Indication and Prognostication

The decision to admit or not admit a patient to the intensive care unit (ICU), thus increasing the intensity of care, should be the result of medical expertise regarding the reversibility of the acute condition that led to the failure of vital organ systems, in accordance with the will of the patient. Since all required information may not be available in the acute situation, nor the certainty of the effectiveness of intensified treatment in the ICU, admission of the patient for a predetermined time period to see any improvement and reversibility may be advisable. This holds especially true for the unknown patient with limited available documentation, seen in an emergency department. Ideally, different scenarios were discussed previously and electively with physicians involved, the patient, and the family. Taking time is important and can be used to collect all required information while also observing the effect of the implemented therapies in the ICU since a patient can die only once. The use of scoring systems for the individual patient to determine indication and prognostication for treatment in an ICU is of limited value.