According to the Centers for Disease Control and Prevention (CDC), about 805,000 people have heart attacks each year in the United States. As many as 200,000 Americans have coronary bypass surgery each year.
Many of these patients will be admitted to a cardiac care unit (CCU). The CCU is a part of a hospital that has special equipment and trained providers who care for people who are very sick from heart problems.
This article will explain why you might need to be admitted to a CCU. You'll learn what to expect while you are in the hospital and what will happen when you're ready to go home.
How to Get Ready for a Hospital Stay
What Is a CCU?
Patients in the CCU usually have serious, acute, and/or unstable cardiac conditions. They can have changes in their condition that come on very fast and without warning.
People in the CCU need to be looked after constantly. That's why the unit is set up specifically to provide round-the-clock care.
Also Known As
Other names for the CCU include:
- Coronary care unit
- Critical coronary care unit
- Critical care unit
- Intensive cardiac care unit (ICCU)
- Cardiovascular intensive care unit (CICU)
Patients also need specific, often intense, treatments. These therapies may require special devices, equipment, medication, and trained staff.
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Conditions Managed in a CCU
An acute heart attack or acute coronary syndrome are the most common reasons a patient needs a stay in the CCU.
Other patients who may need to be in the CCU include those who:
- Are recovering fromcoronary bypass surgery
- Have decompensated heart failure (especially if they're very ill, unstable, and/or need a balloon pump or LVAD)
- Need close monitoring for severe heart failure (even if they've stabilized and are awaiting aheart transplant)
- Have acute coronary syndromes, unstable angina, or life-threateningcardiac arrhythmias
In many hospitals, CCUs treat patients who have other chronic health conditions in addition to heart problems.
For example, a 2017 study of patients admitted to a CCU with heart conditions found that many of them also needed care for other chronic medical conditions.
Here are the conditions that were most common:
- Sepsis
- Acute kidney injury
- Acute respiratory failure
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What to Expect in a CCU
CCUs are staffed and equipped to treat and manage problems that are unique to heart patients, especially when continuous monitoring is necessary.
Nurses, technicians, and other providers in the CCU have been specially trained to take care of people with serious cardiac conditions. They care for patients 24 hours a day.
A CCU will have a much higher staff-to-patient ratio than a typical hospital unit does.
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How a CCU Looks
A CCU is set up differently than other parts of the hospital where patients can be admitted.
Most CCUs have a centralized nursing station that's surrounded by eight to 12 single rooms for each patient.
Many patients in a CCU are on bed rest. However, comfortable seating is available for those who are able to (and may benefit from) being up for a prescribed period of time each day.
Each patient room has a large glass window that allows the patient to be easily seen by staff in the nurse's station.
The nursing station is fitted with monitoring screens that show continuous readouts for every patient. An emergency can be detected quickly and trained medical personnel can respond right away.
What's It Like in the ICU?
Monitoring
All patients admitted to the CCU are placed on a cardiac monitor that records and analyzes each beat of their heart.
The machine will sound an alarm to alert staff if serious problems happen—for example, if the patient has an irregular heartbeat (arrhythmia).
Some patients also have temporary catheters put in a wrist artery to continuously monitor their blood pressure. The catheters can also be put in a pulmonary artery to monitor blood pressure in the heart.
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Treatments
There are many different treatments that patients in the CCU might need. They may need to have more than one during their stay, depending on how sick they are.
Patients with severe heart failure may need to have an intra-aortic balloon pump (IABP) or aleft ventricular assist device (LVAD) to help their hearts pump blood.
One example of a highly specialized treatment in a CCU is targeted temperature management for patients who went into cardiac arrest.
This therapy lowers the patient's body temperature until they have mild hypothermia. Some research has shown that this treatment may help reduce the risk of brain damage.
CCUs also have ventilators for patients who cannot breathe well because of their heart condition.
Why Are Ventilators Used?
Testing
People in the CCU often need to have certain tests to monitor their condition. The units are equipped to perform these tests themselves, which means patients don't have to be moved.
For example, a CCU can handle doing bloodwork, electrocardiograms, echocardiograms, and chest X-rays.
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Can I Visit My Loved One?
Visitors to the CCU are encouraged to provide comfort and company to patients, but most only allow immediate family members. Most units have designated times during the day when people can visit, but they can usually only stay for a short time.
When you go see your loved one in the CCU, be prepared. They will probably be hooked up to wires and tubes.
While the sight can be disturbing, know that it is needed to keep them safe and cared for.
While loved ones might want to bring gifts, there are several things that won't be allowed—for example, food from outside the hospital and plants (like a bouquet of flowers).
Patients in the CCU are usually on special diets and need to stick to the food that they are allowed to have. Plants are not allowed because they can bring infection-causing bacteria into a patient's room.
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After the CCU
The average stay in the CCU is one to six days. However, patients usually don't go straight home once they no longer need to be in the CCU.
Step-Down Care
When they're ready to leave the unit, most patients are transferred to a cardiac “step-down unit" where they will have less intensive care.
Although continuous cardiac monitoring happens in a step-down unit, patients are allowed (and encouraged) to begin walking and moving regularly.
Often, physical therapists or exercise therapists work with patients in the step-down unit to help them make progress with moving about. They can also tell them which activities they will not be allowed to do when they go home.
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Going Home
Most cardiac patients are discharged home from step-down care.
They will usually be prescribed a cardiac rehabilitation program and be educated about any changes in their diet, exercise, and other lifestyle factors that might be necessary.
Making and sticking to these changes are very important for avoiding another stay in the CCU.
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Summary
People who have serious heart problems often need to be in the hospital. Usually, they will be in a special unit that has all the tools and staff needed to provide specialized care to patients with heart conditions and other serious medical problems.
After a person leaves the cardiac care unit (CCU), they will usually go to a "step-down" unit that will help them continue to recover and regain their strength.
When people are allowed to go home from the hospital, they often need to make changes to their diet and lifestyle to help prevent them from needing to go back to the CCU again.
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