Intensive care: Patients' experiences

Emergency admissions to ICU

People are admitted to an intensive care unit (ICU) because they need intense support for failing organ systems, treatment, constant monitoring and frequent nursing care. In some hospitals ICUs are called intensive therapy units (ITUs) or critical care units (CCUs). Critical illness is different from any illness that most people are likely to have encountered before. It is often unexpected and sudden, and can strike the previously fit as well as the frail. It is often life-threatening, and high levels of treatment and support may be required, especially in the early stages. People with critical illness basically suffer from failure of one or more of their body's organ systems such as the heart, lungs, kidneys, liver, or even the brain. All of these organs work closely together in the healthy body, so it is not surprising that when one fails, others often follow. This is called multiple organ failure.

There are many reasons why people are admitted to an ICU - heart attack, stroke, poisoning, pneumonia, surgical complications, major trauma from road traffic accidents and burns are all examples of critical illnesses. People who have had major surgery are also sometimes admitted to ICU (see 'Reasons for admission: planned admissions'). Here people talk about the emergencies that led them to intensive care. For almost all of them, it was their first experience of being critically ill in an ICU and they were there because of an unexpected illness, surgical complication or accident. 

In ICU, patients receive constant care and monitoring by a highly specialised team, including doctors, nurses and physiotherapists, all of whom have specialist knowledge and skills. The ratio of nurses to patients is higher than on a general ward, and they provide round-the-clock care - each ICU patient is usually assigned his or her own 'named' nurse to care for them on each shift (see 'Nursing care in ICU'). 

One of the most noticeable things in ICU is the amount of equipment at each bed. At first, this often frightens relatives, especially seeing their loved one attached to the equipment and looking very different from normal. Most people in ICU need at least some help with their breathing, and this is provided by a machine called a ventilator ('breathing machine' or 'life support machine'). People remain in intensive care for varying lengths of time, depending on the nature of the illness. Some people need surgery, others are treated only with drugs. If the event that takes people to ICU is unexpected, they may not be aware of their condition until late into their stay. Some may recall pain, others don't, but it is common for people not to remember what happened - when they come round in intensive care they may not know where they are or how ill they've been. This is due to the illness as well as medications (see 'Coming round and regaining consciousness'). 

Emergencies treated with drugs

One of the most common reasons for people go into intensive care is severe pneumonia. Some people described having symptoms that were similar to a bad cold but, when their health deteriorated and they had difficulties breathing, they went to hospital and later into intensive care. Two people we spoke to had had pneumonia before but it hadn't been as serious. This was the first time they'd been admitted to ICU because of it. Some people who'd been admitted because of pneumonia also had septicaemia (sepsis/ severe sepsis). This is a serious infection, sometimes referred to as 'blood poisoning', which affects the circulation as well as the lungs

One woman had pneumonia and sepsis. She vaguely recalled what was happening before the ambulance arrived but couldn't remember getting to hospital. Another, who'd had a sore throat, knew something was wrong when she started having problems breathing. She also turned out to have sepsis, as well as a serious throat infection (epiglottitis). 

Another woman, who'd worked in intensive care as a nurse, described the activity around her when she was admitted to the ICU in which she worked. She was pregnant. She had septicaemia (blood poisoning) and septic shock. Septic shock is a life-threatening fall in blood pressure caused by severe sepsis. Sadly, her baby didn't survive.

One woman, whose child also died in intensive care, explained that her 14-month-old daughter had a rare form of meningitis.

Two men described feelings of numbness and weakness in their bodies until, eventually, they couldn't use their muscles. Both were diagnosed with Guillain-Barré Syndrome, a rare disorder in which the body's immune system attacks part of the nervous system causing severe weakness, including weakness with breathing. One man went into intensive care because of a severe asthma attack.

Emergencies involving surgery
Pancreatitis, an inflammation of the pancreas, is another common reason why people are admitted to intensive care. This man with pancreatitis went into intensive care twice. 

Some people went into intensive care because of complications during planned (or elective) surgery. One woman had complications during a hysterectomy but had no idea why she was in intensive care. 

Others deduced they were in intensive care because of their previous illness. One man had complications after bowel cancer surgery. Several people were admitted after complications for other bowel problems. This man experienced complications after knee replacement surgery and remembered very little about being in ICU. 

This woman, admitted because of complications after surgery to remove a brain tumour, remembered nothing about her intensive care stay. 

Occasionally, some women might have complications during pregnancy that mean they need to go into intensive care for close monitoring. 

Accidents

Some people were admitted to ICU because they'd had an accident. Two people discussed the road traffic accidents they'd had.

One man, who had an accident whilst working in the garden, remembered nothing about the actual accident and very little about his hospital stay. Like many people in emergency situations, family members, doctors and nurses have to fill in the gaps when the individual is well enough to take in the information. This man's wife explained that he'd fallen off a ladder whilst working in the garden and was unconscious when she found him. 

Another man needed intensive care because a dog bite had caused an extremely rare infection.

Last reviewed May 2015.

Last updated February 2013.

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