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.
Because of his pneumonia and chest pains, he was admitted to intensive care where doctors could...
How were they giving you the antibiotics and painkillers?
The antibiotics at first were given orally, and after a while that was through a vein.
So it was pneumonia that was causing real chest problems, when you had the pain in your chest at home?
Yeah it was starting.
So then they realised it was pneumonia, did they?
And it was at that point you went to ITU?
Well, that's it. They were trying to treat it. They were trying to treat it on the ward because on a previous occasion when I went into hospital, and I caught a bout of pneumonia as well, and they managed to treat it on the ward. But on this occasion the pain and the pneumonia was so bad they decided it would be better for me to be put into the Intensive Therapy Unit, where I could be watched more closely.
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').
He remembered the conversation he had with his wife before he was sedated in intensive care but...
And I was opposite a lady of about 75 years of age in Intensive Care, who also had pneumonia, and she had obviously had some form of difficulties. And subsequently she managed to survive her treatment and had come out of it in such a way that she seemed to be on an overhead ventilator, from my recollection. And I said to my wife, "Tomorrow, when you come back in, I'm going to look like that." Now that's not necessarily the case, but that's how matters actually felt.
Subsequently I was informed that I would be sedated, which I can recall. I can recall that I was told that I would have to lay very still to have a long needle, for want of a better term, inserted into one of my veins in my neck. And I expressed concern at that point in time because they advised me that I had to stay still for ten minutes, and I couldn't actually stay still without coughing for about thirty seconds. They obviously sedated me at that point in time, and inserted the needle. And that is the last I can really recall for something like twelve to fourteen days.
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.
Her family were all at the hospital when they found out she was critically ill, and she later...
And it remained that way for I think probably a good sort of six or seven days while they threw every single antibiotic they had in the cupboard at me. And desperately tried to work out what it was that was wrong with me because obviously when you go in and present like that, they don't know what it is specifically that you've got wrong with you. And in the end they worked out that it was a fairly common strain of pneumonia that I just had a very bad severe reaction to. But I know none of, you know I knew none of all this obviously. And I was just sort of out for the count.
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).
She didn't feel ill or have pain but a serious throat infection and sepsis caused her breathing...
And he did take photographs and he showed them to me and he said, "That's your throat." He said, "This, that little black dot there, that's your airway." He said, "This is closing up. I think you've got epiglottitis. I need to speak to my consultant." So he went and spoke to his consultant.
But it was obviously far worse than that and it was obviously far more overwhelming. And I mean subsequently I know that I had two things. I had this infection of the throat, which had closed up my airway, but I had sepsis as well. And my bloodstream and my organs were being affected by this enormous infection that I had in my bloodstream. But I didn't feel ill in what I would have thought that I would have felt [laughs]. I didn't have any pain, I didn't feel any pain. I didn't feel ill as such.
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.
She had heard doctors discuss what was happening to her and saw the shock on the doctor's face...
Then I remember the Consultant coming down from Intensive Care who was on call and I knew who it was, I couldn't see him, but I heard his voice so I knew which Consultant it was and I heard him on the telephone asking for another Consultant to come down. They didn't even realise that it was me that they were coming to see, when the other Consultant arrived I could see him. My vision had come back at that point, so I could see him and I just remember his face, he was just in total shock and I could see from people's faces in the room that things were getting worse.
At one point I just could not breathe, I could feel my lungs filling up with fluid and I remember panicking at that stage. Even though people were trying to reassure me all the time, I knew that things were getting worse. I remember saying to the Consultant Obstetrician at one point, "Have I got septic shock?" And he said, "No, no, no, everything's fine."
One woman, whose child also died in intensive care, explained that her 14-month-old daughter had a rare form of meningitis.
Her daughter was transferred from a local to a city hospital to have tests and treatment in a...
So they said they wanted to do a brain scan on her, but because she was so little and she wouldn't keep still they needed to ventilate her. And being a registered nurse I realised what that would entail. And they said that they couldn't care for a child on a ventilator at the local hospital, so they're going to have to transfer her out of that hospital. So I said, "Okay, that's fine." So I said, "Okay, so where is she going to go?" And they said, "To Hospital A or Hospital B, whoever's got an available bed." I thought, "That's fine, that's fair enough."
