The Union Health Ministry’s new guidelines, Govt.of India on ICU admissions were developed by 24 eminent physicians.

For the first time, the government has issued guidelines for hospitals on ICU admissions and directed them that they cannot admit critically ill patients in the intensive care unit in case of a refusal by them and their relatives.

The guidelines for ICU admission and discharge criteria further clarified that the requirements for admitting a patient to ICU should be based on organ failure and the need for organ support or in anticipation of deterioration in the medical condition.

According to the guidelines compiled by a group of twenty-four experts, it is considered futile care to keep a patient in the intensive care unit (ICU) if there is no available or possible treatment for their disease or if the patient is terminally ill and continuing therapy will not improve their prognosis, particularly their chances of survival.

The seven-page guidelines list also said that terminally ill patients with a medical judgment of futility should not be admitted to the ICU.

It also said that those with low priority criteria in a pandemic or disaster situation, where there is resource limitation (e.g. bed, workforce, equipment), should not be admitted to ICU.

It also spelled out admission criteria for the ICU.

This includes the altered level of consciousness of recent onset, hemodynamic instability, need for respiratory support, patients with acute illness requiring intensive monitoring and organ support, or any medical condition or disease with anticipation of deterioration.

Patients who have experienced any major intraoperative complication like cardiovascular or respiratory instability or have undergone major surgery are the other feature among the criteria for ICU admission.

It also lists ICU discharge criteria. This includes the return of physiological aberrations to near normal or baseline status, reasonable resolution and stability of the acute illness that necessitated ICU admission, and patient/family agreeing for ICU discharge for a treatment-limiting decision or palliative care.

According to the guidelines, blood pressure, pulse rate, respiratory rate, breathing pattern, heart rate, oxygen saturation, urine output and neurological status, among other parameters should be monitored in a patient awaiting an ICU bed.

It also lists the qualifications of the Intensivist or critical care specialist which is now mandatory in nature.

This is a milestone decision taken by the Government of India on the health safety of its citizens. Qualified and experienced health care professionals will definitely cater the requirement of the patients and treat them using their emotional intelligence.

AIIMS Technology Council www.iimstc.com