Union Health Ministry issues guidelines for hospitals on ICU admissions; Prior consent of patients or their relatives made mandatory

Union Health Ministry has issued guidelines for hospitals on ICU admissions directing 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. It said, 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.

The guidelines have been developed by 24 eminent physicians, including experts from Dubai and Canada, who have also recommended that



critically ill patients should not be admitted to ICU if any disease has a treatment limitation plan. Besides, anyone with a living will or advanced directive against ICU care and also 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 should not be admitted to ICU.

For ICU discharge criteria, the guideline 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.