How Does the Intensive Care Process Work? A Guide for Families

The intensive care process refers to specialized medical care where patients with life-threatening conditions are monitored 24/7 using advanced technology and their organ functions are supported. In these units, patients are tracked second by second by specialist physicians and specially trained intensive care nurses. Our goal is to provide the time and medical support the body needs to recover itself in the safest way possible. Knowing that a loved one is receiving treatment behind closed doors can be particularly worrying; however, these units are spaces where the most optimal medical conditions are created for the patient's recovery.

• Intensive care offers uninterrupted and advanced life support for patients in critical condition.
• Patients are monitored in real-time for vital signs such as heart rhythm, blood pressure, and blood oxygen levels.
• Patients suffering from respiratory failure may be connected to a breathing machine (ventilator) and intubated.
• To minimize the risk of infection, visiting hours and durations are subject to strict rules.
• Patients showing signs of recovery are gradually weaned off the machines and transferred to a regular ward.

What is Intensive Care and Who is Admitted?

The simplest answer to the question of what intensive care is: these are specially equipped treatment areas with advanced technology for individuals whose vital functions are at risk. Unlike other departments of the hospital, the number of healthcare professionals per patient is much higher in these units. Units are classified as first, second, and third-level (tertiary) based on the medical equipment and level of expertise they offer. While patients requiring close monitoring but without organ failure are observed in first-level units, the most critical patients are followed in third-level intensive care units where advanced life support is provided.

The primary goal here is to keep the patient alive by supporting their failing organ functions with machines and medications. Especially when you hear on television or in the news that famous figures have been admitted to these units after sudden illnesses, the uncertainty of the process might worry you. However, these areas are the safest places where the highest level of medical intervention the patient needs can be performed instantly. Closed doors are an indicator that a feverish and highly controlled fight for life is taking place inside.

Reasons for Admission to Intensive Care

For a patient to be admitted to intensive care, one or more of their vital organs must need support. The most common reasons include severe respiratory failure, serious infections caused by microbes entering the blood (sepsis), major traumas, and traffic accidents. In addition, sudden neurological and systemic crises such as brain hemorrhages, strokes, or poisoning also require direct admission to these units. Patients who develop multiple organ failure receive treatment in these areas where dialysis and respiratory support can be provided simultaneously.

Heart attacks and severe rhythm disorders are among the biggest reasons for admission to coronary intensive care units. If you are curious about the effects of daily life pressures on the heart, you can review our article titled Effects of Stress and a Busy Pace on Heart Health. After planned major surgeries (such as open-heart surgery or brain surgeries), patients may also be temporarily admitted to these units as a precaution to safely emerge from the effects of anesthesia and smoothly get through the critical first 24-hour period. Each patient's situation is unique, and the decision to admit is always made as a result of the physician's detailed evaluation.

The Intensive Care Process and Equipment Used

From the moment the patient is taken inside, the intensive care process begins with an uninterrupted monitoring mechanism. Thanks to electrodes placed on the patient's chest, an oxygen sensor attached to their finger, and a blood pressure cuff on their arm, all vital signs are reflected on the monitors at the bedside. To measure blood pressure second by second, a thin catheter (arterial line) is usually placed in the artery at the wrist. Central venous catheters inserted into large veins in the neck or under the collarbone allow strong medications and IV fluids to be administered safely.

Nutrition and medication are generally provided intravenously or through a thin tube passed down into the stomach (nasogastric tube). A urinary catheter is used for toilet needs, so the patient's fluid output is also calculated to the millimeter. In patients developing kidney failure, continuous dialysis can be performed right at the bedside. Although the rhythmic sounds and alarms of the machines inside may initially seem frightening to families, these sounds are actually signs that the system is working flawlessly and the patient is kept under control at all times.

What Does It Mean to Be an Intubated Patient?

The question of what an intubated patient means, which you often hear in the news, actually refers to a medical respiratory support procedure. A special tube is inserted into the windpipe (trachea) of patients who cannot breathe adequately on their own or cannot protect their airway because they are unconscious. This tube allows the patient to be connected to a breathing machine (ventilator), and the procedure is called intubation. The machine takes over the breathing function by sending oxygen to the patient's lungs at a specific pressure and volume.

While intubation ensures enough oxygen reaches the patient's lungs, it also helps the body save the enormous energy it expends to breathe. During this process, sleep-inducing (sedation) and pain-relieving medications are usually given so that the patient is comfortable, adapts to the tube, and does not feel pain. Intubation is not a disease, but a crucial intervention that keeps the patient alive and buys time for treatment. You can find more detailed information on this topic in our article What Does Intubated Mean? In Which Situations is a Patient Intubated?.

ICU Visitation Rules and Being a Family Member

Critical patients have extremely low immunity against infections. Therefore, intensive care visitation rules are quite strict, both for the patient's safety and to prevent the introduction of outside microbes. Visits are generally held once a day at specific hours determined by the hospital, and only immediate family members are allowed to attend. The duration of the visit is usually limited to a few minutes so as not to prevent the patient from resting and to avoid disrupting medical interventions.

