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Rachel V Thomas

ICU Admissions: Who Really Needs Critical Care? | Explained

In the wake of a young doctor from Chandigarh accusing a well-known private hospital of unnecessarily admitting patients to <span>Intensive Care Units</span> (ICUs), it is imperative to understand who truly requires critical care.

In a widely shared video posted on the social media platform Instagram, Dr <span>Prabhleen Kaur</span> <a href="https://www.healthandme.com/health-news/chandigarh-doctor-alleges-hospital-forcibly-keeping-all-patients-in-icu-article-154007389" data-type="tilCustomLink">alleged that the hospital</a> is making the patients remain admitted in the <span>ICU</span> for as long as possible to mint money.

The doctor did not mention the name of the hospital. And HealthandMe could not independently verify the details and the authenticity of the post.

However, the incident reignited concerns over accountability, patient safety, and standards of care in the country.

Speaking to HealthandMe, Dr. Sachna Shetty, Consultant Emergency Medicine at Jaslok Hospital and Research Centre, said that: "ICU admissions are for patients with life-threatening conditions needing intensive support".

"This includes shock, respiratory failure, neurological emergencies, cardiac issues, and multi-organ dysfunction," the doctor added.

<h2>What Is ICU? Who Needs Critical Care?</h2>

The NHS UK explains that intensive care units (ICUs) are specialist hospital wards that provide treatment and monitoring for people who are very ill.

They're staffed with specially trained healthcare professionals and contain sophisticated monitoring equipment.

Also called critical care units (CCUs) or intensive therapy units (ITUs), it is required in cases where a person is seriously ill and requires intensive treatment and close monitoring.

Doctor Alleges ICU Admissions Done For Profit In Private Hospital #shorts #shortsfeed #icufraud

Most people in an ICU have problems with one or more organs. For example, they may be unable to breathe on their own. Some common reasons include:

<ul><li>a serious accident</li><li>a serious short-term condition</li><li>a serious infection</li><li>a major surgery.</li></ul>"It is not for stable patients, those needing observation, end-stage disease with no reversible cause, or those refusing aggressive care" Dr. Shetty said.

"ICU beds are limited, reserved for those who'll benefit most. Decisions are time-sensitive, based on triage and clinical scoring. It's about who needs advanced life support, not just who looks critical. Fair use of resources is key," the doctor added.

<h2>ICU Admissions: What India’s Guidelines Say </h2>

India’s ICU admission guidelines—issued by the <span>Ministry of Health and Family Welfare</span> in January 2024 — clearly defines who should and should not be admitted to an ICU. According to the guidelines:

<ul><li>ICU admissions must be 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. </li><li>Hospitals cannot admit critically ill patients in ICU in case of refusal by them and their relatives. </li><li>ICU is not recommended in cases where there is no treatment possible or available, and if the continuation of therapy is not going to make an impact on the outcome, especially survival. </li><li>Anyone with a living will or advanced directive against ICU care should not be admitted to ICU.</li><li>Low priority criteria in case of a pandemic or disaster situation, where there is resource limitation, should be taken into account for keeping a patient in the ICU.</li><li>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</li></ul>The criteria for ICU admission includes:

<ol><li>patients with altered level of consciousness, </li><li>hemodynamic instability, </li><li>need for respiratory support, </li><li>patients with acute illness requiring intensive monitoring </li><li>organ support or any medical condition or disease with anticipation of deterioration.</li></ol> 

<h2>Guidelines For ICU Discharge Criteria In India</h2>

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.

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In the wake of a young doctor from Chandigarh accusing a well-known private hospital of unnecessarily admitting patients to Intensive Care Units (ICUs), it is imperative to understand who truly requires critical care.In a widely shared video posted on the social media platform Instagram, Dr Prabhleen Kaur alleged that the hospital is making the patients remain admitted in the ICU for as long as possible to mint money.The doctor did not mention the name of the hospital. And HealthandMe could not independently verify the details and the authenticity of the post.However, the incident reignited concerns over accountability, patient safety, and standards of care in the country.Speaking to HealthandMe, Dr. Sachna Shetty, Consultant Emergency Medicine at Jaslok Hospital and Research Centre, said that: "ICU admissions are for patients with life-threatening conditions needing intensive support"."This includes shock, respiratory failure, neurological emergencies, cardiac issues, and multi-organ dysfunction," the doctor added.What Is ICU? Who Needs Critical Care?The NHS UK explains that intensive care units (ICUs) are specialist hospital wards that provide treatment and monitoring for people who are very ill.They're staffed with specially trained healthcare professionals and contain sophisticated monitoring equipment.Also called critical care units (CCUs) or intensive therapy units (ITUs), it is required in cases where a person is seriously ill and requires intensive treatment and close monitoring.      Most people in an ICU have problems with one or more organs. For example, they may be unable to breathe on their own. Some common reasons include:a serious accidenta serious short-term conditiona serious infectiona major surgery."It is not for stable patients, those needing observation, end-stage disease with no reversible cause, or those refusing aggressive care" Dr. Shetty said."ICU beds are limited, reserved for those who'll benefit most. Decisions are time-sensitive, based on triage and clinical scoring. It's about who needs advanced life support, not just who looks critical. Fair use of resources is key," the doctor added.ICU Admissions: What India’s Guidelines Say India’s ICU admission guidelines—issued by the Ministry of Health and Family Welfare in January 2024 — clearly defines who should and should not be admitted to an ICU. According to the guidelines: ICU admissions must be 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. Hospitals cannot admit critically ill patients in ICU in case of refusal by them and their relatives. ICU is not recommended in cases where there is no treatment possible or available, and if the continuation of therapy is not going to make an impact on the outcome, especially survival. Anyone with a living will or advanced directive against ICU care should not be admitted to ICU.Low priority criteria in case of a pandemic or disaster situation, where there is resource limitation, should be taken into account for keeping a patient in the ICU.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 bedThe criteria for ICU admission includes:patients with altered level of consciousness, hemodynamic instability, need for respiratory support, patients with acute illness requiring intensive monitoring organ support or any medical condition or disease with anticipation of deterioration. Guidelines For ICU Discharge Criteria In IndiaThe 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.

icu admissions: who really needs critical care?

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