Introduction to the Approach to the Critically Ill Patient
Critical care medicine specializes in caring for the most seriously ill patients. These patients are best treated in an ICU staffed by experienced personnel. Some hospitals maintain separate units for special populations (eg, cardiac, trauma, surgical, neurologic, pediatric, or neonatal patients). ICUs have a high nurse:patient ratio to provide the necessary high intensity of service, including treatment and monitoring of physiologic parameters.
Supportive care for the ICU patient includes provision of adequate nutrition and treatment and prevention of infection, stress ulcers and gastritis, and pulmonary embolism. Because 15 to 25% of patients admitted to ICUs die there, physicians should know how to minimize suffering and help dying patients maintain dignity (see The Dying Patient).