This is what actually happens to you in ICU - and a patient's chances of survival

Tuesday, 7th April 2020, 1:25 pm
Updated Tuesday, 7th April 2020, 1:27 pm

A percentage of Covid-19 patients will have symptoms severe enough that they need intensive care. But what exactly does this entail?

Prime Minister Boris Johnson was admitted to the intensive care unit (ICU) at St Thomas' hospital in London on 6 April, as his symptoms of coronavirus worsened, and many are wondering how serious this is.

What is intensive care?

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ICUs are specialist wards which allow patients who are seriously ill to be treated and monitored closely.

ICU patients are situated in a different part of the hospital to other patients, with a higher staff to patient ratio to allow for one-on-one care when needed. Staff will also be specially trained in intensive care.

These wards are kitted out with more specialist monitoring equipment than you might find in other parts of the hospital.

Who needs intensive care?

The NHS says that most people in an ICU have problems with one or more organs. In the case of Covid-19, which is a respiratory disease, patients admitted to the ICU with the virus will likely need help breathing.

Other reasons patients might be in ICU include serious accidents like a car crash, or a serious infection such as sepsis.

What treatment is administered in intensive care?

Patients in ICU will be connected to various equipment by wires, tubes and cables in order to monitor their health and support their bodily functions until they recover.

The NHS says the equipment that may be used in an ICU includes:

- A ventilator – a machine that helps with breathing. A tube is placed in the mouth, nose or through a small cut in the throat (tracheotomy)

- Monitoring equipment: Used to measure important bodily functions, such as heart rate, blood pressure and the level of oxygen in the blood

- IV lines and pumps: Tubes inserted into a vein (intravenously) to provide fluids, nutrition and medication

- Feeding tubes: Tubes placed in the nose, through a small cut made in the tummy or into a vein if a person is unable to eat normally

- Drains and catheters: Drains are tubes used to remove any build-up of blood or fluid from the body. Catheters are thin tubes inserted into the bladder to drain urine

Often, ICU patients will be on painkilling medicines to ease the discomfort that some of the equipment can cause.

In the case of coronavirus, not every patient will need a ventilator to control their breathing. Some may instead be put on a breathing support machine called CPAP (continuous positive airway pressure). This machine uses mild pressure to push oxygen into a patient's airways via a mask.

Unlike with ventilators - which require patients to be sedated - patients can be awake and not sedated while being treated with a CPAP.

St Thomas' Hospital, where PM Boris Johnson is being treated, has a complex life support machine called ECMO (extracorporeal membrane oxygenation) which can be used to treat the most serious cases of coronavirus.

This machine replaces some of the function of the heart and the lungs. However, there are only a handful of these machines around the country.

How long do patients usually spend in ICU?

The length of stay in an ICU depends on the severity of a patient's condition and can vary from a few days to a few weeks.

The UK’s Chief Medical Advisor, Chris Whitty, said in a recent press conference that the average Covid-19 patient spends eight days in hospital. However, for patients with serious complications - requiring a ventilator in ICU - this stay is doubled to an average of 16 days.

What are your chances of survival in intensive care?

Again, the chances of an individual's survival in intensive care vary hugely depending on a variety of factors - from age to the severity of the condition.

One study, conducted by the Intensive Care National Audit and Research Centre (ICNARC) in March, found that the survival rate for coronavirus patients in UK critical care units was around 50 per cent.

The data was collected from 285 UK critical care units, but only includes confirmed cases up to March 26, so may not remain accurate, given the ever-changing situation across the country.