Intensive care - Equipment used in intensive care

Intensive care units (ICUs) contain a variety of specialised equipment, which may vary from one unit to another.

The type of equipment an ICU has will depend on the type of patients it specialises in treating. For example, a neonatal ICU will have incubators for critically ill babies.

The machines in ICUs make a variety of sounds, such as bleeps and alarms. Some sounds make staff aware of slight changes to a patient’s condition, or alert them when something needs attention. A few alarms require the nurse's immediate attention but most just indicate standard monitoring.

Some of the main ICU machines and what they do are described below.

Ventilator

If your lungs have failed and you are unable to breathe on your own, you will need to be attached to a ventilator. A ventilator is a machine that moves oxygen-enriched air in and out of your lungs.

You will usually need to be sedated before being put on a ventilator because it would be very uncomfortable otherwise. A sedative is medication that makes you sleepy.

Ventilators can offer different levels of breathing assistance. For example, if you are having problems inhaling (breathing in), a ventilator can be used solely for this purpose.

If you only need help breathing for a couple of days, you may have a tube from the ventilator placed in your windpipe (an endotracheal tube or ETT), usually through your mouth, but sometimes through your nose. The tube will be held in place behind your neck.

However, if you need assistance with breathing for more than a few days, you may have a short operation called a tracheostomy. The tube in your mouth will be replaced by a shorter tube that is placed directly into your trachea (windpipe).

As well as being more comfortable, a tracheostomy will make keeping your lungs clean easier and will usually require less sedation.

In some cases, your breathing may be assisted with the use of a non-invasive ventilator. This eliminates the need for invasive breathing tubes and sedation, and reduces the risk of the ventilator causing an infection. 

During non-invasive ventilation, a mask will be securely fitted over your mouth or both your nose and mouth. Air will be passed into the mask to help you breathe.

Monitoring equipment

To measure important bodily functions, wires may be attached to various parts of your body by sensor pads linked to computer-style screens. Functions that can be closely monitored include:

• heart and pulse rate (measured by an electrocardiogram or ECG)
• air flow to your lungs
• blood pressure and blood flow
• pressure in your veins (known as central venous pressure or CVP)
• the amount of oxygen in your blood
• your body temperature

The monitoring equipment will track every tiny change in your bodily functions and will alert the ICU staff if there are any changes that could be dangerous.

If you have a head injury or have had brain surgery, the pressure inside your head may be monitored. This is known as an intracranial pressure (ICP) reading.

In some cases, you may also have the pressure in your abdomen (stomach area) monitored. Rising pressure levels can prevent enough blood from reaching your organs and may require further treatment.

IV lines and pumps

Tubes that are inserted intravenously (into a vein in your arm, chest, neck or leg) provide your body with a steady supply of essential fluids, vitamins, nutrients and medication. A tube inserted into the main veins in your neck is known as a central line.

These tubes are called IV lines, IVs or drips. They are often connected to one or more bags of fluid that hang from a pole (drip stands) and are attached to pumps (syringe drivers) that constantly regulate the supply. You may also be given blood intravenously using an IV line.

Medications that are given slowly and continuously by IVs in intensive care can include:

• sedatives – to reduce anxiety and encourage you to sleep
• antibiotics – medication that is usually given in high doses and used to treat infections caused by bacteria
• analgesics – also known as painkillers

Kidney support

Your kidneys filter waste products from your blood and manage the levels of fluid in your body. If your kidneys are not working properly, a dialysis machine can replace this function.

During dialysis, your blood will be fed through the machine, which removes many waste products. Your blood will then be returned to your body.

Feeding tube

If you need help breathing through a ventilator, you will not be able to swallow normally.

A feeding tube can be placed in your nose, through your throat and down into your stomach. This is called a nasogastric tube, or NG tube, and can be used to provide liquid food.

The liquid food contains all the nutrients you need in the right amounts, including:

• protein
• carbohydrates
• vitamins and minerals
• fats

If your digestive system is not working, nutritional support can be fed directly into your veins.

Drains

After surgery, tubes called drains may be used to remove any build up of blood or fluid at the site of the wound. These will usually be removed after a few days. 

Catheters

Catheters are thin, flexible tubes that can be inserted into your bladder. They allow urine to be passed out of your body without you having to visit the toilet.

There may be a clear bag hanging from the side of your bed. This is called a Foley catheter and is connected to the tube that goes into your bladder. It is used to measure the amount of urine you produce. This indicates how well your kidneys are working.

Suction pumps

Another tube can be passed down the inside of your endotracheal tube (breathing tube) and attached to a suction pump. Suction pumps are used to remove excess secretions (fluid) and help keep your airways clear.

Neonatal intensive care equipment

Neonatal intensive care (NIC) units have specialised equipment to care for babies who are unwell, and those born prematurely (before week 37 of pregnancy).

Babies in intensive care are placed in incubators, which are clear, enclosed cots that control the baby's body temperature and protect them from infection. The incubators have hand-sized holes to allow the intensive care doctors and nurses to gain access to your baby.

Babies in intensive care are monitored and treated in much the same way as adults. Your baby's body temperature may be monitored using a small sensor on their skin. The level of oxygen in their blood can also be measured using a clip attached to their hand or foot.

If your baby is unable to breathe on their own, they will require artificial ventilation through a ventilator. They may also need to be fed intravenously (through a tube directly into a vein).