Intensive care medicine

Abstract

Intensive care medicine (ICM) is a relatively new discipline. The first intensive care units (ICUs) were opened in the 1950s in the USA and Europe, and were developed in response to technological advances which allowed long-term respiratory support for patients with breathing difficulties. Such support was first shown to be effective during the polio epidemics of the 1950s; at around the same time, it was recognized that some patients could benefit from respiratory assistance after long or complex surgical procedures. Thus, it was the provision of respiratory support for patients with medical and surgical conditions that led to the evolution of present day intensive care. Initially, because of the requirement for expertise in mechanical ventilatory support, the specialty most involved in ICM, at least in the UK, was anaesthesia. The development of means of supporting other organs, and the need for investigation, diagnosis and treatment of the underlying condition, has led to increasing recognition that ICM is a multidisciplinary medical activity with input from anaesthetists, physicians and surgeons. This is most effective when directed and coordinated by a committed specialist in the field. In addition to the medical staff, there is a requirement for considerable support from nurses, physiotherapists, dieticians, pharmacists, radiographers and others. It can be appreciated, therefore, that running a modem ICU is a complex undertaking.

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