Medical ICU(MICU)-Critical Care
A number of our pulmonary physicians are experts in the care of patients who are in the Medical Intensive Care Unit (MICU). Generally these patients are severely ill, and require intensive, round-the-clock care from a highly trained group of doctors, nurses, and other healthcare professionals.
Information for Families
Families play a very important role for patients in the MICU. At the same time, our patients require rest to regain their strength and enhance healing. We will do everything to make your visits beneficial for you and your loved one. We ask that you:
- Assist us with encouraging rest for the patient;
- Avoid visiting if you are sick;
- Discuss visiting by children in advance with the ICU Nurse or Physician;
- Refrain from eating or drinking and using cell phones in the ICU.
We also provide family support for those that need it. The physician, RN, and other regular MICU staff are available along with social workers, patient representatives and clergy.
Infection Control: Please help us prevent infections by observing precautions posted on doors and walls, following nurses’ instructions, and washing your hands before a visit.
Sounds and Alarms: Alarms should not make you anxious. They alert staff who are trained to respond appropriately.
Sepsis develops when a high number of infectious agents enter the blood stream, often from a burn or open wound, pneumonia, or a urinary tract infection. Symptoms of sepsis include fever, pale skin color, changes in a mental status, and increased heart rate. Untreated, sepsis can be fatal.
While sepsis is on the rise in the United States, affecting nearly a million people annually, the Division of Pulmonary, Critical Care and Sleep Medicine led by Division Chief Charles A. Powell, MD, have been successful in implementing a program to diagnosis and prevent sepsis. This has led to a drop in sepsis-related mortality of 40 percent. The sepsis reduction program is now being implemented throughout the Mount Sinai Health System.
The program uses a clinical decision support model that involves data-driven, multidisciplinary protocols to quickly identify and treat cases of sepsis. As part of the program, nurses receive additional training to recognize warning signs and to call the sepsis reduction team if they determine that a patient is at risk.
Shock occurs when inadequate blood supply threatens multiple organs. Its causes range from congestive heart failure to sepsis. Symptoms of shock include weakness, cool and clammy skin, low blood pressure, dilated pupils, and altered mental status. Treatment of this life-threatening condition includes breathing assistance, blood transfusions, and intravenous medications.
Respiratory failure occurs when the lungs fail to pass enough oxygen to the blood (thereby depriving the organs of oxygen) or fail to remove carbon dioxide from the blood (thereby damaging the organs). Respiratory failure may be acute or chronic, with symptoms ranging from shortness of breath and rapid breathing to a bluish skin color and mental confusion. Depending on the severity of the condition, treatments may include an oxygen therapy mask, a tracheotomy, or use of a ventilator.
Here are brief explanations of terms you may hear in the ICU:
Arterial Blood Gas: Blood test on a sample of blood from the artery that helps evaluate how well the patient is breathing by measuring the amounts of oxygen and carbon dioxide.
Arterial Line: Small plastic catheter placed in an artery and attached to a monitor screen to measure blood pressure and obtain blood samples.
Attending Physician: Senior physician member of the team that oversees the patient’s care.
Cardiac Monitor (heart monitor): Screen that displays the patient’s vital signs (heart rate, blood pressure, oxygen levels, breathing rate, etc.). Various wires, cable and electrodes connect the patient to this monitor.
Catheter (line): Small plastic tube placed in a blood vessel (vein or artery) or elsewhere (e.g., bladder).
Central Line: Special IV catheter placed in a large vein (usually near the neck or collar bone) to give intravenous fluids, medications or nutrition, and/or to measure pressures.
EKG: Monitors and displays the heartbeat.
Endotracheal Tubes (ET Tubes): Breathing tube that is placed in the trachea through the mouth or nose (or through the neck as tracheotomy). This tube is attached to a ventilator or another oxygen source to help the patient breathe.
Face Mask (Oxygen or O2 mask): Plastic mask placed over the nose and mouth. Attached to plastic tubing that delivers oxygen (tank or wall source) to help the patient breathe.
Foley Catheter (Foley): Soft tube inserted into the bladder to drain urine.
Isolation: System to prevent the spread of infection to and from patients. May require staff and visitors to wear mask, gown, and/or gloves in the patient’s room.
Intensivist: Physician or nurse with special training to care for critically ill patients and their families.
Intravenous Catheter (IV, IV line): Small plastic tube placed into a vein to give fluids, medications, or nutrition, and/or measure pressures.
Nasal Cannula (cannula): Plastic tube that fits around the head with two short prongs into nostrils. Delivers oxygen from an oxygen tank or wall source.
Nasogastric or Orogastric Tube (NG, OG): A tube placed through the nose or mouth into the stomach. Used to give medications and nutrition, and/or to drain stomach contents.
Procedure: Test, treatment, or insertion of catheter or device to prevent, treat, or diagnose a medical problem.
Pulse Oximeter (pulse ox, O2 sat monitor): Device with a light sensor placed on finger, toe or ear lobe to monitor levels of oxygen in the blood.
Restraints: Cloth cuffs placed to protect patients by limiting patient movement.
Sequential Compression Devices (SCD, venodynes): Inflate and deflate to massage the legs to prevent blood clots.
Suction: Removal of secretions or drainage from the patient’s airway (trachea, lungs) or other body cavity (e.g., stomach).
Tracheotomy: Surgical opening in the neck for insertion of a breathing (endotracheal) tube into the patient’s airway. This tube is attached to a ventilator or another oxygen source to help the patient breathe.
Vasoactive Drugs (vasopressors, pressors, drips): Medications that are given through an IV to help increase or decrease blood pressure and heart function.
Ventilator/Respirator (vent, breathing machine, mechanical ventilation): Machine attached to the patient through an ET tube (in mouth, nose or neck) to help the patient breathe.