'And they were very good because they didn't let, not that they should have let on that something was wrong, but they never let on that anything was wrong. And it was the doctor that, when my husband got there he told us, the doctor took us into a room and she told us. And I remember listening to her but I didn't understand what she said for a good thirty seconds. And then I just said, 'My baby's dead.' And we just couldn't believe it. And they left us alone for a while and then we went back to see her.
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.
He remembered an asthma attack coming on but nothing else until he came round in ICU three days...
I do not remember making the telephone call. I must have made it but the memory, call register on the mobile phone doesn't come up with 999 calls, when I checked it didn't come up. I do not remember the ambulance arriving but I've been told by Resuscitation that I was outside ready for it. I cannot tell you whether I walked on to the ambulance or whether I was carried on.
I do not remember arriving at the hospital. I'm told that the ambulance crew, when they first arrived, were not particularly concerned, but when I had arrived in hospital I had actually stopped breathing. So the next thing I actually remember, I mean we were talking about, this was 3 o'clock on a Tuesday morning, the next thing I remember was 5 o'clock on Friday morning, when I came round in Intensive Care. And I remember the green-uniformed nurse standing above me.
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.
After his first stay in an ICU he was transferred to another hospital for surgery and ended up...
And then I think I actually recall when I was on the trolley being taken to Intensive Care, that I was going there, but again that could be just my memory playing tricks. And then the next thing I remember is actually coming round about thirty odd days into my stay, being told that I was in Intensive Care. That was the actual first time but later on in February two thousand and two I went, I'd already been transferred to another hospital by then. I had more idea that I was going to Intensive Care because I'd been transferred up there for an operation.
The whole period it was from, as I say, from November the third straight through to the next year to June.
For the operation?
Yeah well I was, as I say, the first hospital I spent two and a half months until I got transferred up to the second hospital a month before I had the operation and then three months in the ward. So the actual overall stay was seven and a half months.
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.
She recalled being ill and a vague conversation with medical staff about what was wrong, but wasn...
They did explain very well then, once I was round properly. The nurses and the doctors came to see me and explained exactly what had happened, what had gone wrong with the original operation, why I'd ended up in Intensive Care, that my lungs had collapsed and that's why I was on a ventilator.
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.
He vaguely recalled being on the ward before having surgery and then coming round in intensive care.
We went home, got the call, went in the ward on the Sunday night. Got up Monday morning, just pottered about. Went down, I think about 2 o'clock in the afternoon and, as I said, I don't remember anything until I woke up in ICU, the following day, what time of day, I do not know.
And they said that you are going back to the ward, which they did. And I remember, well I don't remember but I arrived at the ward. Now whether it was a Tuesday or the Wednesday, I'm still not sure. But anyhow, I got back to the ward about midday, and in the afternoon I wanted to go to the toilet, which I went because they took me in a wheelchair. I was in there for a rather long time. I don't remember pulling the cord, but I know then that two or three of them come in and asked if I was all right. And by that time I was not. And I just do not know what happened after that.
This woman, admitted because of complications after surgery to remove a brain tumour, remembered nothing about her intensive care stay.
She only knew what had really happened because she was given a diary of her time in hospital.
So like the operation was the 20th of January but on the 31st of January the surgeon came round and said I'd be able to go home in a couple of days. And I took myself off to have a shower and shampoo and, while I was in there, I suddenly felt very breathless and I had to pull the cord and I managed to open the door and shout "Wheelchair, oxygen". And I can't remember anything after that, but in fact I had written that in my diary but that's what I said.
I was then transferred to the Intensive Care Unit in [hospital name]. And then eventually I was transferred to [hospital name] on the 19th of February. I was transferred to a medical ward on the 15th of March and then eventually transferred to [hospital name] which was the rehab on the 31st of March.
Occasionally, some women might have complications during pregnancy that mean they need to go into intensive care for close monitoring.
She had a planned caesarean but had complications after delivering her healthy baby.
