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Once a patient is admitted into ICU, and relatives blocked at the entrance, the entire care is in control of the ICU staff. An unconscious patient is put on a ventilator, leads established for recording ECG, temperature, respiration etc and infusion systems and other equipment used for the management of these very sick patients. The attention of the staff then mostly is on the monitoring systems. However, the problems of a conscious patient on a ventilator are different. While the monitoring systems reflect the functioning of the patient's biological system, they do not indicate information on other sensations/ feelings of the patient like feeling cold, pain etc. Also a patient's desire to communicate with the staff with speech is not possible because of the endotracheal tube. This is complicated by the fact that the attention of the staff on entering an ICU cubicle, is first directed to the monitoring panels and finally to the intubated, anxious and conscious patient. Often the patient wishes to communicate something, a doubt, a question or request. Some patients can be made to write with difficulty on a piece of paper, sometimes not coherent and not possible most often.
I expressed some of these problems faced by patients in a previous letter to the editor.
I have the following suggestions for consideration:
ICUs are rapidly developing new fields of patient care. Patient communication is a vital area of concern as complaints often emanate from the patient and the relations.