable reaction and you can help by talking to the staff and your relatives about your feelings.
Transfer to another hospital
Sometimes you may need be transferred to another hospital because it has the very specialised care which you require. This should be done during the day whenever possible, although it may, because of a sudden emergency, occur during the evening or night.
The decision to transfer is always made by the most senior doctors and nurses and all transfers to another hospital must be carried out strictly in accordance with nationally agreed procedures to safeguard your well-being.
Advances in medical knowledge and treatment have been brought about through research and the practice of medicine today is based on evidence of what works.
There are always a number of research trials being undertaken in intensive care units throughout the country into different aspects of medical care all of which have to be approved by an independent ethics committee of outside experts.
Patients, and increasingly relatives, are asked to take part in research trials. Intensive care units have staff who supervise trials and they will seek patients’, and sometime relatives’, approval to take part in an approved trial.
Taking part is entirely voluntary and no one is under any obligation to consent. Even after giving consent withdrawal can take place at any time.
The full details of any trial will be explained by the staff in the unit who are co-ordinating it.