I was visiting the Emory St Joseph Atlanta hospital today, which specializes in Heart and Vascular Care, and I noticed on their internal directory that they have three different ICUs for different parts of the circulatory system: a coronary ICU, a vascular ICU, and a cardiovascular ICU.
Now, I’m sure they had good reasons for having three different ICUs for different parts of the circulatory system, because I imagine they require different types of care/expertise/whatever. My question is: what is the different types of care for those (highly connected) parts of the same system?
They are most likely because the hospital IS a specialized cardiac center. Thus coronary ICU may be reserved for patients who are having a heart attack or have just had a cardaic catheterization with intervention for blocked arteries. Vascular ICU may be more of a surgical ICU for patients who have undergone a CABG or have had some a ruptured aortic aneurysm repaired. Cardiovascular ICU may be for patients who are in more generalized cardiac conditions, such as cardiogenic shock from acute heart failure.
Many large hospitals, particularly academic or tertiary care hospitals, will have multiple ICUs for different systems. In my own hospital we have a neuro ICU, a medical ICU, a cardiothoracic ICU, a surgical ICU, a cardiac ICU, and a pediatric ICU. This allows for staff (nurses, physicians, certain techs) to become proficient at managing particular areas. For instance, a patient who comes in from with massive trauma requiring multiple surgeries requires different care from a patient admitted with overwhelming sepsis due to a bacterial infection. Similarly, a patient who is in cardiogenic shock due to acute heart failure from a heart attack is different from a patient who is in diabetic ketoacidosis from missing their insulin doses. There is often overlap between the ICUs when there are not enough beds in the “correct” ICU but generally the staff makes an effort to put people in the setting most appropriate for them.
So what’s the difference between the facilities? Different equipment? Different training for the staff? What kinds of things would you find in one that you wouldn’t find in another?
…not to sound like a smartass, but “medical ICU” seems kinda redundant. Aren’t they all medical facilities?
There is a big difference between medical ICUs and surgical ICUs. It’s like the difference between cardiologists and cardiothoracic surgeons (which are completely different specialties with different training and skills (although you would never know that from any doctor shows on television.))
Most hospitals I know that have multiple ICUs divide them up like this:
Medical ICUs can include:
-Medical ICU (for patients with the most severe acute medical problems like sepsis, respiratory failure, acute kidney failure)
-Intermediate care (less intense coverage but can still handle things like IV drips that require monitoring, ventilator management)
-Chronic ventilator unit
-Acute cardiac care unit/CCU (for acute heart attacks, heart failure, patients awaiting urgent transplant, life threatening arrhythmias)
-Cardiac stepdown/cadiac care/monitored unit (for arrhythmias that require intense monitoring but not immediately life-threatening, sometimes post-procedure (pacemaker placement, cardiac angioplasty, cardioversion monitoring)-staffed with nurses who are more trained in cardiac disease)
Surgical ICUs:
-Surgical ICU (for severely ill people who have had surgery and need intensive monitoring)
-Cardiothoracic ICU (for those who have had cardiac or pulmonary surgery (heart/lung transplants, bypass, valve surgery etc)
-Vascular ICU (not heard of this specifically but suspect it is for those who have had other vascular surgeries such as carotid endarterectomies-cleaning out of arteries leading to brain, or repair of abdominal aneurysms)
-Trauma ICU (self-explanatory)
I would suspect that any hospital that specializes in cardiac and vascular care would have at minimum a medical ICU, coronary/cardiac ICU, surgical ICU, cardiothoracic +/- vascular surgical ICU and probably a cardiac stepdown/monitoring unit.
Many things are divided up like that.
A car service shop will have bays with certain tools and people trained in the repairs of certain portions of the car.
A restaurant has several areas of the kitchen devoted to and staffed by people trained in that type or part of food preparation.
It makes things run smoother. Less redundancy. Targeting of resources.