Often occurring as an emergency, admission to an intensive care unit is a critical moment. Treatment may need to be intensive and invasive from the outset in order to stabilise the patient and support failing vital functions. It often means that the person’s life is at risk and that they are extremely vulnerable.
The hospital stay that follows may last from a few days to several months, during which every detail matters. A prolonged stay in intensive care often involves alternating periods of improvement and deterioration. Because ICU patients are particularly vulnerable, they are at high risk of complications. This is often described as the “roller coaster” of intensive care: it is important to understand that critical illness is a high-risk period in which uncertainty remains considerable, and this can be particularly difficult to cope with.
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Because patients are so vulnerable and their condition can develop in many different ways, healthcare professionals are usually very cautious when assessing the prognosis and sharing information with family members.
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One of the defining features of intensive care is the intensive, continuous monitoring provided by specialised equipment and a high staff-to-patient ratio within the healthcare team.
Healthcare professionals continuously assess and reassess patients’ health, considering the expected benefits of current treatments and the risks they may involve. Their main aim is to tailor care to each individual and always act in the patient’s best interests, taking account of their wishes and preferences even when the patient cannot express them. The information shared by family members helps the team understand the patient’s health before admission and assess how much they may benefit from intensive treatments.
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The concept of “weaning”:
Treatments used in intensive care can have significant consequences, so it is important to weigh their benefits and risks before starting highly invasive therapies and to reassess their value over time. Whenever possible, the healthcare team tries to “wean” patients from medicines, life-support machines and other treatments as soon as possible: as soon as the patient’s condition allows, the team works to stop invasive treatments in order to limit complications.The patient’s waking process therefore often follows a series of attempts to stop sedation.
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Treatment strategies therefore depend on the patient’s state of health, their ability to benefit from the available treatments and their wishes.
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