The Union Health Ministry has recently issued comprehensive guidelines for hospitals across the country regarding Intensive Care Unit (ICU) admissions. The guidelines emphasize the importance of obtaining prior consent from patients or their relatives before admitting critically ill individuals to the ICU.
Developed by a panel of 24 eminent physicians, which includes experts from Dubai and Canada, these guidelines set clear criteria for ICU admissions and discharge. The primary focus is on ensuring that ICU admissions are based on the severity of organ failure and the necessity for organ support or in anticipation of a potential deterioration in the patient’s medical condition.
Parameters such as blood pressure, pulse rate, respiratory rate, breathing pattern, heart rate, oxygen saturation, urine output, and neurological status are highlighted as critical indicators that should be continuously monitored for patients awaiting an ICU bed.
One of the key recommendations put forth by the expert panel is that critically ill patients should not be admitted to the ICU if there is a pre-existing treatment limitation plan for any underlying disease. Additionally, individuals with a living will or advanced directive explicitly against ICU care, as well as those deemed terminally ill with a medical judgment of futility, are advised not to be admitted to the ICU.
The guidelines also address scenarios where resource limitations are prevalent, such as in a pandemic or disaster situation. In such cases, individuals with low-priority criteria are advised against ICU admission.
For ICU discharge criteria, the guidelines stress the importance of physiological parameters returning to near-normal or baseline status. Furthermore, reasonable resolution and stability of the acute illness that led to ICU admission are essential factors. Patient and family agreement for ICU discharge, particularly in cases where a treatment-limiting decision or palliative care is opted for, is also highlighted.