Inside the Intensive Care Unit (ICU)

What really happens when Critical Care begins

Have you ever wondered what exactly happens in an Intensive Care Unit (ICU)? Over 5 million people in the US were admitted to an ICU last year, accounting for 20% of all inpatient admissions. This number is projected to grow over the next ten years, so the chances you or a loved one may need critical care are increasing.

Fortunately for the Rutland community, Rutland Regional Medical Center (RRMC) has one of only two ICUs in the state of Vermont that are fully staffed with fellowship trained and board-certified Intensivists and highly skilled Advanced Practice Providers, 24 hours a day, seven days a week. In addition to skilled providers, the ICU at RRMC has Registered Nurses (RNs) and Respiratory Care Providers (RCPs) who are specially trained to care for critically ill patients.

The most common medical problems that lead to admission to RRMC’s ICU include heart issues, severe infections like sepsis, trouble breathing (respiratory failure), diabetic ketoacidosis, and drug or alcohol intoxication or withdrawal. All of these conditions have one thing in common: the body needs some form of clinical/medical support to stay safe while it recovers.

For example, a patient with respiratory failure from pneumonia or a flare‑up of chronic obstructive pulmonary disease (COPD) may need help breathing. This support can include non‑invasive machines like CPAP (continuous positive airway pressure) or BiPAP (bilevel positive airway pressure). Some patients may need a breathing machine called a ventilator for a period of time. ICU doctors, advanced practice providers, nurses, and respiratory care practitioners are specially trained to manage these machines while the patient’s lungs rest and heal.

Another very common medical condition requiring admission to the ICU is septic shock. Sepsis is the body’s extreme, life threatening response to an infection. Septic shock is the most severe stage of that response where instead of fighting the infection (germ), your immune system goes into overdrive and attacks your own body. As a result, blood pressure drops to dangerously low levels – so low that blood can’t deliver oxygen and nutrients to the body. The ICU team members are experts in the resuscitation of patients with septic shock. The providers often place special large IV catheters called central lines to deliver lifesaving cardiac medications to increase blood pressure and delivery of blood (perfusion) to vital organs.

Critical care medicine is above all else a team effort. The complex and often unpredictable nature of patient care requires close and continual collaboration among diverse healthcare professionals: cardiologists, infectious disease providers, gastroenterologists, surgeons, pharmacists, palliative care nurses, physical therapists and nutritionists, just to name a few. The intensivist coordinates the care among all these experts, with the patient and their family always at the center of every decision.

We know no one ever chooses to be critically ill and admitted to an ICU. But if you should find yourself or a loved one in our care, rest assured, the RRMC ICU team is committed to your health, safety, and recovery.

By Leah Skypeck, PA-C, Medical Director of Critical Care at Rutland Regional