UTI HISTÓRICO DA CRIAÇÃO DAS UTIS www.medicinaintensiva.com.br
RESUMO HISTÓRICO DA CRIAÇÃO DAS UTIS SEGUNDO A SCCM ( SOCIETY OF CRITICAL CARE - USA )
Critical care evolved from
an historical recognition that the needs of patients with acute,
life-threatening illness or injury could be better treated if they were grouped
into specific areas of the hospital. Nurses have long recognized that very sick
patients receive more attention if they are located near the nursing station.
Florence Nightingale ( foto 1 ) wrote
about the advantages of establishing a separate area of the hospital for
patients recovering from surgery.
Intensive care began in the United States when Dr. W.E.
Dandy ( foto 2 ) opens a three-bed unit for postoperative
neurosurgical patients at the Johns Hopkins
Hospital ( foto 3 ) in Baltimore.
In 1927, the first
hospital premature-born infant care center was established at the Sarah
Morris Hospital in Chicago.
During World War II, shock wards were established to
resuscitate and care for soldiers injured in battle or undergoing surgery.
The nursing shortage, which followed World War II, forced
the grouping of postoperative patients in recovery rooms to ensure attentive
care. The obvious benefits in improved patient care resulted in the spread
of recovery rooms to nearly every hospital by 1960.
In 1947-1948, the polio
epidemic raged through Europe
and the United States, resulting in a breakthrough in the treatment of
patients dying from respiratory paralysis. In Denmark, manual ventilation
was accomplished through a tube placed in the trachea of polio patients.
Patients with respiratory paralysis and/or
suffering from acute circulatory failure
required intensive nursing care.
During the 1950s, the development
of mechanical ventilation led to the organization of respiratory
intensive care units (ICUs) in many European and American hospitals. The
care and monitoring of mechanically ventilated patients proved to be more
efficient when patients were grouped in a single location. General ICUs for
very sick patients, including postoperative patients, were developed for the
similar reasons.
In 1958, approximately 25 percent of community hospitals
with more than 300 beds reported having an ICU. By the late 1960s, most
United States hospitals had at least one ICU.
In 1970, 29 physicians with a major
interest in the care of the critically ill met in Los
Angeles, California to discuss the formation of an organization
committed to meeting the needs of critical care patients: the Society of
Critical Care Medicine (SCCM).
In 1986, the American
Board of Medical Specialties approved a certification
of special competence in critical care
for the four primary boards: anesthesiology, internal medicine, pediatrics,
and surgery.
Between 1990 and the present, critical care significantly
reduced in-hospital time as well as costs incurred by patients with diseases
such as cerebrovascular insufficiency and lung tumors.
The development of new and complicated surgical procedures,
such as transplantation of the liver,
lung, small intestine, and pancreas, created a new and important role for
critical care following transplantation.
Widespread utilization of non-invasive
patient monitoring has further reduced the cost and medical/nursing
complications associated with care of critically ill patients.
Widespread utilization of pharmacologic
therapy for critical care patients with specific organ system
failure reduced time spent in both critical care units and in the health
care facility.
In 1997, more
than 5,000 ICUs were operational in intensive care units across
the United States.
( 2 ) W. E . Dandy - 1886 - 1946
( 1 ) Florence
Nightingale 1820 - 1910
( 3 ) 1900 -Sala cirurgica Johns Hopkins Hospital