What to expect in the trauma ICU

A trauma intensive care unit (ICU) is often a place that families hope they will never have to visit but are grateful for when needed. ICUs are specially equipped units that provide highly specialized care to patients who suffer from a serious injury or illness.

As a family member or friend of someone with a traumatic injury, you may have many questions or worries about your loved one if a stay in a trauma ICU is required, but knowing what to expect might help ease some fears.

What is trauma?

Trauma (derived from the Greek word traumatikos, meaning wound) is an injury, such as a fracture or broken bone. The leading causes of trauma are:

• Falls
• Motor vehicle accidents
• Assaults
• Shootings

In the US,  trauma injury accounts for over 150,000 deaths and over 3 million non-fatal injuries per year. Traumatic injuries are the leading cause of death for individuals up to age 45.

Trauma is defined as a disease process that occurs after applying energy, said Michael Foreman, MD, trauma surgeon at Baylor University Medical Center at Dallas, part of Baylor Scott & White Health.

“Our body has a remarkable ability to deal with forces applied to us,” Dr. Foreman said. “Our skin is amazingly tough, and we have strong muscles and bones that pad us and protect us from the outside world. But any type of armor can be overcome. If it’s minor, just enough to injure a few cells, you’ll end up with familiar-looking bruises and scrapes. But at some point, the amount of force we absorb is more than the body can take. When hit hard enough, a severe and life-threatening injury can potentially result. That’s where we come in.”

How do people end up in the trauma ICU?

Patients may be admitted to the trauma ICU from the emergency room, operating room or another hospital floor.

Once in the trauma ICU, specialized trauma attending physicians serve as the primary group of doctors caring for you or your loved one. They may order X-rays, lab tests, operations and other necessary procedures. Physical and occupational therapy may also be performed while in the ICU. Patients remain in the intensive care unit until they no longer need 24-hour intensive medical and nursing care.

What to expect if you or a loved one is in the ICU

It is essential to know that your loved one may look and act very differently in the ICU. Swelling and bruises are common with traumatic injuries. Pain medication, head injuries, infection and lack of sleep may make patients appear sleepy, restless or confused.

It’s also important to remember that although ICU patients may not respond to a voice or touch, they may be able to hear and feel. When visiting your loved ones, you should talk to them, hold their hand and tell them they are loved.

Visiting hours in the trauma ICU are flexible. However, there may be times when the trauma team will ask for you to wait outside the room. Guidelines for visiting patients can be obtained from your trauma nurse.

Various machines may be attached to patients and may go off without warning. These alarms are signals for the nurse and are not always warnings of an unsafe situation. Sometimes, soft restraints may be used if your loved one tries to remove the tubes, lines or drains.

Support groups, therapy animals and other programs can help provide people with emotional support while in the ICU. Ask a nurse or healthcare provider for help connecting with these resources.

Who works in the trauma ICU?

Patients in the ICU have a team that consists of many doctors who make rounds throughout the day. Members of the ICU team routinely meet with the patient and family members to ensure everyone has a common understanding of the health condition and plan of care. You can expect the ICU staff to keep you informed of any significant changes in the patient’s condition or procedures that are being performed.

It will be necessary to appoint one designated person as the primary contact to receive and pass along new health status reports to others.

A team of clinicians from various disciplines visits the patients’ bedside a few days a week.

This may include doctors, nurses, people who work in nutrition, pharmacy, physical therapy, social work and others who will talk about the patient’s care and progress. Because family is an integral part of the recovery process, we encourage you to attend these meetings as well.

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