ICU

In the ambit of the course of English, part of the 2nd year of Nursing Graduation, it was asked
to write an Oral presentation on a medical subject I was interested in, so I choose to talk about
Intensive Care Units.

I will start by define, Intensive Care Units (ICU) and Intensive Care Medicine (ICM):

ICU - Unit responsible for the critical patient, regardless of the place where the patient is
the hospital, namely in the emergency department, in the intensive units, internment and
through the teams of
internal emergency

ICM - Intensive Medicine is a systemic area of Medical Sciences responsible for the prevention,
diagnosis and treatment of acute disease situations
potentially reversible, in patients who exhibit failure of one or more vital functions.

Now im going to do a brief history on ICUs, that emerge on 1952 in Copenhagen to face the
challenge of ventilation of patients suffering from poliomyelitis.

This challenge encouraged the deepening of the knowledge in acid-base equilibrium, also the
severely injured and infected caused by the wars, and the creation of first medical emergency
responders. These 3 factors became development keys of the ICU concept.

Now I will focus on the evolution of the ICM and ICU on Portugal

So, In Portugal, on the end of the 50’s, the first ICU is created, and later, on 1989 Portuguese
Health Department issues the first regulation on ICM training , allowing the creation of a more
structured and focused training on Intensive Care Medicine.

In 2003 Portuguese Order of Doctors publishes guidelines on ICM doctor’s training, creating
later in 2007 a mandatory exam, also in 2003 Portuguese Health Department issues guidelines
about how the ICU system should be structured, specifying the minimum requirements for a
ICU

In 2012 a study concluded that Portugal lacks ICU beds per 100.000 inhabitants (4,2 beds)
when compared to EU (11,5 beds), in 2016 the number was set on 6.4 beds, a number still
lower than European Union Average.

2015: ICM recognized as primary specialty, but only a year later was issued the first regulation
on professional activity of ICM Physicians.

Usually, the ICUs are classified in 3 levels:

I – Noninvasive monitoring, and resuscitation ability

II – Invasive monitoring and access to differentiated specialties

III – 24h Monitoring by specialty personal (physicians and nurses)

In Portugal, it’s only considered ICU if the Unit offers only level III care.

Now im going to mention a few minimum requirements in human and technical resources:
The Document published in 2003, states that an ICU should be an open space with the
minimum of 6 beds, each with 20 square meters and have at least per bed: --- in the human
resources concern, this document states that: ---

Before ending my presentation id like to mention that here in Leiria, we have an ICU located in
the 5th floor of Hospital Santo André, this ICU is capable of providing care up to 10 critical
patients and his team consists of 5 physicians, 32 nurses, 10 auxiliary staff.

To conclude my oral presentation, I’d like to say that for now, the IC area interests me a lot,
and id like to work there because it’s a place were you make a big difference when it comes to
save a life.