An A-Z of intensive care technical terms
Definitions and explanations of some of the more commonly-used terms in the ICU
Very often, intensive care patients have no recollection (or only some) of their stay in the ICU. There are many causes of amnesia, including certain medications, severe infection, sleep disturbances and mental confusion. Helping patients to understand what has happened during theirstay in the ICU can be very beneficial to their psychological recovery.
Auxiliary nurses help nurses with their tasks and also assist with hospitality, supplies and sterlisation.
The heart pumps the blood which circulates throughout the body and allows oxygen to be carried to the cells of the different organs. When the heart stops, oxygen is no longer delivered and cells are quickly destroyed. In a few minutes, the consequences can be irreversible. Quickness of care (cardiopulmonary resuscitation, also known as 'cardiac massage', artificial ventilation) is essential to minimise the risk of damage and lessen the consequences as much as possible.
Catheters are soft and hollow tubes which are inserted into the patient's veins or arteries. Catheters allow the administration of medication or monitoring of blood pressure. They are often mandatory to treat intensive care patients. Catheters are inserted observing a sterile protocole, under a local anaesthetic. Their maintenance requires sterile conditions and care.
Coma is a cerebral state induced by a severe pathology of the brain which is no longer able to assume vital functions, particularly breathing. A coma prevents the patient from communicating with the people around him. The patient is unable to understand and perform simple orders. There are different kinds of coma depending on the etiology (cause and effects) and the localisation of the damage to the brain. We do not know what a patient can hear when in a coma, but it seems that the presence and voices of the patients' loved ones can be recognised, even if the patient has little or no memory of this later on. Caregivers explain their actions to the patients and warn them before any physical contact. Hearing voices is beneficial to the patient.
Dieticians help the intensive care team to ensure that a patient's nutritional intake is appropriately adapted to meet his/her needs.
Tubes are placed inside the body to help get rid of blood, air or secretions that could prevent a good healing or functioning of an organ.
ICU care continues day and night, weekends and public holidays. There are almost as many caregivers during the night than during the day. The head of service, interns or on call doctors ensure medical permanency readjustment of medication, urgent interventions and reception of new patients. It is sometimes difficult for them to be as available as they are during the day given their restricted number.
An echography is an external examination that allows caregivers to explore the anatomy and functioning of certain organs. The doctor places a probe on the patient's skin close to the organ to be examined. This probe emits ultrasounds that go through tissues, which are then sent back as echoes. The signal is then analysed by a computerised system which re-transmits a live image on a screen. It's a fast and painless exam.
When patients can no longer eat through their mouth (for example, when they are sedated, in a coma, or have problems swallowing), they will be fed through a tube inserted into their stomach through a feeding tube or 'stomach tube'. This is called "enteral feeding". Another possibility if the digestive system is not functional, is to feed the patient through "infusion". This is called "parenteral feeding". Food/nutrients are administrated in liquid form, through the catheter, and cover all the patient's needs.
Medical students are present in the ICU in the mornings and attend lessons in the afternoons. They take part in the monitoring of patients which helps their training for their future career.
This technique uses a catheter and machine to remove toxic waste from the blood which accumulates when the kidneys are malfunctioning or during a acute illness.
This examination explores the inside of the body using an endoscope or fiberscope, inserted through a natural opening. The fibrescope or endoscope is composed of a small soft tube (only a few millimeters in diameter) in which a fibre optic is inserted. It also has a light at one end. Some fibrescopes use a small video camera and are connected to a screen. They can be fitted with surgical pliers in order to take samples for analysis and a remote control system allows it to move around once inside the body. Most fibrescopies are carried out under general anaesthetic.
A gastric tube (or a feeding tube) helps feed the patient during his/her stay in Intensive Care. Through this tube, the patient receives a balanced diet, containing exactly the necessary quantity of carbohydrates, protein, lipids, vitamins and minerals. A gastric tube can be inserted in the oesophagus and the stomach by the nose or mouth. Sometimes a gastronomy tube can be inserted directly into the small intestine with a small surgical intervention.
