Govt issues ICU guidelines today. In the new year, the Indian government has issued some crucial guidelines on ICU treatment. On 3 January, 2024 Union Health ministry has released a new infrastructure and guidelines about ICU admission and discharge, also mentioning that hospitals can not admit any patients in ICU who are in critical condition if they or their family refuse. According to the new guidelines made by 24 experts, keeping a patient in ICU, when no further treatment is available or positive in that hospital in any diseases or any cases is futile, if the patient is not responding to that treatment or their servival issue.
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Table of Contents
Govt of Health Ministry issued ICU guidelines treatment: Every Details
1) Basic Criteria of ICU admission:
The basic criteria to admit a patient in ICU are-
- If the patient medical condition detoriate
- In case of organ support
- In case of organ fail
2) Admission Guidelines in ICU:
There are some admission criteria if hospital want to admit or shift a patient in ICU
- The patient had underwent a critical surgery (like open heart surgery, thoracic, damage kidney removal surgery, thoracoabdominal surgery or thorax and abdomen surgery, brain tumor surgery and any major trauma patients who need highly intensive monitoring)
- A patient who needs ALC or newly set altered level of consciousness which means if the patient condition deteriorated frequently and need more attention
- A patient who had undergone any major wrong surgery before or had going through any problem after any surgery
- In case of Hemodynamic instability which means unstable blood pressure that can cause any internal blood flow.
- Any diseases or medical condition with anticipation of decline
- Patients in critical condition or emergency cases who need life support or intensive monitoring
- Patients who require respiratory or inhaling support like in case of de novo inhaling system fail, patient needs ventilation system)
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3) The criteria under which ill Patient should not admit in ICU:
- Patients whose treatment are limited or can be cure without iCU support
- Refusal of ill patients or their family can’t be admitted in ICU
- In case of any disaster or pandemic situation when resources are limited ( like equipment, workers and bed), less needed patients will get low chance of ICU treatment
- Critically ill patients with futility medical judgement
4) Discharge Criteria from ICU:
- Family agree to discharge from ICU treatment in case of limitations discussion
- Lack of benefit from confront care ( this decision should be taken by family members or due to economic crises, this decision should taken by doctors and medical team)
- Stable solution for acute patients with necessary equipment
- Patients return to normal condition or stable condition
5) Things to monitoring while awaiting for ICU bed:
- Pulse rate and breathing pattern
- Blood pressure (continuously)
- Oxygen saturation (continuously)
- Urine output ( continuously)
- Blood sugar
- Intermittent Temperature (monitoring)
- Capillary refilling time
- Neurological conditions, in case of GCS ( Glasgow Coma Scale) and AVPU (Alert Verbal Pain Unresponsive)
- SpO2 (continuously)
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According to Dr. R K Mani, these experts of ICU guidelines said that their decisions are made for people with judicious concern to ensure the right patients can use the ICU facility and those who require it.
“India has almost 5 – 10 lakhs ICU beds which are mostly located in big cities and in private hospitals so poor people have to struggle to get these facilities’ ‘ told by public Health activist and advocate Ashok Agarwal. In private hospitals these ICU beds cost 5- 10 times more than a general bed, which has to be changed and ICU administration should look into these matters also, he added.
