Smarter, kinder, closer, how India's open ICU model is changing critical care
Dr Sameer Jog, senior intensivist at Deenanath Mangeshkar Hospital, Pune,
about the shift to a more humane and inclusive approach to critical care
What's the most significant shift in ICU care over the past two decades?
When I began practising, ICUs were almost off-limits to families.
Communication was minimal, access was restricted, and it felt like a world run by machines. Today, Indian ICUs are far more inclusive and patient centric.
Families are part of the discussion, counselling is routine, and visiting hours are more liberal. However, the most profound shift is not just in attitudes, but also in how we have adapted the Open ICU model to work for India.
How is it different from the closed ICU systems used in the West?
A closed ICU, standard in most western hospitals, is a system where the moment a patient enters, their primary care shifts entirely to the intensivist — a specialist in critical care.
The primary doctor (cardiologist, nephrologist or surgeon) steps back completely. While this ensures standardised ICU protocols and rapid decisions, it also disconnects the patient from the doctor who knows them best. India's Open ICU model allows the patient's primary doctor and the intensivist to work together.
This respects our context, as doctor-patient relationships here are long-term and deeply personal.
by Taboola
by Taboola
Sponsored Links
Sponsored Links
Promoted Links
Promoted Links
You May Like
Alexa Automated Homes in Santacruz West
Veena Solace – Santacruz
Learn More
Undo
Many families trust their primary doctor more than a hospital system. The open model preserves that trust while still providing ICU-level expertise.
How does it aid patients' families?
In traditional ICUs, families may feel isolated from the care process, especially when the doctor they trust is not involved. Critical decisions — like whether to intubate, perform a high-risk procedure, or shift to palliative care — are sometimes made without emotional context.
In India, where doctors often serve generations, this disconnect can create confusion, distress, and even conflict. The Open ICU model reduces that tension, creating a shared decision-making environment that's more transparent, culturally appropriate, and emotionally supportive.
What about concerns that it may lead to inconsistent care or conflict between specialists?
It's a valid concern but, over time, we have developed protocol-driven systems that ensure safety while allowing flexibility.
The intensivist ensures evidence-based critical care, while the primary physician brings continuity and context. When done right, it becomes a partnership, not a turf war.
How are tele-ICUs changing care, especially outside metro hospitals?
We've built hub-and-spoke systems where experienced intensivists in urban centres remotely guide doctors in smaller towns via video feeds and real-time data. They assist in ventilator adjustments, drug titration, and even code blue (emergency) situations.
This model is saving lives where no intensivist is physically available without the patient needing to be shifted. It's cost-effective, scalable, and immediate.
What are the major tech advances transforming Indian ICUs today?
The technological leap has been remarkable. We have gone from basic monitors to AI-driven early warning systems that predict patient deterioration hours in advance. Today, ventilators come with adaptive modes that intuitively sync with a patient's natural breathing, offering precision support.
ECMO systems, once limited to a few tertiary centres, now function as life-saving heart-lung machines for patients in severe cardiac or respiratory distress.
Bedside diagnostics has become equally game changing. Intensivists can now perform ultrasounds and echocardiograms right at the bedside, cutting delays and enabling real-time clinical decisions. There are portable dialysis units and integrated monitoring dashboards that consolidate a patient's vitals, lab trends, and medication infusions onto a single interface, improving decision-making speed and clarity during high-pressure situations.
Is there any use of AI?
AI-powered early warning systems are one of the most groundbreaking developments in critical care. These algorithms can detect subtle physiological changes and predict sepsis or a sudden drop in oxygen levels, often hours before visible clinical signs emerge. This gives ICU teams a vital window to intervene early, potentially preventing deterioration. AI systems are also used in enhanced diagnostics in radiology, ultrasound, and echocardiography.
India's Open ICU model allows the patient's primary doctor and the intensivist to work together. This respects our context, as doctor-patient relationships here are long-term and deeply personal. Many families trust their primary doctor more than a hospital system
Dr Sameer Jog
You said ICU care also happens at home now. How does that work?
For patients who require prolonged critical care but are medically stable — such as after a stroke or major surgery — ICU-at-home services are now a viable option. These setups allow patients to recover in the comfort and familiarity of their own homes. This reduces hospital stays, lowers infection risk, and is especially valuable for elderly patients or those in the palliative stages.
Speaking of palliative care, how has that role evolved in ICUs?
