Intensive Care Med.
Goto Newcentury to know more.
; 46(8): &#;.doi:
10./s-020--0PMCID:
PMC
PMID:
and
1Department of Intensive Care Medicine, Dutch Poisons Information Center, University Medical Center Utrecht, Heidelberglaan 100, CX Utrecht, The Netherlands
Find articles by Dylan W. de Lange
2Department of Critical Care and Graduate Program in Translational Medicine, D&#;Or Institute for Research and Education, Rua Diniz Cordeiro, Rio de Janeiro, Brazil
3Programa de Pós-Graduação em Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Find articles by Marcio Soares
4The Department of Intensive Care, The Alfred Hospital, Melbourne, Australia
5Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia
6The Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation, Camberwell, Australia
Find articles by David Pilcher
Author information Article notes Copyright and License information PMC Disclaimer1Department of Intensive Care Medicine, Dutch Poisons Information Center, University Medical Center Utrecht, Heidelberglaan 100, CX Utrecht, The Netherlands
2Department of Critical Care and Graduate Program in Translational Medicine, D&#;Or Institute for Research and Education, Rua Diniz Cordeiro, Rio de Janeiro, Brazil
3Programa de Pós-Graduação em Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
4The Department of Intensive Care, The Alfred Hospital, Melbourne, Australia
5Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia
6The Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation, Camberwell, Australia
Dylan W. de Lange,
:
ln.thcertucmu@egnaLed.W.DContributor Information.Corresponding author.Corresponding author.
Copyright © Springer-Verlag GmbH Germany, part of Springer NatureThis article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
I have seen the future and it is very much like the present, only longer
(Kehlog Albran)
If we want to predict the future, we have to look at the past and the present. The COVID-19 pandemic has highlighted the need for intensive care unit (ICU) beds in an unprecendented manner. However, the reasons why we need more ICU beds are not new.
Worldwide the population is growing and people live longer. This is mirrored in the increasing age of ICU patients. In many high income countries, the proportion of patients aged over 80 years has risen to 10&#;15% and is estimated to rise even further [1]. As the age of patients increases, we not only see more patients with increasing comorbidities and frailty but also increasing numbers of elderly patients with high functional status [2]. In addition, increasing numbers of children with corrected or supported congenital disorders are growing into adulthood. More ICU beds are required to treat all these growing populations.
Historically, many ICU treatments were limited solely to patients most likely to benefit. However, as resources have increased, some have become &#;mainstay&#; and available to more vulnerable and frail patients. During the influenza pandemic of , extracorporeal membrane oxygenation was reserved for young otherwise healthy patients with respiratory failure. Today, indications have broadened and many more patients are eligible. Artificial organs and mechanical circulatory assist devices now offer long-term survival options to many patients in whom ICU care was previously not considered. Outside the ICU, the increasing availability of new anticancer therapies such as monoclonal antibodies, CAR-T cells and checkpoint inhibitors whose side effects may include severe organ failure is creating a growing cohort of patients who also need ICU admission. As a consequence, the increasing availability of all these treatments will result in greater demand for ICU care.
Increasingly treatments are being delivered successfully to patients in the community, with only the sickest admitted to the hospital. As a consequence, in the near future, hospitalised patients will be more severely ill than those of today. A small increase in illness severity will then necessitate ICU admission [3]. This may already be a contributing factor in the increasing ICU admissions due to sepsis [4].
Patients are increasingly admitted to ICU for observation, e.g. intoxicated patients waiting until the time of maximum toxin concentration has past [5]. Other patients need monitoring where therapy can be delivered urgently if required, such as those with potential airway compromise. Admission to an ICU results in better outcomes than admission to a hospital ward [6].
Can these patients be observed elsewhere? Yes, but only in areas adequately equipped and appropriately manned by well-trained staff. Failure to meet these high standards cannot be compensated for by medical emergency intervention teams who respond to deterioration after it has happened. It is time to accept that wards are not staffed and trained to adequately deal with such patients. More ICU beds will bring more patients to the personnel most likely to improve their outcomes.
