New Delhi: The Union Health Ministry has issued guidelines on ICU admissions, stating that hospitals cannot admit critically ill patients to the intensive care unit if they or their relatives refuse. The guidelines, compiled by 24 experts, emphasize that ICU admission criteria should be based on organ failure, the need for organ support, or anticipation of deterioration in medical condition. The guidelines recommend against admitting patients with a living will or advanced directive against ICU care and highlight low priority criteria during a pandemic or disaster situation with resource limitations.

Criteria for ICU admission include altered level of consciousness, hemodynamic instability, need for respiratory support, acute illness requiring intensive monitoring or organ support, major intraoperative complications, and anticipation of deterioration. Critically ill patients who should not be admitted to the ICU include those refusing admission, with a treatment limitation plan, living will or advanced directive against ICU care, terminally ill patients judged futile, and those with low priority criteria during a pandemic or disaster. The guidelines also outline criteria for ICU discharge, including the return of physiological parameters to near normal, resolution and stability of acute illness, and agreement for ICU discharge for treatment-limiting decisions or palliative care.

Monitoring parameters for a patient awaiting an ICU bed include blood pressure, pulse rate, respiratory rate, breathing pattern, heart rate, oxygen saturation, urine output, and neurological status, among others. The guidelines aim to provide clarity and standardization in ICU admissions, considering the patient's condition and available resources.

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