Heads of clinical practices and hospital practitioners are medical doctors. They are generally in charge of six patients and supervise the work of the interns as well as the training of medical students.
Visiting your loved one is possible 24 hours a day, seven days a week in some ICU. They are desirable and even encouraged. Children can also visit, but they must be prepared beforehand so that they are not disturbed by what they may see.
In some cases, in order to protect brain cells, it is possible to keep the patients in hypothermia, which means to keep their body temperature under 36°C (generally around 34°C). This therapy usually lasts 24h. During this period, patients are sedated because hypothermia is very uncomfortable.
Adverse condition resulting from a medication or medical treatment by a physician or surgeon.
Iatrogenic infections are hospital-borne infections. Despite the constant awareness and a huge importance given to hygiene, because of their major fragility and invasive techniques, 1 in 5 patients will contract one in an ICU.
An infusion or syringe pump is a device that injects medication and liquid solutions into the veins, often using a catheter inserted into a large vein.
Interns are young doctors who have passed the internship exam (at the end of their 6th year of medical studies). They are allowed to prescribe under the responsibility of the head of service. They are very active in the ICU and will be your contact person and a leading partner.
Among the numerous hygiene measures taken in the hospital, is the isolation of a patient. Isolation is used to protect the most fragile patients from the germs that are naturally present in each of us, or to protect visitors and other patients from MRB (multi resistant bacteria). The particular measures to be taken are indicated on the patient's hospital room door.
It is also quite common for patients who are conscious to undergo some mental confusion. That can be due to stress, infection, medication or tiredness. It is important to regularly 'position' them in time and space, by reminding them about where they are, the day and time of day. News media (TV, radio) is often used to allow patients to keep track of time that passes in a closed environment where all the days feel the same.
A monitor or scope records the heart and respiratory rate, blood pressure and oxygen saturation in the blood. This data is collected thanks to sensors and electrodes connected to the monitor. Monitors are configurated to warn the medical staff if the condition of the patient becomes unstable. The monitors are also connected to a central surveillance platform, so that the patient remains permanently under surveillance, even when the staff are outside of the room.
A bacteria that has developed a defence against a number of antibiotics. This makes it difficult to fight and it is extremely important to avoid its spreading inside the hospital. This is the reason why caregivers may ask you to take special precautions when entering patients' rooms : isolation or quarantine precautions.
Forced immobility leads to muscle waste, which can be significant when hospitalisation is prolonged. Recovery of personal autonomy will be much longer and this is why physiotherapists and nurses intervene early to stop this and mobilise patients as soon as they are in in a position to manage it.
Mainly used in non invasive ventilation, a nasal cannula is a tube used to bring extra oxygen through the nostrils, in the case where the oxygen present in the air is insufficient for the patient.
Non-invasive ventilation is an alternative method to tracheal intubation, in certain, specific cases. It works thanks to a ventilator which blows air in the same way than a tube would, but with a tightly sealed mask on the face.
Nurses carry out prescribed care, as well as hygiene and comfort to the patient, working in pairs with the nurse's aids. A ICU nurse is responsible for three patients.
To administer medication, this is diluted in water-based solutions to avoid inflammation of the veins. Therefore, patients receive large quantity of liquids every day, and, despite the treatments used to stimulate their elimination, it is quite usual for patients in Intensive Care to retain fluid. Limbs can swell, particularly the back of hands. In some cases, swelling can be all over the body, including the face, but this goes down after the treatments. Patients are regularly weighed and, if necessary, it is possible to speed up the resorption.
This is when a tube is inserted through the nose or mouth into the trachea of an anesthetised patient, in order to ventilate him or her (supplying oxygen to help him/her breath). Extubation is the removal of this tube.
