A patient with Hypoxic Brain Damage and a Patient with Stroke: Prioritized in ICU

Providing resources to meet all health and medical needs in the health sector is not totally realized even in wealthy countries. Hence, the issue of resource allocation and prioritization has always been one of the management challenges in health systems.
Patient The patient was a 63-year-old man who taken to the hospital because of a reduced level of consciousness. In the ambulance, the patient had a heart attack and received electric shock due to ventricular fibrillation (VF). Immediately after admission to the hospital, he was hospitalized in the intensive care unit (ICU). After two days, the patient's consciousness was still low and his pupil showed a slight reaction to light. A few hours later, the patient suffered a seizure and the CT Scan results indicated hypoxic brain damage. Despite medical and special care efforts, he has remained in the same situation in the ICU and no improvement has been found. It is 22 days that he has been in the hospital. Recently, an 18-year-old patient has been taken to the hospital due to a stroke in a car accident. However, there is no blank capacity of ICU in other wards of the hospital and we face a shortage of ICU beds. Through the establishment of the hospital ethics committee, review of indications, and involvement of the 62-year-old patient’s fellows in decision-making, one bed can be added to one of the wards and the necessary ICU services can be provided to the patient with a higher emergency status. Another suggestion is that an extra bed can be added to the ICU in order to keep both patients in this ward. In this case, considering the resource constraints, the quality of serving all patients will similarly reduce from the standard level.
Keywords: Prioritization; Resource allocation; ICU bed; Medical ethics