So half way through I realised I couldn't breathe properly so I said to the anaesthetist, "I'm finding it difficult to breathe." So she was like, "ok" and then she gave me an oxygen mask to help me breathe. By this time my son had been delivered, no problems delivering him and I think the nurse had him in the corner. I could see him getting wiped down and everything. My husband was over there and they were still getting on with probably trying to, I thought, trying to stitch me up and get me off the couch or whatever. So, and then I could hear my son crying. They showed me my son when they delivered him and he was crying and he looked well and he was big, 7lbs 9oz.
And so, as I said, I said to the anaesthetist, "I can't, I'm finding it difficult to breathe." There must have been a few, by this time I was losing a lot of blood because they couldn't stop my bleeding so there must have been a few faces sort of thinking, we're in trouble here, you know we're can't stop her bleeding.
Thursday morning the consultant, the ITU consultant and the consultant that done the operation and another consultant who's also an obstetric gynaecologist came up to me and they began to tell me what happened. So she began to explain that what had happened was that I'd had a placenta accreta which they didn't even know. I'd had quite a lot of scans because of complications I had because of sickness and him being breached but they didn't pick up that that was happening. And she said that's quite normal. Sometimes you know, it will take a very good technician to pick up such a thing and it can be missed.
Some people were admitted to ICU because they'd had an accident. Two people discussed the road traffic accidents they'd had.
She had vague memories of having a car accident and a scan in hospital, but learnt more about...
And everything goes sort of very, no timescale whatsoever. And then I don't know whether I was in an assessment ward for a while before I went into Intensive Care or whether it was sort of straight into Intensive Care. I can remember being taken, put into, I don't know what it was, some sort of scanning machine I suppose, where I had to hold my breath until I was told I could breathe again. And then they told me what injuries I'd got and that there was a possibility that I'd ruptured my intestine, but they weren't sure, and they'd have to wait and see. And it turned out that I had.
Yeah. What had happened? People told you afterwards, talked to you about what happened, you were driving and?
Yes, it would appear that for whatever reason I veered on to the wrong side of the road into the path of the oncoming vehicle, and it was a more or less head-on collision. But, as I say, I don't actually remember the accident.
He had an accident riding on his motorbike but remembered nothing of his time in intensive care.
I would have got away with it but because of what happened, it was a stupid thing to do. I was always a competent rider. I always have been a competent driver. I've respected other road users and I find it very difficult to put myself or recollect being in the position that I overtook those three vehicles. There was nothing wrong in overtaking the vehicles. I understand they were travelling at about 45 miles an hour and I overtook keeping within the speed limit according to the witnesses. I overtook at about 55, 60 miles an hour.
I'd got up the, from what I can recollect because I got in front of the lead vehicle and a young lad on a scooter decided to do a U-turn in my path and I had, there was no where to go. There was no distance between him and the car in front for me to avoid him. I just ploughed straight into him.
I have no recollection of the accident. I understand there was a helicopter hovering above. Paramedics were there. Evidently two people who were, I presume in the vehicles, lifted the bike from me and in doing so I presume they extracted the cycle stand from the back of my ankle.
And, like I say, I have no recollection of the accident, only the pain and then punishment afterwards.
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.
She vividly recalled finding her husband in the garden and calling for an ambulance.
It was cloudy, it was cold, and there was a hose that was running. And I suddenly realised from the colour of his clothing that he was completely drenched. And then I saw the ladder on the side, by his side. And I immediately put two and two together and realised and rushed outside. And then fortunately there was no ill effect of what I then did. Because I mean, like a lot of people, I've done a St John's Ambulance course, and you know what to do as first aid. But when you see your husband lying there, all that goes out of your head and so you immediately rush there. And then, you know, I immediately picked him up, you know, sort of off his back and cradled him. And of course that's the last thing I should have done.
Thankfully there was no, you know, permanent damage from that at all and it didn't have an impact on his rehabilitation. And of course then immediately rang the ambulance, who were here within ten to twelve minutes. And we were very fortunate.
Another man needed intensive care because a dog bite had caused an extremely rare infection.
He often took his daughter's dogs for a walk but on this occasion a little bite led to a serious...
Last reviewed August 2018.
Last updated February 2013.