Criteria for admission to an intensive care unit (ICU):
(1) presence of either invasive ventilatory support or significant hypotension
(2) absence of exclusion criteria at initial assessment
(3) determine priority based on clinical features
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Clinical Features
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Color Code
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Management
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single organ failure OR SOFA <= 7
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red
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highest priority for intensive care
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SOFA 8-11 AND multiple organ failure
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yellow
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intermediate priority for intensive care
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no significant organ damage (no longer meets inclusion criteria)
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green
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discharge or defer
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SOFA >= 12 OR exclusion criteria present at any time up to 48 hours after initial assessment
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blue
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manage medically; provide palliative care if needed; discharge from ICU
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where:
• The priority table has gaps in the assignments. For example, no SOFA score is given for green, and probably reflects no longer meeting the inclusion criteria. Red should be single organ failure AND SOFA <=7, or yellow should be multiple organ failure AND SOFA 8-11.
• It is hard to imagine that a person would have a low SOFA score and still meet the requirement for evaluation (need for respiratory support and/or hypotension).
Criteria for needing mechanical ventilatory support - one or more of the following:
(1) refractory hypoxemia (FIO2 > 0.85 or SpO2 < 90% on non-rebreather mask)
(2) respiratory acidosis with pH <= 7.19
(3) impending respiratory failure on clinical exam
(4) unable to maintain or protect the airway
Criteria for significant hypotension - all of the following
(1) systolic blood pressure < 90 mm Hg or relative hypotension
(2) shock (altered level of consciousness, decreased urine output, other signs of end-organ failure)
(3) refractory to volume resuscitation
(4) requirement for vasopressor or inotrope support
(5) cannot be managed on a ward setting
