History of Intensive Care

In 1854, Florence Nightingale described the advantage of grouping together the sickest patients during the treatment of soldiers injured in the Crimean War. It was a natural progression to try and apply this strategy in the hospital setting. One of the first descriptions of an ICU proper was in 1927 at the Sarah Morris Hospital in Chicago (designed to improve the care of premature infants). By comparison, the clustering of adult critically ill patients in the mid 20th Century was often temporary and involved the use of postoperative recovery areas during particular times of need such as the 'Coconut Grove' Nightclub fire in Boston, Massachusetts (1942). One of the first permanent ICUs was set up by Walter Dandy (a neurosurgeon) in the late 1940s to facilitate the care of postoperative neurosurgical patients at Johns Hopkins Hospital in Baltimore.