In some hospitals, the ICU is the only facility which can provide optimal treatment to terminally ill patients requiring potent analgesic drugs or non-invasive ventilation. Increasingly, ICU admission is being offered to provide end-of-life care (e.g. to facilitate time for family members to attend patients with non-survivable brain injuries who were intubated prior to ICU admission, or to allow opportunities for organ donation, in turn saving the lives of others through transplantation) [7].
The largest increase in demand for ICU beds may come from middle income countries where more than half the global population live [8]. As schooling, social consciousness, wealth and healthcare systems improve, there will be increasing demand to care for the critically ill. This may be greatest in regions where cultural and religious attitudes about sanctity of life lead to indefinite continuation of treatments which might be withdrawn in other countries. Ultimately, those patients will be treated in long-term facilities, but, prior to that, they will stay in ICU longer [9].
When few ICU beds are available, delays in ICU admission hinder timely provision of care leading to worse outcomes [10, 11]. The impact of ICU strain on patient outcomes is already well-recognised today [12]. Lack of access to ICU puts patients at risk through increased interhospital transfers, cancellation of surgery and premature or out-of-hours discharge from the ICU [13]. Without more ICU beds, increasing pressure to admit patients will exacerbate ICU strain and leaves us little capacity to cope with sudden surges in ICU demand. ICUs in many countries have been overwhelmed by patients with coronavirus (SARS-CoV-2) infections. Lack of intensive care capacity has undoubtedly cost lives during the pandemic and will do again without greater baseline ICU capacity [14].
Looking at the present, it is clear we need more ICU beds to meet current demands, to improve care for our present patients and to cater for future patients. However, we can also deliver these ICU beds more efficiently and responsibly by streamlining processes of care which reduce ICU length of stay, using ICU telehealth, developing practitioner specialist roles and leveraging economies of scale in larger ICUs [15]. The need for &#;more ICU&#; has never been more obvious than today as we watch a global pandemic overwhelm our present ICU resources. Let this be a lesson for the future (Table ).
No surge capacity
Cancelled elective surgery
Unnecessary interhospital patient transfers
Delays in treatment to critically ill outside ICU
Premature and after-hours discharge from ICU
Why we will need more ICU beds tomorrowNew patientsThe next pandemic
If you are looking for more details, kindly visit icu hospital bed.
More vulnerable and elderly patients
Critical care in the developing world
New indications&#;Just in case&#; admissions for observation
Organ donation and palliative ICU admissions
New treatmentsNew and expanding artificial organ supports within ICU
Novel high-risk drug therapies for patients outside ICU
Complex elective and emergency surgical procedures
Open in a separate windowConflicts of interest
Dr de Lange and Dr Pilcher has no conflicts to declare. Dr. Soares is founder and equity shareholder of Epimed Solutions®, which commercializes the Epimed Monitor System®, a cloud-based software for ICU management and benchmarking.
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Dylan W. de Lange, : ln.thcertucmu@egnaLed.W.D.
David Pilcher, : ua.gro.derfla@rehclip.d.
Difference between an ICU bed and a regular hospital bed
Every Hospital has a hospital bed, but not all have an ICU bed. Intensive Care Unit beds are special beds used by patients in critical conditions. An ICU bed is considered special because they assist medical staff to react and provide treatment quicker in an emergency. A regular hospital bed cannot be used in place of an ICU bed. So to understand these two types of beds, you need to know the specifications and features of each bed. Let&#;s have a look.
Hospital bed types?
ICU bed &#; Descriptions of ICU beds tend to vary, it&#;s believed that any bed used in an Intensive Care Unit is referred to as an ICU bed. However, the Department of Health and social care tend to disagree with this description. It has a deeper explanation of what an ICU bed is.
&#;It is an electric bed that attains chair and Trendelenburg positions and is fitted with a pressure-relieving mattress.
Electric bed &#; An ICU bed should be operated automatically and not manually. The patient should be able to control the movement of the bed with control panels without necessarily requiring a nurse.
