The North Shore Hospital Intensive Care Unit and High Dependency Unit provide intensive care and high dependency care for adult patients (>15 years). However, this excludes conditions where tertiary/quaternary input is required, details are listed below:
- heart, lung and blood vessel surgery is provided by Auckland City Hospital (ICU patients then stay in Cardiothoracic and Vascular ICU)
- brain surgery, liver/kidney/pancreas transplantation, complex major trauma and some types of liver failure management are provided by Auckland City Hospital (ICU patients then stay in the Department of Critical Care Medicine)
- burn management is provided by Middlemore Hospital (ICU patients then stay in Middlemore Hospital ICU).
The North Shore Hospital combined ICU/HDU admits patients to the Intensive Care Team. The intensive care patients are the sickest patients and have one to one nursing. High dependency patients are those who are not as sick but need more specialised medical and nursing input than can be provided on a general ward and may be nursed in a two to one ratio.
The multidisciplinary team within ICU/HDU is made up of highly experienced and professional doctors, nurses and allied health staff. The doctors are those who have specialised in taking care of very ill patients (intensivists) and doctors training to be specialists in intensive care, anaesthesia, emergency medicine, internal medicine and surgery. The registered nurses are specialised in intensive care and high dependency nursing. Allied health members include physiotherapists, dietitians, pharmacists, radiographers, occupational therapists, speech language technicians and biomedical technicians.
What is Intensive Care?
Intensive care is the specialist care given to patients with acute (sudden), potentially reversible, life-threatening diseases. This may include patients who have life-threatening conditions such as a major accident, a severe infection or those recovering from a major operation. Intensive care units may be divided into two areas; the Intensive Care Unit (ICU) where the sickest patients are cared for, and the High Dependency Unit (HDU) where patients who are not well enough to return to general wards are treated. In some hospitals coronary care patients and other high care areas may be combined within an intensive care area.
Intensive Care is staffed by a team of highly experienced and professional doctors and nurses who are supported by other allied healthcare professionals. Specialist doctors trained to look after very ill patients staff the ICU. Most patients requiring intensive care treatment have a nurse allocated to look after them individually. High Dependency Unit patients may be cared for by a nurse who is also looking after other patients in the HDU. The ICU and HDU also have physiotherapists, dietitians, pharmacists and many other healthcare professionals to help care for these very ill people.
What to expect
Much of the value of the Intensive Care Unit comes the careful monitoring of the progress of a disease and the body’s response to complex treatments. This allows timely adjustment of such treatments. In order to achieve this, many investigations and monitoring processes will occur. It may be necessary at times to perform complex procedures in the ICU, which may be time-consuming and require the Unit to be closed to visitors.
Besides blood tests (see below), monitoring of other body functions is also commonplace. Heart rate, arterial blood pressure, central venous pressure, oxygen saturation and urine output monitoring are routine. Specific conditions may require other investigations. The changes are monitored and therapy adjusted as a result of the monitoring.