New Delhi: An expert committee constituted by the Supreme Court has set minimum standards for intensive care units (ICUs), defining what hospitals should qualify to have ICUs – including infrastructure, equipment and staff. The framework mandates a dedicated ICU space with power backup, sanitation and proper layout along with access to emergency services, operation theaters and laboratories. Bedside essentials include oxygen, suction and electrical points as well as equipment such as monitors, ventilators, defibrillators, crash carts, infusion and syringe pumps, glucometers and ECG machines.

New rules at a glance

Staffing is at the heart of the norms. ICUs should be led by trained doctors and staffed around the clock with nurse-to-patient ratios comparable to wards – ranging from 1:2 to 1:3 and up to 1:1 for critically ill or ventilated patients – supported by paramedic health care staff. The guidelines also emphasize the constant monitoring, life-support systems and strict infection control protocols required for ICU care. The criteria are part of the “Guidelines for the Organization and Delivery of Intensive Care Services”, a report prepared by a three-member committee and examined by medical experts, and endorsed by the court as “practical, implementable and necessary as a minimum standard for ICUs”. A bench of Justices Ahsanuddin Amanullah and R Mahadevan asked the states and Union Territories to identify the shortcomings and submit action plans and implementation strategies by May 18. The Supreme Court-appointed panel – comprising AIIMS doctor Nitish Naik, Additional Solicitor General Aishwarya Bhati and lawyer 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 reviewed the guidelines, said it recognizes the gaps in rural and remote areas and suggests measures such as interim staffing norms and linking smaller ICUs to higher centers through e-ICU or tele-ICU support. Dr. Soumitra Rawat of Sir Ganga Ram Hospital, part of the group reviewing the guidelines, said, “The new guidelines classify ICUs into tiers, making it mandatory for even entry-level units to meet the defined criteria,” he said.