The Internet of Things (IoT) has the power to transform medical procedures and improve measures of the state of the world's health. Because it cares for patients who have been in catastrophic accidents, have serious illnesses, or are receiving successful medical treatment, the Intensive Care Unit (ICU) is a crucial component of the medical industry. Due to a heavy workload, a lack of patient monitoring systems may result in medical errors. A smart IoT-based ICU patient monitoring system is suggested to help doctors and hospitals watch the patients continuously and make timely judgments in order to optimize the ICU monitoring process. The device can monitor a patient's body parameters in real-time, and if any numbers are abnormal, it will notify the doctor who has been assigned to the patient and the Emergency Care Unit. (ECU). Through the device, doctors may also keep an eye on the patient from a distance. The biggest challenge is sorting only contextual data related to patient health. It's impossible to have a simple sensor-to-cloud architecture, and that's where fog layers come into play. This not only reduces the amount of data sent back and forth between the cloud and the sensors, but also improves the efficiency of the entire system as it eliminates the risk of data-center failure. We are also reviewing the security and deployment of this fog computing layer.