What criteria should I use to determine whether a patient requires admission to the ICU?

Criteria for ICU Admission: Patients should be admitted to the intensive care unit (ICU) if they have or are at high risk of developing life-threatening organ dysfunction requiring advanced monitoring and support that cannot be provided in a general ward setting. This includes severe respiratory failure requiring mechanical ventilation, circulatory shock needing vasoactive drugs, or multi-organ failure. Early recognition of clinical deterioration using validated scoring systems and physiological parameters is essential to identify those who need ICU care promptly ¹ (Unknown, 1999).

Admission decisions should consider the severity and reversibility of the acute illness, the patient’s baseline functional status, comorbidities, and the potential for benefit from intensive care interventions ¹ (Unknown, 1999). For pediatric patients, intermediate care or high-dependency units may be appropriate for those requiring close monitoring but not full ICU support, with ICU admission reserved for those needing invasive ventilation or complex organ support (Jaimovich and Committee on Hospital Care and Section on Critical Care, 2004).

Specific clinical triggers for ICU admission include but are not limited to: respiratory distress with hypoxia or hypercapnia unresponsive to standard oxygen therapy, haemodynamic instability despite fluid resuscitation, altered mental status due to critical illness, and the need for continuous renal replacement therapy or other advanced organ support ¹ (Unknown, 1999). The decision should also integrate multidisciplinary clinical judgment and consider patient preferences and overall prognosis.