A History of Intensive Care

The first intensive care unit was established in the UK in 1966, but the foundations for our specialty were laid many years earlier

1546

The first successful tracheostomy performed on a human is recorded by Antonio Musa Brassavola. His account says the patient not only survived, but made a full recovery (1).

1733

The first central vein catheterisation is performed by clergyman Stephen Hales using a vertical glass tube. His patient is a horse, rather than a human, and the blood reaches more than eight feet. Further work by Hales and  others goes on to describe blood pressure in different animals.

1850

During the Crimean War, Florence Nightingale organises patients so that those most unwell, and therefore requiring the most intensive nursing, are located nearest the nursing station.

An illustration of patients being treated in a 19th century war setting
Source: National Army Museum

 

1923

Johns Hopkins hospital in Baltimore creates a postoperative care unit for neurosurgical patients. This unit is staffed by specialist nurses and anaesthetists.

1929

The first devices for performing central vein catheterisation are used clinically in humans.

1950s

To treat children with Polio, Boston Children’s Hospital designs a very large negative pressure ventilator that can accommodate four children simultaneously.

1952

The poliomyelitis epidemic hits Copenhagen and those requiring respiratory support are placed inside an iron lung. But, when the hospitals become overwhelmed, patients are hand ventilated by medical students via tracheostomy tubes. The students are paid £1.50 per day.

Two doctors ventilating by hand a patient in a hospital bed. They wear white lab coats and the photograph is black and white

 

1953

In December, Bjorn Ibsen sets up the first intensive care unit. It's in Copenhagen, and is established to care for polio patients.

1959

A critical care unit is established at the University of Pittsburgh. It is the first to include the constant presence of critical care physicians.

1966

Mead Ward Intensive Care Unit is established at St Thomas’ Hospital in London. It is the first of its kind in the United Kingdom.

1970

On 8 June the Intensive Care Society is founded. Our first Council Meeting is held in 1973, and in 2020 we celebrate our 50th birthday in the middle of the COVID-19 pandemic.

1994

Intensive Care National Audit and Research Centre (ICNARC) is established, to help ensure the best experience of critical care for both patients and those who care for them (2).

2010

The Faculty of Intensive Care Medicine (FICM) is created.

2012

A stand-alone training programme for Intensive Care Trainees is initiated in the United Kingdom.

2020

COVID-19 sweeps through populations around the globe, fundamentally changing the way we live. Of those COVID patients admitted to hospital in the United Kingdom, one in six are treated in intensive care. In January 2020 there are fewer than 4000 intensive care beds across the country. In January 2021 there are 6099 occupied intensive care beds in the UK.