Search



English Spanish     

Critical Care

What is critical care?

Critical care is medical care for people who have life-threatening injuries and illnesses. It usually takes place in an intensive care unit (ICU). A team of specially-trained health care providers gives you 24-hour care. This includes using machines to constantly monitor your vital signs. It also usually involves giving you specialized treatments.

Who needs critical care?

You need critical care if you have a life-threatening illness or injury, such as:

  • Severe burns
  • COVID-19
  • Heart attack
  • Heart failure
  • Kidney failure
  • People recovering from certain major surgeries
  • Respiratory failure
  • Sepsis
  • Severe bleeding
  • Serious infections
  • Serious injuries, such as from car crashes, falls, and shootings
  • Shock
  • Stroke
What happens in a critical care unit?

In a critical care unit, health care providers use lots of different equipment, including:

  • Catheters, flexible tubes used to get fluids into the body or to drain fluids from the body
  • Dialysis machines ("artificial kidneys") for people with kidney failure
  • Feeding tubes, which give you nutritional support
  • Intravenous (IV) tubes to give you fluids and medicines
  • Machines which check your vital signs and display them on monitors
  • Oxygen therapy to give you extra oxygen to breathe in
  • Tracheostomy tubes, which are breathing tubes. The tube is placed in a surgically made hole that goes through the front of the neck and into the windpipe.
  • Ventilators (breathing machines), which move air in and out of your lungs. This is for people who have respiratory failure.

These machines can help keep you alive, but many of them can also raise your risk of infection.

Sometimes people in a critical care unit are not able to communicate. It's important that you have an advance directive in place. This can help your health care providers and family members make important decisions, including end-of-life decisions, if you are not able to make them.

Croup

Croup is an inflammation of the vocal cords (larynx) and windpipe (trachea). It causes difficulty breathing, a barking cough, and a hoarse voice. The cause is usually a virus, often parainfluenza virus. Other causes include allergies and reflux.

Croup often starts out like a cold. But then the vocal cords and windpipe become swollen, causing the hoarseness and the cough. There may also be a fever and high-pitched noisy sounds when breathing. The symptoms are usually worse at night, and last for about three to five days. Children between the ages of 6 months and 3 years have the highest risk of getting croup. They may also have more severe symptoms. Croup is more common in the fall and winter.

Most cases of viral croup are mild and can be treated at home. Rarely, croup can become serious and interfere with your child's breathing. If you are worried about your child's breathing, call your health care provider right away.

Dislocated Shoulder

What is a dislocated shoulder?

Your shoulder joint is made up of three bones: your collarbone, your shoulder blade, and your upper arm bone. The top of your upper arm bone is shaped like a ball. This ball fits into a cuplike socket in your shoulder blade. A shoulder dislocation is an injury that happens when the ball pops out of your socket. A dislocation may be partial, where the ball is only partially out of the socket. It can also be a full dislocation, where the ball is completely out of the socket.

What causes a dislocated shoulder?

Your shoulders are the most movable joints in your body. They are also the most commonly dislocated joints.

The most common causes of shoulder dislocations are:

  • Sports injuries
  • Accidents, including traffic accidents
  • Falling on your shoulder or outstretched arm
  • Seizures and electric shocks, which can cause muscle contractions that pull the arm out of place
Who is at risk for a dislocated shoulder?

A dislocated shoulder can happen to anyone, but they are more common in young men, who are more often involved in sports and other physical activities. Older adults, especially women, are also at higher risk because they are more likely to fall.

What are the symptoms of a dislocated shoulder?

The symptoms of a dislocated shoulder include:

  • Severe shoulder pain
  • Swelling and bruising of your shoulder or upper arm
  • Numbness and/or weakness in your arm, neck, hand, or fingers
  • Trouble moving your arm
  • Your arm seems to be out of place
  • Muscle spasms in your shoulder

If you are having these symptoms, get medical treatment right away.

How is a dislocated shoulder diagnosed?

To make a diagnosis, your health care provider will take a medical history and examine your shoulder. Your provider may also ask you to get an x-ray to confirm the diagnosis.

What are the treatments for a dislocated shoulder?

The treatment for dislocated shoulder usually involves three steps:

  • The first step is a closed reduction, a procedure in which your health care provider puts the ball of your upper arm back into the socket. You may first get medicine to relieve the pain and relax your shoulder muscles. Once the joint is back in place, the severe pain should end.
  • The second step is wearing a sling or other device to keep your shoulder in place. You will wear it for a few days to several weeks.
  • The third step is rehabilitation, once the pain and swelling have improved. You will do exercises to improve your range of motion and strengthen your muscles.

You may need surgery if you injure the tissues or nerves around the shoulder or if you get repeated dislocations.

A dislocation can make your shoulder unstable. When that happens, it takes less force to dislocate it. This means that there is a higher risk of it happening again. Your health care provider may ask you to continue doing some exercises to prevent another dislocation.

Dislocations

Dislocations are joint injuries that force the ends of your bones out of position. The cause is often a fall or a blow, sometimes from playing a contact sport. You can dislocate your ankles, knees, shoulders, hips, elbows and jaw. You can also dislocate your finger and toe joints. Dislocated joints often are swollen, very painful and visibly out of place. You may not be able to move it.

A dislocated joint is an emergency. If you have one, seek medical attention. Treatment depends on which joint you dislocate and the severity of the injury. It might include manipulations to reposition your bones, medicine, a splint or sling, and rehabilitation. When properly repositioned, a joint will usually function and move normally again in a few weeks. Once you dislocate a shoulder or kneecap, you are more likely to dislocate it again. Wearing protective gear during sports may help prevent dislocations.

Exercise for Older Adults

Exercise and physical activity are good for just about everyone, including older adults. There are four main types and each type is different. Doing them all will give you more benefits.:

  • Endurance, or aerobic, activities increase your breathing and heart rate. Brisk walking or jogging, dancing, swimming, and biking are examples.
  • Strength exercises make your muscles stronger. Lifting weights or using a resistance band can build strength.
  • Balance exercises help prevent falls
  • Flexibility exercises stretch your muscles and can help your body stay limber

If you have not been active, you can start slowly and work up to your goal. How much exercise you need depends on your age and health. Check with your health care provider on what is right for you.

NIH: National Institute on Aging