Critical Care Medicine - Medical School Crash Course

INTRODUCTION Critical care medicine is a medical subspecialty focused on treating patients with life-threatening illnesses and injuries. These patients are treated in special critical care units of the hospital, commonly referred to as intensive care units or ICUs. They often require mechanical and pharmacologic support to maintain organ system functions and close hemodynamic monitoring of their vital signs. ICUs have a low staff to patient ratio, allowing for close monitoring, complicated therapies, and quick intervention when required. Patients are transferred to these ICUs after initial stabilization in the emergency department, following surgeries, or from the hospital wards if their condition worsens. ICUs include the medical intensive care unit or MICU, the coronary intensive care unit or CCU, the neuroscience critical care unit or NCCU, the pediatric intensive care unit or PICU, the neonatal intensive care unit or NICU, and the surgical intensive care unit or SICU. Post operative recovery units are also considered critical care units since patients here are emerging from anesthesia and are at risk for a variety of post operative complications. Emergency departments also routinely care for these critical patients. In the emergency department, care is supervised by emergency physicians often with the support and assistance of the critical care specialists who will take over care when the patient is transferred to the ICU. Critical care specialists working in an ICU perform a variety of life-saving procedures including intubation and ventilator management, central venous catheterization, thoracostomy or chest-tube placement, and resuscitation during cardiopulmonary arrest. The most common pathway to becoming a critical care specialist is to complete a three-year internal medicine residency followed by a pulmonary and critical care medicine fellowship. Critical care fellowships may also be undertaken following a pediatric, surgical, emergency medicine, or anesthesiology residency. Some ICUs are staffed by anesthesiologists who have not completed an additional fellowship in critical care medicine.

The first recognized intensive care unit was developed in 1952 in response to a 2