Critical Care Medicine is the direct delivery of medical care by a physician to a critically ill or critically injured patient. Critical illness or injury acutely impairs one or more vital organ systems such that there is a high probability of imminent or life-threatening deterioration in the patient’s condition. Care of these patients can take place anywhere in the inpatient hospital setting, although it typically occurs in the ICU. Critical care involves highly complex decision making to assess, manipulate, and support vital system functions, to treat single or multiple vital organ system failure, and/or to prevent further life-threatening deterioration of the patient’s condition.
Modern intensive care originated during the poliomyelitis epidemics of the 1950s in Copenhagen when tracheal intubation & positive pressure ventilation were applied to polio victims. This resulted in substantial reduction in mortality i.e. from 90% to 40%. This gradually led to the concept of Intensive Care Units.
Intensive care is a known but neglected concept in Bangladesh. The first ICU in Bangladesh was established in NICVD in 1980. Since then the numbers of ICUs have been increasing steadily. BIRDEM, a well-known & tertiary care hospital, situated in Shahbag, Dhaka has its ICU from 1989. Till 1995, it was an open unit i.e. primary doctors who choose to admit patients, generally made management decisions leaving the responsibility of managing ventilators & doing procedures to the Intensivists. In 1996, the name was changed from “Intensive Care Unit” to “Department of Critical Care Medicine” & it became a closed one i.e. the Intensivists take on the senior role & patients have been admitted under the service of Critical Care Medicine (CCM).
Cardio-Pulmonary Resuscitation (CPR) training is mandatory for all health service professionals including both medical & paramedical. Unfortunately it is relatively a new concept in our country. Prof. Mohammad Omar Faruq was first to initiate this training in Bangladesh in 1995 in BSMMU. That was soon followed by BIRDEM & the CPR training program was institutionalized here in 1999. Till then it has been going on successfully & more than 70 workshops have taken place. In July 2007, the department celebrated the 50th workshop program.
At the beginning, the number of beds in BIRDEM ICU was only 6. Total number of beds in BIRDEM hospital is 593. Not only indoor patients but also out patients from different hospitals & ICUs are admitted in BIRDEM ICU. In December 2004, the number of beds increased to 10.
There is a severe shortage of medical specialists in intensive care in our country. To overcome this, Department of Critical Care Medicine of BIRDEM initiated MD course in Critical Care Medicine (CCM) in 2007 under Dhaka University & played the role of pioneer.
Recently the department of Critical Care Medicine of BIRDEM has introduced short one day course on Critical Care Nursing offered to nurses of BIRDEM and other hospitals.