How One Doctor's Card Game Is Helping ICU Patients

Marie DeFreitas

October 22, 2021

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Since the beginning of the pandemic, intensive care units (ICUs) all across the country have seen a massive influx of patients, leaving hospital staff overwhelmed and overworked. Visitation with patients has been restricted, as have face-to-face conversations between staff and family. To convey information, more time-consuming methods — such as phone and video calls — have become necessary, causing even more strain on staff. What was once a bustling environment of physicians, patients, and their loved ones soon became a dismal and lonely place.

Staff were burned out and struggling to effectively communicate information about the COVID-19 virus to their patients. For Lakshman Swamy, MD, who at the time was a fellow at the Boston Medical Center, the ICU that once felt like a second home was now a grueling and distressing environment.

When Swamy returned home each night, he began to imagine what the ICU was like before the pandemic. "It was kind of a private journaling experience for me at first, where I just started to kind of put this whole ICU together on paper that I missed, frankly," Swamy told Boston.com.

Soon, the game Critical Care was born.

Critical Care is a card game in which players diagnose, treat, and heal their patients using real ICU therapies and diagnoses. With patient-friendly language and descriptions, players learn the world of ICU medicine and procedures as they play.

Swarmy hopes that Critical Care can not only help people understand the nature of an ICU but also help medical staff reconnect to a pre-COVID environment.

"The biggest challenge was keeping it authentic and also accessible. In the beginning, I tried making it so all of the cards had plain English titles, but it just didn't work. 'Gallbladder disease' is just not the same as 'cholecystitis.' So I decided to stick to all medical terminology in the titles, which kept the thematic content extremely authentic," Swamy told Medscape Medical News.

There are over 300 unique cards, and it can be played by one to four players. The game encourages players to think critically about the best way to help their patients. Players face challenges, such as infections and staff shortages. In addition, the longer a patient is in the ICU, the more trauma they will endure. From heart attacks to brain injuries, players will experience all of the ups and downs of a real ICU.

Over 300 cards represent various situations that may occur in an actual ICU, forcing players to adapt quickly.

Swamy created the game in hopes of decreasing staff burnout and improving staff-to-patient communication while sharing the joy he finds in working in the ICU.

"I know it sounds strange, but I found refuge in escaping to the pre-COVID ICU. My favorite part of making the game has to be the many hours I put in reminding myself what it was like before COVID ― families at the bedside, close connections with colleagues, feeling like we were making a big difference in people's lives ― all of which were lost or diminished with the pandemic."

The game also takes into consideration different aspects of social justice and how it affects the players and their patients.

"We wanted to democratize the language of the intensive care unit and medicine in the hospital in general," Swamy said. "It's [historically] patriarchal, you know. There's a huge barrier of access; it's not equitable.

"You don't need to know any medicine to play, and the education is coming along for the ride, which I hope means it reaches many more people."

Swamy worked to ensure that the team he created to bring the game to fruition was diverse and would bring a range of perspectives and expertise to the table. The team includes a game designer, a clinical researcher, an author, and an ICU survivor.

"My dream is to see families playing this game and starting conversations around the coffee table about health and healthcare, about clinical careers. It is a real dream of mine that people play Critical Care and are inspired to become doctors, nurses, respiratory therapists, whatever," Swamy told Medscape.

The public can pledge donations for the Critical Care Kickstarter on the website.

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