“Life asked death, why do people love me, but hate you? Death responded because you are a beautiful lie and I’m a painful truth.”
This just might sound like a quote to you, but for an intensivist who works at the best ICU hospital, it is a painful truth. Every single day I have to see people battling for life. At times, I find it challenging to convey the news of death to the patient’s relatives.
The reason behind writing this blog is to make you aware of the life support systems available at Janvi Multispeciality hospital and also a little awareness about when such systems can be put to use.
This blog will also give you an idea about when we cannot put life support systems to use. As doctors, those are the most testing times for us. Without much ado, let’s begin.
Overview
Life support systems are medical devices that are essential for survival. When our body is not able to support the basic functions, then life support systems come into play and support our body till the time our organs begin functioning again.
When should life support be started?
As an intensivist, if we feel that crucial organs of the body like the heart, lungs, kidney and brain are not functioning properly and need some time for recovery then to bypass it, we use support systems. A wide range of life support systems can be used to support the body till the time the affected body organ starts functioning again.
Why are life support systems crucial in ICU?
Best ICU hospital has various life support systems that help the patient to recover faster. Just because the person who is in the ICU is critically ill and cannot breathe or perform the vital functions of his body on his own, support systems are used.
What kinds of equipment are used in an ICU?
Generally, all ICU hospitals have life-saving devices. As an ICU hospital in Vadodara, we have the following equipment in our ICU.
A ventilator – When lungs are not able to breathe properly, ventilators are used. It is done under general anaesthesia.
If a person is to be kept on the ventilator for a long time, tubes are inserted by making an incision in the throat. Medically this procedure is known as tracheostomy.
Monitoring equipment – When a patient is in ICU he/she needs to be monitored frequently. For that reason, there are various monitoring equipment attached to the body. We measure heart rate, blood pressure, level of oxygen in blood etc.
IV lines and pumps – They are inserted into veins which makes it very easy for us to administer the medicines.
ECMO – ECMO machines are not present in every ICU hospital because they are too costly and require expertise to run them. They are particularly useful if we want to bypass the functions of the lungs and heart. It takes blood from the body purifies it, adds oxygen to it and again pumps it into the body.
CRRT – When kidneys fail all of a sudden and it is diagnosed as ‘acute kidney injury’ then CRRT machines are used. They purify the blood and pump it slowly into the body so that the body is able to withstand it.
Feeding tubes – If the patient is unable to eat or drink food on his own, then we need to insert a feeding tube that can help us to feed the patient. Generally, it is done by making an incision in the tummy or in the vein.
Drains and catheters – In order to remove body waste, catheters are inserted into the body. They help to remove fluid from the body.
Procedure Details
Different types of life support systems at Janvi Multispeciality Hospital – the best ICU hospital in Vadodara include the following
Continuous Renal Replacement Therapy (CRRT)
In case of acute kidney failure, normal dialysis procedure does not work. In such cases, CRRT is used. CRRT is a slow process where impure blood is purified and replaced in the body slowly. In case of acute kidney failure, the body has become weak and cannot tolerate fast dialysis. Therefore CRRT is used.
Slow Low-Efficiency DIalysis (SLED)
SLED is ideal for patients with Critically ill patients and those who have hyperkalemia. Depending on the condition of the patient we suggest CRRT or SLED.
Extracorporeal membrane oxygenation (ECMO)
ECMO is used in the case of patients who have problems with the heart and lungs. It is a bypass machine that does the work of the heart and lungs.
Evidence-based physical therapy (EBPT)
- Gathering external evidence to evaluate the patient’s situation
- Putting personal experiences to work when treating the patients
- Considering the values and preferences of individual patients.
Invasive Ventilation including Prone Ventilation, Airway pressure release ventilation (APRV)
We all are familiar with ventilators post-Covid. However, there are different types of ventilators and depending on the condition of the patient we decide which type of ventilator will work best for the patient.
In the case of intubation, the patient is given anaesthesia and later the process of inserting tubes is done. As long as the person is facing breathing issues, he/she needs to stay on the ventilator.
Recruitment Manoeuvres
When lungs are not functioning properly, then recruitment manoeuvres are used. When the alveoli are not working properly then recruitment manoeuvres are used. In this process, air pressure is increased to open the alveoli.
Haemodialysis
Non-invasive Ventilation- CPAP & BIPAP
If the patient is unable to breathe and there is a problem with the lungs then non-invasive CPAP or BIPAP machines are used. As an ICU hospital, Vadodara, we look at the patient’s condition and depending on that we decide whether invasive or non-invasive ventilation support is a better treatment.
Cardiac Pacing
When the patient is having slow heartbeats, then to regularise it, as the best ICU hospital, we use cardiac pacing devices. It sends electrical signals to the heart and tries to normalise the heartbeats. We use an anaesthesia machine for seducing the patients while doing the procedure.
