Kamal Ghorui
New Delhi: An expert committee formed by Supreme Court has laid down minimum standards for intensive care units (ICUs), defining what hospitals must have to qualify as possessing an ICU – covering infrastructure, equipment and staffing. The framework mandates a dedicated ICU space with access to emergency services, operation theatres and laboratories, along with power backup, sanitation and proper layout. Bedside essentials include oxygen, suction and electrical points, along with equipment such as monitors, ventilators, defibrillators, crash carts, infusion and syringe pumps, glucometers and ECG machines.
New rules at a glance
Staffing is central to the norms. ICUs must be led by trained doctors and be manned round the clock, with higher nurse-to-patient ratios than in wards – ranging from 1:2 to 1:3 and up to 1:1 for critically ill or ventilated patients – supported by allied healthcare staff. The guidelines also emphasise continuous monitoring, life-support systems and strict infection control protocols as essential to ICU care. The norms are part of “Guidelines for the Organisation and Delivery of Intensive Care Services”, a report drafted by a three-member committee and vetted by medical experts, and endorsed by the court as “practical, implementable and necessary as a minimum standard for an ICU”. A bench of Justices Ahsanuddin Amanullah and R Mahadevan has asked states and Union territories to submit action plans identifying gaps and implementation strategies by May 18. The Supreme Court-appointed panel – comprising AIIMS doctor Nitish Naik, additional solicitor general Aishwarya Bhati and advocate Karan Bharioke – has said clinical judgment should guide decisions on the level of care required. Dr Harsh Mahajan, chairman of Mahajan Imaging Lab and one of the experts who vetted the guidelines, said it recognises gaps in rural and remote areas and suggests measures such as interim staffing norms and linking smaller ICUs with higher centres through e-ICU or tele-ICU support. Dr Saumitra Rawat of Sir Ganga Ram Hospital, part of group that vetted the guidelines, said, “The new guidelines classify ICUs into levels, making it mandatory for even entry-level units to meet defined norms,” he said.