End-of-life care was once a taboo subject in ICUs.
Today, palliative care protocols are increasingly integrated into critical care practice, shifting focus from aggressive treatment to comfort, dignity, and emotional support for both the patient and the family. This shift does not signify giving up; rather, it ensures that patients are not subjected to unnecessary suffering when further medical intervention offers no real benefit.
It allows for peaceful goodbyes, with families involved in the decision-making process, marking a vital step in making intensive care more humane.
Finally, what does the future hold?
The ICU of the future will be more connected, compassionate, and intelligent, with more prominent predictive algorithms and remote-guided care. The ICU journey here is no longer just about survival, but about surviving with dignity, trust, and care.
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
News18
36 minutes ago
- News18
'Whistle Of Death': India's Most Dangerous Snake Hisses Like A Cooker But One Bite Can Kill
The hiss of Russell's Viper, known as the "Whistle of Death," is causing alarm from Assam to Rajasthan, leading to more snakebite cases and calls for better awareness From the lush fields of Assam to the outskirts of Bengaluru and the rural belts of Rajasthan, an eerie sound has begun to echo, sending shockwaves through communities. It's not the screech of machinery or a siren. It's the unmistakable hiss of Russell's Viper, one of the country's deadliest snakes, now earning a chilling nickname – the 'Whistle of Death". The hissing of the Russell's Viper closely resembles the whistle of a pressure cooker – loud, sudden, and unsettling. For those who live in areas where this snake has made its presence known, the sound is a dire warning that danger is near, and flight may be the only option. Russell's Viper (Daboia russelii) is not a rare species. In fact, it's found widely across the Indian subcontinent. Part of the infamous 'Big Four" snakes responsible for the majority of fatal bites, alongside the Cobra, Common Krait, and Saw-scaled Viper, this snake thrives in agricultural fields, grasslands, and even urban areas. Why? Its primary prey is rodents, and where there are people, there are rats. The viper's venom is hemotoxic, meaning it targets blood and tissues, causing internal bleeding, clotting, and in severe cases, kidney failure. Just 40 mgs of its venom can kill a human. A single adult viper can inject more than three times that amount in one bite. Reports of deadly encounters have surged in recent months. In Assam's Sonitpur district, a 13-year-old boy died after being bitten. He had heard the hiss, panicked, and ran, an instinctive reaction that ironically helped the venom spread faster through his body. The boy's death has cast a pall over the village, where people now listen nervously for the tell-tale whistle before stepping outside. In Karnataka and Rajasthan too, hospitals have recorded an uptick in snakebite cases, many attributed to this highly venomous species. Monsoon season, when snakes venture out of their flooded burrows, has only amplified the threat. Despite its lethal capabilities, herpetologists maintain that the Russell's Viper is not inherently aggressive. It doesn't chase humans. But if it feels cornered or is accidentally stepped on, as often happens during farming or walking through tall grass, it defends itself with terrifying speed. Before it strikes, the viper coils into an 'S' shape, raises its upper body, and lets out its signature hiss. This isn't just a scare tactic; it's a biological siren to back off or face the consequences. Adil Khan, a wildlife expert from Satpura who documents such encounters, recently shared a viral video on Instagram that captured the moment a Russell's Viper began its warning hiss. The post has drawn attention to just how intimidating, and loud, this sound can be, especially in quiet rural landscapes. Experts advise that if you hear the hiss and suspect a snake nearby, do not investigate. Move away calmly but quickly. Trying to capture or kill the snake can trigger an attack. Snakebite survival often depends on how quickly a victim receives medical help, and many rural areas still lack rapid access to antivenom. The rise in Russell's Viper sightings and bites has prompted calls for greater public awareness and improved snakebite management infrastructure in healthcare systems. News18's viral page features trending stories, videos, and memes, covering quirky incidents, social media buzz from india and around the world, Also Download the News18 App to stay updated! First Published: Disclaimer: Comments reflect users' views, not News18's. Please keep discussions respectful and constructive. Abusive, defamatory, or illegal comments will be removed. News18 may disable any comment at its discretion. By posting, you agree to our Terms of Use and Privacy Policy.
Time of India
37 minutes ago
- Time of India
This 70-year-old lifts weight at the gym. Her simple, vegetarian diet goes viral, "Ghar par, thoda sa...."