Before entering, you are asked to wash your hands, disinfect, wear a protective gown, and put on a mask. It is of vital importance not to speak loudly inside and not to touch the machines or cables. Even if your patient is sedated, they might be able to hear your voice; so it is recommended that you say encouraging, calm, and positive things to them. The restricted visitation might be hard for you, but knowing that these rules are implemented entirely to protect the health of your loved one should put your mind at ease. Taking care of your own health and eating regularly while waiting outside is essential so you can support your patient when they are transferred to a regular ward.

The Recovery Process and Transfer to the Ward

When the organ functions of the patient treated in intensive care begin to improve and the life-threatening situation disappears, the recovery process accelerates. For patients connected to a ventilator, the first step is to gradually reduce the machine's support. When the patient starts taking in enough oxygen and expelling carbon dioxide on their own, the tube in the windpipe is removed; this procedure is called extubation. After extubation, the patient is supported with an oxygen mask for a while longer and closely monitored.

When the patient regains consciousness and their values such as blood pressure and pulse remain within normal limits without the support of high-dose medications, a transfer to the ward is planned. Moving to a regular room means the patient no longer needs that intensive and uninterrupted machine-dependent monitoring, which is a massive step in recovery. However, a patient transferred to the ward may still be tired and weak. Physical therapy for muscle loss or weakness due to prolonged bed rest usually begins in the ward room. In addition, time and space confusion (delirium) may be seen in the patient; this condition is temporary and improves rapidly as they move to a normal room and see familiar faces.

Emergencies: When to Call 112?

Situations requiring intensive care usually arise suddenly, and even seconds are of great importance. Certain symptoms you encounter at home or on the street can be direct harbingers of crises requiring advanced life support. Recognizing these symptoms and calling for professional help without wasting time directly increases the patient's chances of survival.

If you observe any of the following symptoms, you should immediately call the 112 Emergency Call Center:

• Pressure or squeezing in the middle of the chest, or severe pain spreading to the left arm or jaw.
• Sudden onset of shortness of breath, wheezing, a feeling of choking, or bruising on the lips.
• Loss of consciousness, the patient not responding to verbal stimuli, shaking, or pain.
• Drooping on one side of the face, speech impairment, saying meaningless words, or sudden loss of strength in the arms.
• Unstoppable severe bleeding, or major physical traumas such as falling from a height or a traffic accident.

In these situations, waiting for an ambulance instead of trying to take the patient to the hospital in your own vehicle is much safer in terms of the first aid that can be provided on the way (such as giving oxygen or performing CPR).

The Intensive Care Process at BHT CLINIC

As BHT CLINIC İstanbul Tema Hastanesi, we are by your side in your toughest moments with our advanced technology and expert staff. Our hospital provides tertiary Intensive Care services, including Adult, Coronary, and Neonatal (NICU) units. With our isolation rooms equipped with the highest level of medical gear and modern ventilator infrastructure, we provide 24/7 uninterrupted life support to our critical patients. In our neonatal unit, premature babies or those with health issues are carefully nurtured by our neonatology specialists in delicate incubators.

Our patients admitted from our emergency department, operating room, or other hospitals are meticulously monitored by experienced intensive care specialists and specially trained nurses. The process of informing family members is carried out by our physicians at regular intervals in a transparent and understandable language. Knowing that while your loved one is fighting for their life inside, you also need accurate information and psychological support outside, we manage the process in the most reliable way.

Frequently Asked Questions

Is the patient conscious in intensive care?

It depends on the patient's condition and the reason for admission. Some patients who only require close monitoring are fully conscious and can talk. However, patients connected to a ventilator, those with severe infections, or serious brain damage are medically put to sleep (sedation), so they remain unconscious.

Can an intubated patient recover?

Yes, many intubated patients recover once the underlying disease (such as pneumonia or heart failure) is treated. The breathing machine is a support that buys the patient time until their body recovers. When the patient's condition improves, they can be disconnected from the machine and return to normal breathing.

Are intensive care patients allowed to have phones?

As a general rule, mobile phones are not allowed inside due to the risk of infection and the possibility of medical devices being affected by signals. Communication between conscious patients and their families is facilitated under the supervision of nurses and physicians, within the rules set by the hospital.

Can a companion stay with the patient?

No, there is no companion practice in intensive care units. All the self-care needs, feeding, cleaning, and medical follow-ups of the patients are met by expert intensive care nurses working 24/7.

How long does the intensive care process take?

This duration depends entirely on the patient's diagnosis, age, additional diseases, and response to treatment. While some patients stay for only 24 hours as a precaution after surgery, this process can take weeks or even months in cases of severe infection, multiple organ failure, or trauma.

To get detailed information and discuss the services offered by our hospital, you can book an appointment or reach us 24/7 via our call center at 0850 811 34 00.

This article is for informational purposes only; please consult your physician for diagnosis and treatment.