Indications for referral to ITU

Sites for the care of the critically ill:

Intensive care/therapy unit (ICU/ITU):

• An area where patients are treated for actual, impending or potential organ failure
• Require a high degree of organ support, including mechanical ventilation
• 1:1 nursing
• Medical cover immediately available

High-dependency unit:

• An area where patients at high risk are continuously and invasively monitored
• Mechanical ventilation is not normally required
• 1:2/3 nursing
• Medical cover immediately available

Criteria:

It is very difficult to have set rules for who should be admitted and who should not as patients in ITU are such a heterogeneous group. There are, however, some common criteria:

• Shock (systolic BP <90mmHg or 40mmHg fall from baseline) not responding to therapy
• Respiratory failure:
• Type I - P_aO₂ <8kPa and P_aO₂ <6kPa
• Type II - P_aO₂ <8kPa and P_aO₂ >6kPa

• Severe acidosis (pH <7.25, BE<-8)
• Exhaustion, drowsiness or coma
• Respiratory arrest