The antics of the 4 ICUs

My other job, as most of you know, is as a RN in the MICU (medical intensive care unit) of a busy downtown hospital. *the following post is based off of information from various websites, and my own observations*

I work MICU because I am opposed to seeing the insides of my patients (which is what happens in the burn unit and SICU). I like my patients looking good on the outside, regardless of the state of their internal organs. I don't like my patients being able to use their call lights to tell me "I am having the worst chest pain of my life!" (which is what happens in the CICU. My first, and only, unexpected patient death on my shift happened right after my patient said those very words...no wonder I am skittish).

Let me tell you a little more about the units:


1. SICU (Surgical Intensive Care Unit)- this is where the traumas go. Basically, car or snowmobile meets patient plus alcohol. (yes, I know, we all know people in traumas that were not intoxicated, but I did read a study that stated that 1/3rd to 1/2 of traumas that end up in critical care units involve alcohol.)

2. The Burn Unit- this is where people go after attempting to let fire and alcohol coexist in their lives. (once again, don't get offended please).


3. The CICU (Coronary Intensive Care Unit)- This is the less alcohol area...it is where you end up when you have a heart attack- risk factors for those are smoking, obesity etc. By the way, I read something that said tobacco and alcohol account for 3/4th of substance abuse ICU admissions.


4. The MICU (Medical Intensive Care Unit)- this is where we get the substance abuse, detoxing patients as well as the GI bleeds, liver failure, kidney failure,and respiratory failure. Unfortunantly, a lot of the multisystem failure patients have a history of alcoholism. I've been telling Noah for years that it seems like 50%-75% of my patients have at least a history of Alcohol. Unfortunately, even if it is not the primary reason for their admission it does complicate the admission when they start withdrawing in addition to their primary problems.

This link talks about AUDs in the ICU. http://www.news.vcu.edu/news.aspx?v=detail&nid=2125 (AUDs are alcohol use disorders.) This particular author claims that in his ICU more than 40% of his MICU admits have AUD. According to the article, patients with AUDs are more likely to be ventilated mechanically, which is more dangerous for the patient and also costs more. I read on a couple of different sites that give slightly different numbers, but basically what I found was that the cost of medical complications that relate to alcohol range from $100 billion to $185 billion a year. http://www.hcupus.ahrq.gov/reports/statbriefs/sb4.pdf is a site that talks about statistics relating to alcohol abuse in the general hospital admissions. Alcohol abuse disorders were the 4th most common admit reason for the uninsured and men age 35-44.

I was going to commentate, but I am not going to now. I don't know how to find a solution to this, although I do have some ideas. Just thought I would share some of the details about another part of my life :)