Hospitals cannot admit critically ill patients in ICU if they or kin refuse: Govt guidelines
New Delhi (PTI): Hospitals cannot admit critically ill patients in the intensive care unit in case of refusal by them and their relatives, the Union Health Ministry has said in its recent guidelines on ICU admissions.
The guidelines compiled by 24 experts further recommended that when no further treatment is possible or available in a disease or in terminally ill patients if the continuation of therapy is not going make an impact on the outcome, especially survival, then keeping in ICU is futile care.
Further, anyone with a living will or advanced directive against ICU care should not be admitted to ICU.
Besides, low priority criteria in case of pandemic or disaster situation, where there is resource limitation, should be taken into account for keeping a patient in the ICU.
Criteria for admitting a patient to ICU should be based on organ failure and need for organ support or in anticipation of deterioration in the medical condition, the guidelines stated.
Altered level of consciousness of recent onset, hemodynamic instability, need for respiratory support, patients with acute illness requiring intensive monitoring and/or organ support or any medical condition or disease with anticipation of deterioration have been listed as criteria for ICU admission.
Patients who have experienced any major intraoperative complication like cardiovascular or respiratory instability or have undergone major surgery also feature among the criteria.
"The following critically ill patients should not be admitted to ICU -- patient's or next of ?kin's informed refusal to be admitted in ICU, any disease with a treatment limitation plan, anyone with a living will or advanced directive against ICU care, terminally ill patients with a medical judgement of futility and low priority criteria in case of pandemic or disaster situation where there is resource limitation (e.g. bed, workforce, equipment)," the guidelines stated.
Return of physiological aberrations to near normal or baseline statu, reasonable resolution and stability of the acute illness that necessitated ICU admission, patient/family agreeing for ICU discharge for a treatment-limiting decision or palliative care have been mentioned in the ICU discharge criteria.
According to the guidelines, 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.
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Hundreds of TVK supporters return disappointed from cancelled swearing in ceremony venue
Chennai (PTI): Hundreds of TVK supporters, fuelled by the hope of seeing their leader Vijay as chief minister, gathered at Nehru Indoor Stadium in the city on Thursday, only to be met with locked gates and a lack of information regarding the scheduled proceedings.
Many supporters, travelling from various parts of the state, near and far, like Arumbakkam and Coimbatore, expressed deep disappointment and confusion upon finding the premises closed and without official communication.
Speaking to PTI Videos, fans and party loyalists described a sense of heartbreak after arriving early to secure a place in line.
Charulatha, a supporter, noted the emotional toll of the situation: "We came with so much joy thinking he would become the chief minister today, but there is nothing here. The gates are closed. It is very painful."
Sai Deepika, her daughter and a student set to enter the 12th grade, shared her excitement for the event: "I was very excited to be here. I have been telling everyone he will win and do good things for the people."
A visibly distressed Gunasundari, a long-time political observer from a family of AIADMK supporters, stated she shifted her loyalty to Vijay: "I publicly say I voted for Vijay. I have a belief that he will help those in need. Seeing the gates closed like this is a shock."
Despite the confusion on the ground, the gathered crowd remained steadfast in their political choice. Several supporters highlighted Vijay’s decision to fund party activities independently as a key reason for their trust.
"He didn't take a single rupee from the people for his flag or the stage. He did it all himself," said an emotional Gunasundari. "Even if they try to shame him or create obstacles, he is the one who will eventually win."
Many attendees cited news reports and social media claims as their reason for arriving early on Thursday morning. Some supporters mentioned they had travelled via public transport and waited for hours under the impression that an official declaration or event was imminent.
"My son told me that declarations were made yesterday and everyone was coming today," Gunasundari added. "I didn't even tell him I was leaving; I just started my journey to see him in person for the first time".