Offers Cardiac chair and Trendelenburg positioning &#; This is an important feature as it facilitates respiration, and it aids circulation for the body to function properly.
Has pressure relieving mattresses &#; It is intensive care, so the patient should be comfortable and have a mattress that relieves pressure. The best mattress to be used is the foam and replacement air mattresses.
Regular Hospital Beds &#; A regular hospital bed can be manual, or semi electrical. They include normal hospital beds that you see in any hospital. It is mandatory to have these hospital beds in a hospital facility. Most times, a regular hospital bed is operated manually. Patients who use the regular hospital bed are not in any critical condition and can be able to position their bodies, which means they do not necessarily need a fully automatic bed. The regular hospital bed comes with fewer features as compared to the ICU bed.
Hospital Bed Sizes and Weight
A regular hospital bed has a standard size and can be compared with a twin-size bed. It is normally 80 inches long and 36 inches wide. This size cannot be able to stand patients with much weight. It is however recommended that beds should be designed to suit the patient&#;s weight that eases movement. The ICU bed is typically a typically bariatric hospital bed that offers both a higher weight capacity and larger dimensions. The bed mattresses also accommodate different sizes and weights.
3. Hospital Bed Accessories.
There are two types of accessories, optional and non-optional accessories, in a hospital bed. The ICU bed has more accessories than the regular hospital bed because it&#;s fully automatic and patients are in the intensive care unit. These accessories contribute to the patient&#;s recovery process as well as make them feel comfortable. The regular bed does not contain so many accessories because the patient is not in a serious condition.
Different Hospital Mattress Types
You will often be given an option to choose the type of mattress to go with your hospital bed, the standard types being either foam or innerspring. However, many other types are used for different conditions or for avoiding bed ulcers. These specialized mattress options include alternating pressure relief mattresses and low air loss mattresses. For ICU beds, the main priority is to get a good, suitable, and comfortable mattress to protect the wellbeing of the patient. Regular hospital beds also offer good mattresses, however, the mattresses in a regular bed are standard and not adjustable to the size of the bed.
The Level of Care.
In any hospital, patients are normally classified with different levels of care or different intensity of treatment. The levels include Level 0 to Level 3. Patients in Level 0 are not in serious condition, and they can be treated in a regular hospital bed. Patients in Level 1 are recovering patients from levels 2 and 3, whereas patients in Level 2 &3 require intensive care support, and therefore they cannot be treated in a regular hospital bed, so they require an ICU bed. The Medical or levels of care will determine which type of bed the patients will use. Hover the overall goal of these two types of beds is to help medical staff to react and provide treatment quicker in an emergency.
ICU and Regular Hospital bed Price
A regular hospital bed and ICU bed vary in price. This is contributed by features and accessories on the bed. However, the ICU bed is normally expensive compared to the regular hospital bed. The ICU bed has features and characteristics that support the patient during the conditions. It is designed to allow medics to act quickly in case of an emergency.
Home care
The best suitable hospital bed to facilitate the patient&#;s recovery is the ICU hospital bed. A patient can recover comfortably in their home. The hospital bed home use is designed to suit the home and also to allow movement of the patient. This can be operated at home by a hired nurse or a caregiver.
Adjustable and Versatile
Most ICU beds are electrical beds, and they normally come with remote control. Often, if the bed doesn&#;t come with a remote, it can be purchased separately. The remote control allows for adjusting the head and foot sections. However, with a regular hospital bed, the height of the bed must be adjusted manually, which gives the caregiver a lot of work.
Electrical bed
The ICU bed is fully electrical, which means that all adjustments are made by electronic control with a remote. When there is a power outage, the bed cannot be operated manually unless it came with a backup battery. This poses an advantage to the regular hospital bed, they are not fully dependent on electricity as they can be operated manually.
The company is the world’s best 3 function hospital bed supplier. We are your one-stop shop for all needs. Our staff are highly-specialized and will help you find the product you need.