An ICU consultant is asked to assess an 85-year-old man with advanced dementia and community-acquired pneumonia. The patient lives in a care home and ...

Question

An ICU consultant is asked to assess an 85-year-old man with advanced dementia and community-acquired pneumonia. The patient lives in a care home and has severe frailty (Clinical Frailty Scale 8/9). He is unable to communicate and is bedbound. There is no ADRT or LPA. His family is present. The consultant considers that ICU admission would not be appropriate and recommends ward-based ceiling of care. According to FICM/ICS guidance, what process should be followed?

Accepted Answer

A clear, documented assessment of benefit and burden should be made, the family should be consulted to understand the patient's values and wishes, and the decision should be communicated compassionately with clear reasoning

Answer

The consultant can unilaterally decide without any consultation

Answer

The decision must be made jointly with the family - they must agree

Answer

All patients referred to ICU must be admitted regardless of clinical circumstances

Answer

The decision can only be made by two consultants of different specialties

uk-fficm MCQ (SBA): ICU Admission Decision-Making