Physiotherapists play a major part in intensive care. They participate in patient care every day and work with them in order to keep joints supple and preserve muscle function. They also have an important role in the withdrawal of artificial respiration.
Prescriptions are updated permanently: in the morning, after the doctor has seen the latest results of examinations and throughout the day, according to the evolution of the patient's vital signs (pulse, blood pressure, oxygen saturation) and condition.
Pressure ulcers are skin lesions (skin damage) due to patient's confinement to bed. Staying in bed without moving is necessary to keep intensive care patients safe, but can have consequences. The skin is subjected to pressure and rubbing. To avoid pressure ulcers, nurses and carers frequently massage patients pressure points (back of the head, back, sacrum, elbows and heels) and ensure that they are receiving sufficient nutritional intake. You can help prevent pressure ulcers by giving light massages to your loved one.
To advance scientific knowledge improve medical techniques, our unit takes an active part in research. The data collected during a patient's stay may be used anonymously in evaluation and research programmes. Furthermore, the patient's or his/her family's consent may be requested for comparative studies to evaluate different kinds of drugs or patient care. To do this, a consent form must be signed, which includes the terms and conditions of the study. Of course the patient and his/her family is free to refuse and this will not change the quality of care or the relationships with medical staff in any way.
Sedation is an administration of medication to ensure a good quality sleep for the patient. This avoids pain and helps patients to better tolerate the mechanical respiration devices.
Senior nurses who have followed further training and are responsible for the management of the ICU in terms of its logistics and staff.
A shock is a sudden and deep drop in blood pressure. This clinical condition can have serious consequences for the vital organs (kidneys, lungs, liver...) There are different kinds of shock: septic shock, which results from a severe infection; hemorrhagic shock, which results from a significant loss of blood; cardiogenic shock, which results from a malfunction of the heart; and anaphylactic (or allergic) shock, which results from a severe allergy.
During a stay in Intensive Care, the evolution of a patient's condition may raise questions about the suitability of the ongoing treatments. The absence of the expected benefits despite the heavy and sometimes aggressive treatments can lead to the reduction or suspension of some treatements, even to the limiting of care. Decisions to limit or stop Life Sustaining Therapies (LSTs) are taken in consultation with all the medical team, taking into account the patient's wishes and after informing the patient's family. The decisions are re-evaluated daily, in function of the patient's condition.
This passes by the mouth and is usually fixed with a cord around the head of the patient. Often this makes the cheeks look a little gaunt, which changes the face slightly and this can be a little overwhelming.
A small intervention involving the placing of a probe into the trachea via an incision in the neck. It is done to ease and accelerate respiratory autonomy when the process is too long and/or uncomfortable for the patient. In most cases, this tracheotomy is then taken out and the hole heals naturally.
Patients may be moved from one hospital department to another for an examination or surgery. During transportation, care and surveillance of the patient continues. It is a delicate undertaking, requiring a specific logistic, as well as a medical escort.
A urinary catheter is a plastic tube used to drain urine from the bladder. These catheters are required when patients are unconscious. The urinary catheter helps caregivers monitor the patient's kidneys' surveillance.
Many patients need help to breathe during their stay, so a ventilator is used for this purpose. This is a machine that blows air into the patient's lungs, and is used to help when the patient has a respiratory, cardio-vascular disease or when a coma compromises breathing capacities. The ventilator allows oxygen levels in the blood to maintain a sufficient level and get rid of carbon dioxide. The patient is connected to the ventilator by a tracheal tube placed in the throat. The placing of this tube is always done under anaesthetic.
A CT scan, also known as 'tomodensitometry', is an examination which uses a computerised x-ray imaging procedure. A narrow beam of x-rays is aimed at a patient and quickly rotated around the body, producing signals that are processed by the machine's computer to generate cross-sectional images (or "slices") of the body. Pictures need to be interpretated by a specialist to obtain a diagnosis. Frequently an iodine product is used to enhance the quality of the images; which is injected by perfusion (using a drip).