Background
What is the SICU?
The surgical intensive care unit (SICU) is a special part of the hospital where patients go after major surgery or when they are very sick and need a surgeon’s care and special monitoring. In the SICU, doctors, nurses and other medical staff work together around the clock to help patients recover. The work in the SICU never stops, making sure patients always get the care they need.
Patients in the SICU often have serious medical problems. They may need machines to help them breathe, medicines to help their heart work or special care to manage pain and prevent infections. Families may hear a lot of noises from these machines and see many tubes and wires. This can feel overwhelming, but it all helps doctors and nurses keep track of the patient’s health. If questions come up, always feel free to ask the nearest nurse or doctor.
What happens in the SICU
Patients are sent to the SICU for many reasons, such as:
Major surgery: some operations, like heart or brain surgery, require close monitoring by doctors and nurses afterward.
Injury: people with serious injuries from car accidents or falls may need extra care that can only be provided in a SICU.
Serious illness: conditions like severe infections or problems with the heart, lungs or kidneys might require SICU treatment.
Intense nursing care: many patients require a lot of care by nurses that can only be done in the SICU.
Doctors use tests, like blood work and X-rays, to figure out the best treatment. In the SICU, the medical team makes quick decisions based on these results.
When a patient arrives in the SICU, the team sets up equipment to monitor their body (Resource 1).
This may include:
Heart monitors: to check how well the heart is working. Electrical signals stream across the screen giving providers information by the second on patients’ health.
Ventilators: machines that help with breathing if needed.
Intravenous lines: small tubes that go into the arms to give medicines, fluids or nutrition.
Dialysis machine: to help support a patient’s kidneys if they are not working properly.
Heart/lung machine (ECMO): to help support a patient’s heart and/or lungs if they are not working properly.
The team checks on the patient often and adjusts treatments as needed. The team works closely with the surgeons to ensure that the patient has all issues addressed. Nurses who work in the SICU have specialized training to recognise and manage critical illness. Every SICU will have its own rules about when a patient can have visitors. It is important to understand this early in the hospitalisation so families can plan when to visit their loved one and meet with the team to get updates.
Treatments in the SICU
Medical (non-surgical) options
Sometimes, surgery is not needed. Medical treatments in the SICU can include:
Antibiotics: medicines that are given as pills or in intravenous lines to treat infections.
Pain management: medicines to keep patients from hurting.
Sedation: medicine to help patients relax or sleep to make them comfortable.
Fluids and nutrition: special solutions through an intravenous or feeding tube.
Surgical options
If surgery is needed, the timing and type depend on the patient’s condition. The SICU team works with surgeons to decide the best plan. After surgery, patients may return to the SICU for further monitoring and care. Often, the SICU team helps doctors and nurses from different parts of the hospital work together.
Recovering in the SICU
Recovery can take days to weeks. The team works to get the patient stable so they can move to a regular hospital room. While in the SICU, patients may:
Get physical therapy to keep their muscles strong.
Have blood tests to check progress.
Be slowly removed from machines, like ventilators, as their condition improves.
Possible complications/issues
Being in the SICU is not always smooth. Some common issues include:
Infections: the medical team takes steps to stop this, like cleaning the patient’s skin and equipment.
Weakness: patients may feel tired after being in bed for a long time. Muscles can lose size and strength from not moving as much.
Emotional stress: it is normal for patients and families to feel worried. The team is there to provide support and information as questions and concerns come up.
What happens next?
Moving out of the SICU
Patients leaving the SICU might go to another hospital room, a rehabilitation center or even home, depending on their condition. The team will explain the next steps.
Caring for wounds
Patients with surgical wounds will learn how to clean wounds and watch for infections. Nurses may also help families learn how to do this.
Eating and moving around
The team, with the surgeon, will let patients know when they can start eating regular foods or walking again. Sometimes, therapy may also be given after they leave the SICU.
The SICU is a place where people go to heal from big wounds and bad illness. While it can feel scary, the goal is to give patients the best chance at recovery. The SICU team is always there to help every step of the way. The SICU is one of the most specialised units in a hospital with its focus on improving patients’ health and providing clear communication to all involved.
Resources
ICU bed interactive: My Life After ICU— an interactive image that describes the machines surrounding the patient.
Learn About the ICU: My ICU Workbook—a website dedicated to helping family members understand the function of the ICU and the difficult decisions that come with having a loved one in a critical care unit.
Funding Statement
The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.