Ask a Critical Care Online

1. What is a Critical Care Specialist?

A critical care medicine specialist is a doctor who specializes in providing intensive treatment and care to a critically ill patient. To become a critical care medicine specialist, after graduating from medical school, a doctor completes a residency program in internal medicine, followed by a fellowship in critical care medicine. Other specialists such as anesthesiologists, surgeons, pediatricians, or pulmonary disease specialists may also obtain subspecialty or dual specialty certification in critical care.
A critical care medicine specialist is trained to manage severe and life-threatening conditions that require complex treatment and constant monitoring of body functions. Patients requiring critical care and life support are usually treated in intensive care units (ICU), coronary care, post-surgical care, or other specialized care units. Life-threatening conditions most commonly requiring critical care include acute respiratory distress syndrome (ARDS), shock, septicemia or sepsis, multiple organ failure, trauma, acute renal failure, traumatic brain injury, stroke, poisoning, surgical complications, as well as complications and comorbidities of acute myocardial infarction (heart attack), stroke, or heart arrhythmias.

Critical care specialists frequently work within a team that includes other physician specialists, as well as critical care nurses, respiratory therapists, pharmacists, dieticians, and others. In addition to providing treatment, critical care specialists can also counsel the patients and their families about prognosis, palliative care, and end-of-life decisions.

2. When Should I See A Critical Care Specialist?
A critical care specialist may be required for:
• Respiratory failure
• Trauma
• Burns
• Poisoning
• Severe pneumonia
• Stroke
• Sepsis
• Traffic or other accidents
• Heart failure
• Acute renal failure
• Multiple organ dysfunction syndrome
• Brain injury
• Ruptured brain aneurysm
• Surgical complications

You can also ask a critical care specialist online to get more information/opinion.

3. What Tests Does a Critical Care Specialist Perform or Recommend?

The critical care specialist may request several tests in critically ill patients. These include:

• Blood tests including complete blood count (CBC), blood sugar, liver function, kidney function, coagulation, toxicology, arterial blood gas, and other tests
• Urinalysis and other urine tests
• Microbiology and immunology tests including blood or urine cultures, viral infection tests, or others
• Electrocardiography (ECG)
• Electroencephalography (EEG)
• Non-invasive and invasive imaging tests including ultrasonography and Doppler ultrasonography, X-rays, CT, MRI, angiography, gastrointestinal endoscopy, bronchoscopy, or others

4. What Procedures Does a Critical Care Specialist Perform or Recommend?

Intensive care unit patients may be treated with several procedures or life supportive devices and other equipment for body function monitoring, support, and drug administration, including:

• Cardiopulmonary resuscitation (CPR)
• Endotracheal intubation
• Tracheostomy
• Vascular catheterization (central venous catheter, arterial lines)
• Urinary (Foley) catheterization
• Nasogastric or gastric intubation
• ECG monitoring
• Pulse oximetry
• Blood pressure monitoring
• Pneumography
• Pulmonary artery catheterization
• Mechanical ventilation
• Pericardiocentesis
• Paracentesis
• Thoracocentesis and chest tube placement
• Continuous renal replacement therapy
• Blood transfusion
• Lumbar puncture
• Splinting
• Cardiac pacing
• DC cardioversion

5. What Questions Should I Ask A Critical Care Specialist?

You may want to ask critical care specialist these questions about your loved one in the critical care unit:

• What is the diagnosis?
• Is the patient going to recover? What are the chances? How long will recovery take?
• What treatment is the patient receiving?
• How is the procedure going to help the patient?
• Why is the patient unconscious? How long will the patient remain unconscious?
• What are the tubes attached to the patient for? How long will they be used for?
• What are the machines doing? What does it mean when a machine is beeping?
• Can the patient eat? What kind of food can be given to the patient?
• How will the patient get nourishment if she or he cannot eat?
• Can the patient hear or feel if he or she is unconscious?
• Should the patient be moved or touched?
• How long will the patient stay in the ICU?
• What are the complications of the condition? Will the patient be able to lead a normal life after going home?
• Is it okay to visit or stay with the patient in the ICU?
• Is there a risk of passing infections to and from the patient in the ICU?
• Will the patient need life support system?
• What if the patient does not recover?
• What does “do not resuscitate” mean? What medical decision does the family need to take and how to take them?