ICU

The Intensive Care Unit is an expensive resource area and should be reserved for patients with reversible medical conditions with a reasonable prospect of substantial recovery. Patients with the following conditions are candidates for admission to the General Intensive Care Unit.

A. Respiratory

• Acute respiratory failure requiring ventilatory support
• Acute pulmonary embolism with hemodynamic instability
• Massive hemoptysis
• Upper airway obstruction

B. Cardiovascular

• Shock states
• Life-Threatening dysrhythmias
• Dissecting aortic aneurysms
• Hypertensive emergencies
• Need for continuous invasive monitoring of cardiovascular system
• (arterial pressure, central venous pressure, cardiac output)

C. Neurological

• Severe head trauma
• Status epilepticus
• Meningitis with altered mental status or respiratory compromise
• Acutely altered sensorium with the potential for airway compromise
• Progressive neuromuscular dysfunction requiring respiratory support and / or cardiovascular monitoring (myasthenia gravis, Gullain- Barre syndrome).
• Brain dead or potentially brain dead patients who are being aggressively managed while determining organ donation status Program.

D. Renal

• Requirement for acute renal replacement therapies in an unstable patient 
• Acute rhabdomyolysis with renal insufficiency

E. Endocrine

•  Diabetic ketoacidosis complicated by hemodynamic instability, altered mental status 
• Severe metabolic acidotic states
• Thyroid storm or myxedema coma with hemodynamic instability 
• Hyperosmolar state with coma and/or hemodynamic instability 
• Adrenal crises with hemodynamic instability
•  Other severe electrolyte abnormalities, such as:

- Hypo or hyperkalemia with dysrhythmias or muscular weakness
 - Severe hypo or hypernatremia with seizures, altered mental status
 - Severe hypercalcemia with altered mental status, requiring hemodynamic monitoring
 
 

F. Gastrointestinal

•  Life threatening gastrointestinal bleeding
• Acute hepatic failure leading to coma, hemodynamic instability 3. Severe acute pancreatitis

 G. Hematology

•  Severe coagulopathy and/or bleeding diathesis.
•  Severe anemia resulting in hemodynamic and/or respiratory compromise. 
•  Severe complications of sickle cell crisis.
•  Hematological malignancies with multi-organ failure.

H. Obstetric

•  Medical conditions complicating pregnancy
•  Severe pregnancy induced hypertension/eclampsia 
•  Obstetric hemorrhage
•  Amniotic fluid embolism

I. Multi-system

•  Severe sepsis or septic shock
•  Multi-organ dysfunction syndrome
•  Polytrauma
•  Dengue hemorrhagic fever/dengue shock syndrome
•  Drug overdose with potential acute decompensation of major organ systems 
•  Environmental injuries (lightning, near drowning,  hypo/hyperthermia
•  Severe burns

J. Surgical

• High risk patients in the peri-operative period
• Post-operative patients requiring continuous hemodynamic monitoring/ ventilatory support, usually following:

        - Vascular surgery

        - thoracic surgery

        - airway surgery

        - craniofacial surgery

        - major orthopedic and spine surgery

        - general surgery with major blood loss / fluid shift

        - neurosurgical procedures