Cardiac pacing is a life support system that is used in the case of patients with a slow heartbeat. If needed, surgery is done and the pacemaker is permanently fixed into the body.
Upper and lower GI endoscopy (to control bleeding)
In the case of patients who have bleeding peptic ulcers or adherent clots, we use upper and lower GI endoscopy to control the bleeding. The patient is administered anaesthesia during the process. The endoscope is passed through to the mouth or the rectum as needed and then a further process is done to stop the internal bleeding.
The most commonly used techniques to stop internal bleeding include:
- Injections
- Thermal coagulation
- Endoscopic clipping
- Hemostatic powders
Defibrillation
A defibrillator works if the patient is experiencing very fast heartbeats. It is a portable medical device that is used as life support in case of critical patients who are facing racing hearts. This device delivers electric shocks to the heart which can help the heart to return to normalcy.
Left ventricular assist device (LVAD)
LVAD is a life support system that is used for patients who are facing the risk of heart failure. LVAD can help them to stay fit till the time they get a donor for the heart.
Artificial nutrition
If a patient is unable to eat through the mouth then the nutrients are directly injected into the body. This can be either done through the nasogastric tube or through injections. The patient can continue being on this life support system till the time he/she is able to intake food through the mouth.
Frequently Asked Questions
What is an intensive care physician?
ICU is a place where trained doctors and nurses are needed 24 hours to handle critical cases. An intensivist is a doctor who is professionally qualified to deal with any medical emergencies. As intensivists working with the best ICU hospital in Vadodara, we are trained to handle critical cases as well as accidental cases that involve trauma.
What is an intensive care physician?
Critical cases or cases that involve injuries or trauma often find a place in an ICU. Such patients might need a life support system to stay alive and need artificial feeds. Some common reasons why a patient needs to be shifted to ICU include:
- Severe burns
- Head injury
- A serious accident
- Heart attack
- Brain stroke
- Major surgery
- Pneumonia
- Sepsis
- Heart problems
- Lung problems
- Organ failure
- Brain stroke
- Blood infections (Sepsis)
- Drug-resistant infections
- Serious injury (accidents, burns)
- Serious injury (accidents, burns)
- Excessive rise in blood sugar levels
When do doctors decide to keep patients on life support systems?
If there are problems with the different organs of the patient that make it impossible for him to feed himself or he/she comma, unable to breathe or organs and fail to perform the desired functions then the patient can be kept on the life support system that performs the function of a specific organ externally.
Why are critical patients kept in ICU?
In an ICU you can find specialists who know how to deal with any emergency situation. It is not possible to keep track of patients and monitor the minute health details every minute. Hence, critical cases are always kept in an ICU.
Unless a patient needs specialised attention, he/she can be kept with a similar set of patients who need an ICU. This helps the ICU nursing staff to look after all ICU patients in one go and in case of any emergency they can rush to the patient instead of shifting from room to room.
In Janvi Multispeciality hospital, our intensivists and special nurse force have their working desks placed inside the ICU itself. This helps them to monitor the health of critical patients without wasting time.
For how long can one be in ICU on life support systems?
There is no limit to how long a person can stay on a life support system. It purely depends on how the patient responds to the treatment. Take for instance the case of Dr Vishal Sardhara. He himself was battling for life. See the snip.
What is a step-up ICU?
After a person is stable in the ICU, we move him to a step-up ICU to see how he/she is doing. Patients are kept here for observation because they cannot be directly shifted to special rooms. Step-up ICU also has temperature controlled environment so that patient is safe from catching any external infections.
Are intensivists professionally qualified to handle critical cases?
As ICU intensivists are professionally qualified to handle critical cases. Not only this, we know how to handle the emotions of the relatives waiting outside the ICU. Some common procedures that an ICU intensivist can do include:
- Intubation
- Ventilation
- Dialysis
- Percutaneous tracheostomy
- Central venous access
- Arterial cannulation
What do intensive care practitioners treat?
Intensive practitioners treat critically ill patients or traumatic cases. They can also handle cases which require medical intervention after surgery.
In general, they deal with:
- Surgical intensive care
- Medical intensive care
- Paediatric intensive care
When do doctors decide to remove life support systems?
If the patient is not responding even after keeping him/her alive on the life the support system and we, as ICU intensivists, find that the condition of the patient deteriorating day-by-day then we explain it to the relatives of the patient regarding discontinuing the life support systems.
Is it legal to remove the life support system?
Removing a life support system does not mean that you are killing a person. It is the disease which kills the person and not the absence of a life support system. If the relatives of the patient give written consent that life support systems should be discontinued and the patient should be allowed to die a natural death, only in such cases life support systems can be removed.
We hope that we have cleared most of your doubts regarding the ICU, the kinds of devices used in it and why the patient needs ICU. We hope this write-up helps you. If it helps you then consider sharing it with your friends. If you have any more questions to ask then you can ask us via comment or join our Facebook page.