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Critical care medicine is the healthcare specialty that cares for
patients with acute, life-threatening illness or injury. Nearly 80
percent of all Americans will experience a critical illness or
injury, either as the patient, family member or friend of a
patient.
Critical care can be provided wherever life is threatened - at the
scene of an accident, in an ambulance or med-evac helicopter, in a
hospital trauma center or emergency room, or in the operating
room. Most critical care today, however, is delivered in highly
specialized intensive care units (ICUs) and trauma centers.
Multidisciplinary teams of highly experienced physicians, nurses,
respiratory care technicians, pharmacists, dieticians and other
allied health professionals provide comprehensive care for these
critically ill patients. This team uses their unique expertise,
ability to interpret important therapeutic information, access to
highly sophisticated equipment, and the services of support
personnel to provide care that leads to the best outcome for the
patient.
Patients are rarely admitted directly to the critical care unit.
Rather, they are usually admitted from the emergency room,
operating room or hospital rooms where they are first given care
and stabilized. The continuum of critical care begins at the
moment of illness or injury and continues throughout the patient's
hospitalization, treatment and subsequent recovery
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Typical examples of critical illness include heart attack,
pneumonia, poisoning, complex or prolonged surgery, surgical
complications, premature birth, and stroke. Critical care also
includes trauma care - care of the severely injured – from any
cause.
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Critical care refers exclusively to the treatment of patients who
suffer from life-threatening conditions. Emergency room physicians
and nurses treat patients who suffer from relatively minor
emergencies (sprained ankles, broken arms) to those with major
problems including heart attack, knife or gunshot wounds or drug
overdoses. In the Emergency Department, physicians and nurses
stabilize patients and transfer them to the ICU for further
treatment. The long-term management of critically ill and injured
patients is provided by critical care professionals in the ICU.
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An intensivist is a specialist physician with additional
sub-specialty (fellowship) training, or equivalent qualifications,
in critical care medicine. An intensivist directs the care of
critically ill patients and works in collaboration with other
health care professionals necessary for the care of patients in
critical care units.
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Mechanical ventilation is the method of using machines to help
patients breathe when they are unable to breathe sufficiently on
their own. Most often, mechanical ventilation is used for a few
days or weeks to help a patient breathe during a serious illness.
This type of breathing support is usually done in an intensive
care unit.
Sometimes patients still can't breathe on their own after the
acute illness is over, despite efforts to restore spontaneous
breathing. Patients may no longer need to be in the ICU but still
require mechanical ventilation because of an extended need for the
breathing assistance of the ventilator. Other patients may have
stable, longer-term (chronic) conditions that make them unable to
breathe on their own.
Due to a variety of reasons, including the patient's quality of
life, for the patient who is dependent on a ventilator for
breathing assistance, it may be better to receive mechanical
ventilation at home or at a non-hospital institution offering
specialized nursing and rehabilitation services.
Over time, with professional support, some ventilator-assisted
individuals are able to become less dependent on the ventilator
and breathe on their own for substantial portions of every day.
Other patients may have medical conditions that require 24-hour
mechanical ventilation for many months or years, or even for a
lifetime.
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