Expert Insights from Dr Pratheema Ramachandran
When a family member requires admission to the Intensive Care Unit (ICU), their loved ones go through a harrowing and tiresome experience. To shed light on the need for early intervention, emergency procedures, patient recovery, and the importance of nutrition, we spoke with Dr. Pratheema Ramachandran, ICU expert at Apollo Speciality Hospitals, OMR, Chennai. With her extensive experience in critical care, the doctor sheds light on the essential aspects of ICU treatment and what families should know.
Urgent Actions When ICU Care is Needed
Among the most significant factors determining the fate of seriously ill patients are the minutes of reaching a hospital on time. Dr. Pratheema emphasises, “Do not wait to call a doctor or try to diagnose yourself at home. The sooner a patient arrives at the emergency room, the better their chances of survival.”
“In my hospital, we are conducting audits to quantify the interval between onset of symptoms and arrival at a health centre. Delays—due to such reasons as uncertainty, self-treatment, or consulting multiple consultants—can have a significant effect on survival,” she continues. Families with elderly members or patients with chronic disease must always have an advance emergency plan in place, including knowledge of availability of a hospital in proximity.
Improving Emergency Response and Intensive Care Access
Improving critical care requires the use of external and internal interventions within the hospital. Outside of the hospital, ambulance services and Emergency Medical Services (EMS) are essential. A few apps now allow for instant ambulance booking, and some hospitals naturally provide specialist networks of ambulances staffed by trained paramedics.
Behind the walls of hospitals, according to Dr. Pratheema, “rapid response teams are a must.” She says, “We have medical emergency teams on call to deal with serious situations at once. Seconds count, and getting patients treated as soon as possible can make a big difference.”
Educating medical and non-medical staff on emergency alerts such as code blue guarantees timely and effective medical response.
The Psychological and Emotional Implications of ICU Admission
ICU admissions are not just physically stressful but emotionally draining for the patients and their family members. Isolation, pain, and unfamiliar environment can lead to distress. Critical care Units follow the multiple quality checks and initiatives to make efficient plans for a patient with respect to feeding, analgesia (pain relief), sedation, mobilisation, and psychological support, says the doctor.
To keep the patients oriented, physicians and nurses speak to patients regularly by addressing them and informing them of the time and their condition. Families are also important when it comes to the recovery of patients. Nowadays, hospitals have extended visiting hours for critically ill patients and incorporate psychological counselling into the recovery process.
For relatives too, emotional and financial guidance is given priority. “Transparency is the key. We prepare families for all outcomes—whether the recovery will be smooth or tough, and what the financial implications can be,” she says.
Dr. Pratheema also emphasises the importance of having multidisciplinary teams so that patients are treated as a whole, from nutrition to physiotherapy.
The ICU Recovery Role of Nutrition
Critical illness increases the nutritional needs of the body, and patients are prone to muscle wasting. “Malnutrition can lead to a 40 percent increase in mortality,” cautions she. The route of nutrition—oral, through nasogastric tube, or intravenous nutrition—is determined based on the condition of the patient.
Mobilisation is also important. “Muscle movement is important in recovery as it helps glucose metabolism and insulin control. Without mobilisation and nutritional support, patients are at risk of prolonged weakness and delayed recovery,” the doctor says. Early rehabilitation, such as dietetics and physiotherapy counselling, is now being given priority in hospitals.
Post-ICU Recovery: Problems and Solutions
ICU admission recovery is a physical, emotional, and cognitive process of challenges such as post-traumatic stress disorder (PTSD) that the patients may go through. Due to this reason, post-ICU care clinics are now being implemented in hospitals to lead patients through recovery.
Return to work and daily life is also a challenge. Periodic follow-up medical review post-discharge is advised to the patient—initially five days, then two weeks, and longer and longer intervals as improvement occurs. Dr. Pratheema stresses the importance of vocational rehabilitation and psychological counselling to restore people to normalcy.
Preventing ICU Admission: Lifestyle and Early Detection
While emergencies often are unforeseen, the majority of ICU admissions are preventable. Regular health check-ups, especially concerning severe chronic diseases such as diabetes, blood pressure, and heart disease, can effectively reduce the scope for severe medical emergencies.
Sleep hygiene is yet another often-overlooked element. Poor sleeping habits are linked with a myriad of health issues. She suggests avoiding the use of caffeine in the evening, limiting screen time before bedtime, and following a routine sleeping schedule. “Over 40 percent of diseases would be prevented with good sleep hygiene,” the doctor explains.
Common Misconceptions Regarding ICU Care
Several myths surround ICU admissions, often causing unnecessary fear.
ICU is death – This is a widespread myth. ICU is meant to give the best possible care, and most patients recover completely.
Ventilator use is no return – Ventilators are dreaded by patients, yet they are saviours. Patients can wean from ventilators and recover without a hitch.
ICU psychosis, or illness-induced delirium, sleep disturbance, and medications, is often mistaken for chronic mental impairment but usually is reversible. The name is a misnomer as delirium happens because of the illness in the ICU and not because of ICU.
Understanding End-of-Life Care in the ICU
For terminally ill patients, end-of-life care focuses on comfort when cure is not possible. There are various types of management of terminally ill patients
Conservative treatment means all the treatment except life-support devices. Palliative care – Where hope of cure is none, focus is on pain control and dignity during the final days. Terminal care – Sustaining patients with palliative interventions and embracing the inevitable outcome. These decisions are made through discussions with medical professionals and families, ensuring the patient’s best interests remain the priority.
Critical care is an evolving field where early intervention, emergency preparedness, psychological support, nutrition, and rehabilitation play vital roles. Dr. Pratheema’s insights highlight the importance of awareness, timely medical attention, and holistic patient care. Whether it is preventing ICU admissions through lifestyle changes or improving patient outcomes within the ICU, a collaborative approach involving medical professionals, patients, and families is essential to saving lives and ensuring a better quality of life post-recovery.
