The Intensive Care Unit (IZ) or intensive therapy unit treats all patients with acute life-threatening conditions. Patients are also admitted to the department after major surgical procedures.
The need for intensive care is increasing worldwide. Some of the causes are the ageing population, the medical practice pushing its limits and a society making ever greater demands on the provision of care.
At the intensive care unit, patients are treated in optimal spatial and technical conditions. At the Jan Yperman Hospital, there are 14 isolated patient boxes that are identically equipped with state-of-the-art high-tech equipment.
A patient’s admission to the intensive therapy unit (ITE) is usually the result of a major surgical procedure, a serious illness or may be required after a trauma when continuous monitoring is required.
Patients enter intensive care because one or more of their organ systems is failing or at risk of failing. This may be the circulatory system (shock), the respiratory system (asthma, pneumonia), the heart (heart attack, cardiac arrest), the digestive system (gastric bleeding, bowel obstruction), the nervous system (brain trauma, epilepsy, coma)...
A hospitalisation is sometimes very unexpected and brings uncertainty about the future. The aim of the department is to help patients through a critical, sometimes life-threatening phase, so that they can recover from the underlying disease or operation.
The attending physicians at the ICU are anaesthetists-intensivists. In addition, a whole team of specially trained nurses is responsible for the constant monitoring of the patients. The intensivists work in close multidisciplinary cooperation with all other disciplines.
Patients in the intensive therapy unit are monitored. Heart rate, blood pressure, oxygen level and temperature are constantly measured. The monitor and other devices, such as ventilators (which take over the patient's breathing), dialysis machines (which take over the patient's kidney function) and so on, allow us to monitor the patient's condition and intervene accurately in case of unexpected problems.
At Jan Yperman Hospital, each patient is cared for in a separate box with a special 'intensive' bed. In addition, each patient has an alternating mattress (anti-bedsore mattress) aimed at pressure injury prevention. The vital parameters (pulse, blood pressure, respiration, etc.) are displayed on a monitor.
Medication and infusions are controlled electronically. All data is joined via a separate computer. This way, an overall picture of the patient can be obtained and 'tailor-made' care can be provided.
The heart rate of patients in a hospital ward can be followed on a monitor (telemetry) at the ICU. Some patients whose heart rhythm is too slow will have a temporary or even permanent pacemaker implanted.
Artificial respiration means that the patient’s breathing is completely taken over or supported by a ventilator.
The ventilator is connected to the patient’s endotracheal tube (breathing tube) or tracheostomy tube (tube in the neck) by means of the ventilation tubes.
Ventilation is necessary when the patient’s oxygen levels are too low to breathe alone, when the patient is kept sedated or when the patient is in shock.
Sometimes the patient may also receive temporary non-invasive ventilation (without a breathing tube). This involves using a face mask that is connected to the ventilator, which supplies oxygen and removes carbon dioxide. Depending on the patient's condition, they can eat, drink and talk. When the gas exchange is better, this form of ventilation stops.
However, sometimes the patient does not breathe or hardly breathes at all (due to exhaustion, coma...). The patient is then placed on artificial respiration and kept asleep (artificial coma). Newer ventilation techniques ensure that the lungs are not further damaged: this often requires applying ventilation when the patient is lying in the prone position.
Patients with kidney disease may be admitted to the ICU for conventional kidney dialysis (artificial kidney) or CVVH (Continuous Veno-Venous Hemofiltration), where the function of the kidney is supported or taken over 24 hours a day with the aid of high-tech equipment.
The cooling mattress is used in intensive care units for patients after reanimation or patients who have suffered severe head trauma after a fall, car or bicycle accident. The cooling mattress is a white wrapping mattress containing ice-cold liquids which help to lower the temperature of the patients.
The cooling mattress aims to improve the patient's chances of survival.
A ventricular drain (intracranial drain) is a narrow plastic tube located in the cerebrospinal fluid at the level of the cerebral ventricle. The drain is connected to a monitor and a receptacle. The ventricular drain monitors the pressure in the skull and ensure the drainage of excess cerebrospinal fluid. Intensive Care patients who have a brain trauma, brain haemorrhage, brain surgery or other conditions where the brain may swell, in most cases require an intracranial pressure measurement. If this pressure becomes too high, it can obstruct the flow of blood to the brain and cause brain damage.
A long-term stay in the intensive therapy unit may in some cases mean that behavioural changes such as agitation, confusion, fear and aggression occur during the admission.
Seeing a family member confined to bed can be harrowing. We have a low-restraint policy in our units and will restrain the patient as a last resort when the patient may put himself at risk.
As a department, we suggest appointing a contact person within the family or circle of friends. His/her phone number is noted in the file by the nurse in charge.
This person can request information by telephone 24 hours a day. And this designated contact will pass on the information to other family members or next of kin. This agreement is made to avoid misunderstandings when transferring information.
This person is also a point of contact for the nurses or doctors (e.g. when the condition deteriorates, upon discharge).
During each visit, the nurse in charge will speak to the family. If the family wants more information from a doctor, this can also be arranged.
As a standard measure, hygienic care is provided with a yellow apron and gloves. This is to prevent the spread of any disease-causing germs (fungi, viruses or bacteria) from patient to patient.
In most cases, the pathogen does not pose a risk to visitors and normal social contact with the patient is therefore allowed. In exceptional cases, the visitor should take precautions, but for most pathogenic germs disinfecting the hands when entering and leaving the room is sufficient.
Patients may also be isolated during their stay in the intensive care unit because of infections. This means that the single room may only be entered after strict precautions have been taken by hospital staff and (in exceptional cases) by visitors.
With this form of isolation, visitors should postpone any visits to other departments within the hospital for a while or visit the patient in the ICU first. Visitors who feel ill should not visit for a while to protect the patient.
For strictly hygienic reasons in the ward, it is not allowed to bring flowers or other gifts.