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Adult Intensive Care Units

About our units

Medical and Neurosurgical Intensive Care Unit: Cares for medicine, neurotrauma, neurology and neurological patients, hematology and neuro-oncology. Cardiac Intensive Care Unit: Cares for cardiology patients, cardiac surgery and oncology patients. Surgical Intensive Care Unit: Cares for burn, trauma and surgical patients.

Each 18-bed unit is staffed by experienced nurses who have additional training in all aspects of critical care. Nurses are trained to care for patients in all three of these ICUs. A fully licensed resident physician is available 24 hours a day. Attending physicians and their teams oversee each patient’s care in the unit and visit daily. They make rounds primarily in the mornings and prescribe a plan of care for the day. If you have questions for the physician team, you are encouraged to contact the patient’s nurse, who will arrange for you to meet the appropriate physician.

Visiting hours

Upon admission to our ICUs and after any procedures we will try to get family members in as soon as possible, but please be patient as our priority is your loved one. Visiting hours are from 10:30 a.m. to 7 p.m. and 8:30 p.m. to 11 p.m. daily. The unit is closed to visitors from 11 p.m. to 10:30 a.m. Brief visits after 11 p.m. may be allowed at the discretion of the unit supervisor. All visits are limited to two people at a time as long as patient care is not disrupted. Children under the age of 13 are not allowed in the ICUs unless prior arrangements are made by the unit supervisor and physician. If your family member is critically ill and you would like a pager, please designate a family spokesperson and contact the Information Desk at 882-3948.

Overnight guest guidelines

Because of our limited space, we ask that you plan to spend the night only when your family member is critically ill. We ask that only two family members stay overnight. All overnight guests must be 18 or older. You will need to check with the unit nurse supervisor to determine if you are eligible to stay overnight. If problems arise in waiting rooms, please contact Security at 882-7147 or the unit attendant.

Patient condition reports

Call the Care Coordination Center day or night at (573) 882-4141 to request a condition report on a patient. A one-word condition will be released. More detailed information can be obtained by calling the unit. To reduce the number of calls to the unit regarding a patient’s condition, we ask that your family designate a family spokesperson. This person will be responsible for keeping other family members updated and will be contacted in case of an emergency. The unit phone numbers are as follows:

Cardiac ICU: 882-2986
Medical/Nursing ICU: 882-8176
Surgical ICU: 882-7995
Security: 882-7147

ICU technology

Our technology allows us to monitor patients from more than one location. Even when nurses aren’t at the bedside, they are still observing their patients.

Personal belongings, flowers, gifts

Live flowers and plants cannot be delivered to ICU rooms because of infection-control requirements. Gifts are not encouraged because of limited space. Visitors may bring cards, but please do not bring food.

ICU issues and answers

Understanding Life Support Measures: Life support replaces or supports a failing body function. In treatable or curable conditions, life support is used temporarily until the body can resume normal functioning. But in situations in which a cure is not possible, life support may prolong suffering. The information on this web page is meant to explain various life support terminology and measures the intensivist-led team may need to address while your loved one is in the ICU. A treatment may be beneficial if it relieves suffering, restores functioning, or enhances the quality of life. The same treatment can be considered detrimental if it causes pain or prolongs the dying process without offering benefit. That treatment may diminish a person’s quality of life.

The decision to forego life support is a personal one. It is important to talk to your physician regarding the risk and benefit of each therapy. All life-support measures are optional treatments.

Common terminology

Do-not-resuscitate order (DNR):
A DNR order is an order written by your physician instructing health-care providers not to attempt cardiopulmonary resuscitation (CPR) in case of cardiac (heart stops beating) or respiratory arrest (breathing stops). A person with a valid DNR order will not be given CPR under these circumstances.

Do-not-resuscitate/full care:
Remember: Do-not-resuscitate does not mean do not treat. Patients have the right to receive any and all treatments. When a cure is not possible, your physician may decide that the use of CPR may not be medically appropriate. It is a choice to say no to CPR, but yes to all other medically appropriate treatments.

Common life-support measures

Cardiopulmonary resuscitation (CPR/ACLS):
CPR/ACLS are a group of treatments used when someone’s heart and/or breathing stops. CPR is used in an attempt to restart the heart and breathing. It may consist of artificial breathing and can include pressing on the chest to mimic the heart’s function to restart circulation. Electric shocks (defibrillation) and drugs can also be used to stimulate the heart.

What is defibrillation?
Defibrillation is the sending of a powerful electric shock through the heart. It is used when the heart stops beating effectively on its own.

Does defibrillation always restart the heart?
If the heart has lost all of its electrical activity or is so damaged that it no longer has enough muscle to pump blood through the body, defibrillation may not be successful in restarting the heart. If you do not wish to receive CPR, your physician must write a do-not-resuscitate (DNR) order on the chart. This order can be revoked at any time for any reason.

Vasopressors: Vasopressors are a group of powerful drugs that cause blood vessels to get smaller and tighter, thereby raising blood pressure. This therapy is only given in the ICU.

Artificial nutrition and hydration (tube feeding): Tube feeding is the administration of a chemically balanced mix of nutrients and fluids through a feeding tube. Most commonly, a feeding tube is inserted into the stomach via the nasal passage (nasogastric or “NG” tube) or through the wall of the abdomen (gastronomy tube or “PEG”) by means of a surgical procedure. Another type of feeding tube is inserted surgically through the abdominal wall into the small intestine (jejunostomy tube).

Intravenous feeding: Intravenous (IV) feedings are given to patients who are unable to tolerate tube feedings. Similar to tube feedings, the IV feeding provides the patient with the needed amount of protein, carbohydrate, fat, vitamins and minerals. Nutrition and hydration may be supplied temporarily, until the patient recovers adequate ability to eat and drink, or it can be supplied indefinitely. Although potentially valuable and life saving in many situations, artificial nutrition and hydration do not provide comfort care for dying patients. Available scientific evidence has shown that death without artificial nutrition or hydration may cause less suffering.

Mechanical ventilation (MV): Mechanical ventilation is used to support or replace the function of the lungs. A machine called a ventilator (or respirator) forces air into the lungs. The ventilator is attached to a tube inserted in the nose or mouth and down into the windpipe (trachea). MV may be used short term (treating pneumonia), or it may be needed indefinitely for permanent lung disease or trauma to the brain. Some patients on long-term MV live a quality of life that is acceptable to them. For some patients, MV may only prolong the dying process.

Dialysis: Dialysis does the work of the kidneys, which remove waste from the blood and manage fluid levels. This procedure requires a special central venous catheter. Blood circulates from the body through the dialysis machine, where it is filtered and then returned. Dialysis can be performed in the ICU or in the dialysis unit, depending upon the condition of the patient. Some patients may live on dialysis for years. But dialysis for the chronically ill/dying patient may only prolong the dying process.

Pacemakers: A pacemaker is a device that produces a low electrical current that stimulates the heart muscle to beat. The heart can be paced temporarily until healing occurs. A surgical procedure to insert a permanent pacer may be required. Patients with noncurable heart disease may choose not to have a pacemaker. Society of Critical Care Medicine, 2002 SCCM

For a copy of the brochure “ICU Issues and Answers,” please see the unit attendant.

Patient Safety Net

University Hospital allows you to submit comments via the Internet. The Patient Safety Net is designed to provide rapid response to customer comments and can be accessed through our website at muhealth.org. Look for the prompt “submit compliments and complaints” on our home page, and you will be provided instructions on how to enter your comment. Your comment is immediately forwarded to the appropriate personnel for acknowledgement and resolution.