Everything about Coronary Care Unit totally explained
A
coronary care unit (CCU) is a hospital ward specialized in the care of
patients with
heart attacks,
unstable angina and (in practice) various other cardiac conditions that require continuous monitoring and treatment.
Characteristics
The main feature of coronary care is the availability of
telemetry or the continuous monitoring of the cardiac rhythm by
electrocardiography. This allows early intervention with
medication,
cardioversion or
defibrillation, improving the prognosis. As
arrhythmias are relatively common in this group, patients with myocardial infarction or unstable angina are routinely admitted to the coronary care unit. For other indications, such as
atrial fibrillation, a specific indication is generally necessary, while for others, such as
heart block, coronary care unit admission is standard.
Local differences
In the United States, coronary care units are usually subsets of
intensive care units (ICU) dedicated to the care of critically ill cardiac patients. These units are usually present in hospitals that routine engage in cardiothoracic surgery. Invasive monitoring such as with
pulmonary artery catheters is common, as are supportive modalities such as
mechanical ventilation and
intra-aortic balloon pumps (IABP).
Certain hospitals, such as Johns Hopkins
(External Link
), maintain mixed units consisting of both Acute care units for the critically ill, and intermediate care units for patients who are not critical.
Acute coronary care
Acute coronary care units (ACCU), also called "critical coronary care units" (CCCU) is equivalent to intensive care in the level of service provided. Patients with acute myocardial infarction,
cardiogenic shock, or post-operative "open-heart" patients commonly abide here.
Subacute coronary care
Subacute coronary care units (SCCU), also called Progressive care units (PCU), Intermediate coronary care units (ICCU), or stepdown units, and provide a level of care intermediate to that of the intensive care unit and that of the general medical floor. These units typically serve patients who require cardiac telemetry such as those with
unstable angina.
History
Coronary care units developed in the
1960s when it became clear that close monitoring by specially trained staff,
cardiopulmonary resuscitation and medical measures could reduce the mortality from complications of cardiovascular disease. The first description of a CCU was given in 1961 to the
British Thoracic Society, and early CCUs were located in
Sydney,
Kansas and
Philadelphia. Studies published in 1967 revealed that those observed in a coronary care setting had consistently better outcomes (Mehta & Khan 2002). The first coronary care unit was developed by Dr Robert MacMillan and Dr Ken Brown at Toronto General Hospital.
Further Information
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