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118 Tropical and Parasitic Infections in the ICU
will have to be made about the responsible cost effective utilization of
expensive resources. Some of these decisions will raise serious clinical
and ethical dilemmas with which each affected institution and country will
have to grapple, and which will often be resolved at a political level.
There are a number of serious life-threatening disease complications that
necessitate consideration for intensive care intervention. These include
pulmonary complications resulting in acute respiratory failure, central
nervous system infections such as cryptococcal meningitis, acute systemic
bacterial infections that result in severe sepsis and organ compromise, and
non-HIV related disease processes such as trauma, post elective surgery
ICU care and obstetric complications
ADMISSION CRITERIA AT CHRIS HANI
BARAGWANATH HOSPITAL – BROAD GUIDELINES
FOR ADMISSION
The following are guidelines that we use to govern admission of patients
to a multidisciplinary ICU. The final decision to admit or to refuse
admission of a patient to ICU is the prerogative of the ICU consultant on
call.
Prospective candidates for ICU admission should have a demonstrable
reversible disease process with a reasonable outcome. The general concept
that as a consequence of admission to an intensive care unit, positive
benefit is expected for the patient is applied.
1.
2.
3.
Patients (both paediatric and adult) who have AIDS-defining illnesses
are not admitted, as a general rule. The reasons include the poor longterm
outlook for HIV-infected people without access to HAART and
the poor outcomes of many such patients in an ICU (6).
Patients with severe neurological devastation, from whatever cause,
are not considered for admission.
Patients with end-stage organ or neoplastic diseases are not
considered good ICU admission candidates. The exceptions are
patients with these conditions who are postoperative for palliative
procedures requiring less than 48hrs post-operative observation in
ICU.
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