I spend a significant amount of time working in an MICU, but I realized a lot of people don’t really know what that is—or what I do.

MICU stands for Mobile Intensive Care Unit. An Intensive Care Unit (ICU) is typically a specialized facility in a hospital designed to provide advanced medical care for critically ill patients. Nearly all hospitals have a handful of ICU beds, while bigger hospitals specialize with cardiac ICUs, pediatric ICUs, trauma ICUs, neurological ICUs, and many others. A MICU is essentially a general-purpose ICU room mounted on a vehicle. MICUs are the highest level of ambulance made.

Ambulances range from simple vans with a stretcher, oxygen bottle, and first aid kit all the way up to the state-of-the-art MICU I work in at ETMC. An MICU carries significant equipment and is staffed with a highly trained paramedic (me!) who can deliver intensive care medicine. What does this involve?

• Breathing care including the ability to anestheize patients, insert breathing tubes, puncture the neck with needles to bypass the mouth, and a mechanical ventilator that lets us completely and precisely breathe for the patient. We also have monitoring capabilities to detect the amount of oxygen and carbon dioxide in the blood stream.
• Heart care including pacing, electrical therapy (defibrillation), cardiac monitoring, and 12-lead ECGs (which gives us a precise, thorough picture of the heart and what it is doing). We can also upload this data directly to cardiologists at the hospital.
• Medications including the ability to start IVs, administer a multitude of drugs to treat pain, provide sedation, and treat the patient’s condition, IV Pumps to provide long-term administration of drugs.

All of the equipment and supplies to treat almost any kind of patient is stocked in the cabinets of our MICUs, and the staff is thoroughly trained to use the equipment and handle emergencies.

Typically, our work is done in the pre-hospital setting—picking patients up from their homes or nursing homes and transporting them to the hospital. Having the ability to deliver life-saving care in the field significantly reduces complications that arise later on and give us the ability to save more lives.

Occasionally, we will do inter-facility transports with critical care patients (usually going to a higher level of care, such as a pediatric hospital or burn center in Dallas).

Most people have no idea what the extensive capabilities of ambulance crews are or the amount of training that is required to work on one. A paramedic certification requires the equivalent of an AS degree worth of training. Unfortunately, paramedic pay doesn’t match up with the training requirements and demand of the job, so there is a major national shortage of paramedics.