Introduction

Patients in the intensive care unit (ICU) cannot react normally to danger because they are acutely ill. They cannot describe adverse symptoms properly nor indicate pain accurately. In many instances they will be sedated in order to tolerate their treatment. Some may be both sedated and paralysed. Such patients are unable to protect themselves and rely completely on the medical and nursing staff attending them to keep them safe.

Procedures which are designed to benefit intensive care patients also carry risks. Many procedures are invasive, i.e. they break the patient's natural skin barrier, putting him or her at risk of infection. Monitoring and treatment often require the use of numerous pieces of equipment with the consequent danger of malfunction. In addition, drugs have undesirable as well as desirable effects.

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