What Are India’s New ICU Guidelines

If a family member needs to be admitted to the ICU, it’s crucial to understand the admission criteria beforehand to avoid confusion and delays in treatment. These guidelines, provided by the health ministry, outline the criteria for ICU admission and also specify who should not be admitted to the ICU.

Criteria for ICU Admission:

  1. Organ failure and need for organ support, or anticipation of medical deterioration.
  2. Altered level of consciousness of recent onset.
  3. Hemodynamic instability, such as clinical signs of shock or arrhythmias.
  4. Need for respiratory support, including escalating oxygen requirement or respiratory failure requiring ventilation.
  5. Severe acute or acute-on-chronic illness requiring intensive monitoring or organ support.
  6. Major intraoperative complications or major surgery, necessitating intensive monitoring.

Who Should Not Be Admitted To ICU:

  1. Patient’s or next-of-kin’s refusal to be admitted to the ICU.
  2. Diseases with a treatment limitation plan.
  3. Living will or advanced directive against ICU care.
  4. Terminally ill patients with a medical judgment of futility.
  5. Low priority criteria during pandemics or disasters, when resources are limited.

Additionally, the guidelines emphasize the importance of monitoring vital signs and neurological status for patients awaiting ICU admission. Discharge criteria include the return of physiological parameters to near-normal levels, reasonable resolution and stability of the acute illness, and agreement from the patient or family for discharge, especially for palliative care decisions.