The ICU: Life-Saving Care During COVID-19 and Every Day

Hospital Intensive care units, or ICUs, are exactly what they sound like: units that offer intensive patient care. ICU providers specialize in caring for the sickest people and have been critical to saving lives throughout the COVID-19 pandemic — at UC Davis Health and across the country.

What is an ICU?

The ICU provides care for patients who are critically ill and require life-saving support. This includes people suffering from major trauma, heart failure, serious burns, COVID-19 and many other conditions. An ICU is home to specialized equipment and highly trained doctors, nurses and other critical care staff who can handle acute illness.

What makes the UC Davis Health ICU different?

“We are a big, regional, tertiary care center, which means we provide specialized care for complex cases. Very few hospitals can handle some of the cases we see,” said Christian Sandrock, pulmonary expert and director of critical care at the medical center. “Right now, we are handling some of the more severe COVID patients, plus, as the only Level 1 trauma center in the region, burns and pediatric ICU cases come to us as well,” he said.

UC Davis Medical Center cares for patients from a huge region that covers 6 million people in 33 counties.

Why are ICUs so important during COVID-19?

Patients who are severely ill with COVID-19 tend to require a higher level of care than typical ICU patients. They may need to be on a ventilator or other life-saving equipment and require the attention of multiple providers. Coronavirus patients also tend to have longer ICU stays.

“On average, if you come in with pneumonia, heart failure or a heart attack and need a ventilator, you’re on it just a couple of days,” Sandrock said. “But with COVID, the shortest we see is 7-10 days, and some are on ventilators for 60, 90, even 100 days.”

Are the ICUs full due to COVID-19?

It’s complicated. 

ICUs, especially those at Level 1 trauma center and tertiary care hospitals, are generally always quite full – not just during the pandemic. ICUs are among the most expensive types of patient care settings to operate, so we constantly strive to make the best use of our facilities at all times. Having empty ICUs is not a good use of resources when there are patients in need.

At UC Davis Health we often have around 90 ICU beds occupied, including both adult and pediatric patients. But there’s nearly always more “room” in the ICU, because, like an accordion, it can be expanded. UC Davis Health has a well-established process to respond to patient surges, whether it’s from a mass casualty incident or a pandemic. We are able to make changes in less than 24 hours, should demands change. 

How do we create more ICU beds?

As a Level 1 trauma center that must always be prepared for incidents that could bring large numbers of patients, UC Davis Medical Center is nimble and can expand ICU care to several different areas of the hospital. The hospital was designed with such flexibility in mind. Entire floors can be converted to ICU wards if necessary.

“We can adapt and expand significantly beyond our usual capacity, but exactly how many extra beds we can create on any given day depends on a lot of factors,” Sandrock noted. “We look at the acuity of our patients, the availability of staff, supplies and space.”

The ideal number of ICU beds is a constantly moving target. “We are recalibrating daily,” Sandrock said.  “Every day we review, and drill based on the latest information about the level of illness from COVID and everything else. We adapt based on trends and case numbers.”

How prepared is UC Davis Health for the current surge?

“We have a robust plan that involves multiple layers of bed expansions that allows us to handle a surge of critically ill patients, so we hope that we’re never in crisis,” Sandrock said. “But this is uncharted territory, and we are relying on people to comply with the public health advice to slow the spread of COVID-19.”

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