70-year-old weightlifter Roshni Devi Sangwan, who has gone viral on IG for her weight lifting videos, recently revealed her simple, vegetarian diet at home. Nothing fancy or fad, the septuagenarian, while talking to Ranveer Allahabadia, said 'Oats thoda sa. 10 almonds, raisins. Uska juice banakar peekar jaati hun. Ghar par, thoda sa chawal, dal, salad, dahi. Yeh khaati hun. Shaam ko ek hi moong chilla banati hun. Usme paneer daalti hun and 1-2 hari mirchi. Uske baad ek glass doodh. Yehi khaati hun. Aur kuch nahi khaati (I have oats with 10 almonds and raisins in a drink. At lunch, I have a little bit of rice, dal, salad, and curd. In the evenings, I have a single soaked moong chilla with paneer and 1-2 green chillies. I drink one glass of milk after that. This is what I eat. Apart from these, I don't eat anything else.' View this post on Instagram A post shared by Roshni Devi Sangwan (@weightliftermummy) Why Roshni's diet works While extremely simple, Roshni's diet works on many counts. It is simple, homemade, protein rich, and most importantly, consistent. Here are some other reasons why a protein rich Indian vegetarian meal might work for many (though each individuals is different, and there is no "one size fits all" diet) Multiple nutritional benefits Roshni consumes enough daal and paneer in her diet. Lentils and beans, along with chickpeas, peas, soy, paneer and nuts form the diverse plant-based protein sources in our vegetarian "ghar ka khaana". These foods supply protein together with essential vitamins and minerals along with fiber content. The protein content of lentils and dals such as moong dal and masoor dal, makes them easy to digest, while also providing high nutritional value. The combination of rice with dal produces a complete protein that contains all necessary amino acids which the human body requires. The diverse selection of foods, allows for complete nutritional balance, while eliminating the necessity for animal-derived foods. Simple ingredients Most of us shy away from fad diets because of how impractical they are to follow, while living at home with others. However Roshni's diet is just the opposite. The process of preparing dal or chickpea curry, remains simple while requiring minimal cooking time. By making your own meals (like Roshni), you gain full control over ingredient selection, which allows you to stay away from preservatives, as well as reduce your use of excessive oil and salt. The cooking process at home helps maintain higher nutrient levels than both fast and processed foods. Supports muscle growth and repair Muscle building, together with tissue repair, requires protein as a fundamental component. Weight lifters like Roshni, will obtain substantial advantages from consuming vegetarian protein sources. Muscle protein needs are met through paneer, as well as tofu and various soy products. Beans together with lentils, provide sustained energy release, which keeps you upbeat all day, while supporting your healthy lifestyle. Promotes heart health and weight management A diet consisting of lots of daal, with vegetables and whole grains, brings naturally low levels of unhealthy fats and cholesterol. The foods in this diet help decrease dangerous cholesterol levels, which protects against heart disease. Beans and whole grains contain fiber which helps digestion, and maintains weight health because they keep you satisfied for longer periods. Homemade cooking allows you to determine the amount of oil and spices used in your meals which results in healthier and lighter dishes. These views are not generic in nature, and offer no guarantee of specific results. The content is not intended in any way as a substitute for professional advice.
Hindustan Times
an hour ago
- Hindustan Times
Lactation specialist says 'breastfeeding requires extra 300–500 calories per day'; shares nutrition tips for new mothers
Mothers who breastfeed know how tough it can be, and it is not because the moms are not trying enough. Often, several mental, environmental, and nutritional factors intervene, making the process, which is beneficial for both the mother and the child, a lot tougher. Breastfeeding typically requires an additional 300–500 calories per day. These should come from healthy, nutrient-rich foods. (Freepik) Also Read | Cardiologist reveals why people in 30s, 40s are collapsing during workouts: Treadmill isn't the enemy but… What new mothers should keep in mind about their nutritional needs Nutrition plays a major role in preparing a mother for her breastfeeding journey. In an interview with HT Lifestyle, Dr Payel Biswas Soo, MS Lact (Spain), IBCLC (USA), a lactation specialist, Milann Hospital, Bengaluru, stressed that breastfeeding mothers have unique nutritional needs to support both their own health and their baby's development. 'Producing breast milk requires extra energy and nutrients, so eating a balanced, nourishing diet is essential during this period,' Dr Biswas stressed. Here are a few key things to keep in mind, as suggested by her: Producing breast milk requires extra energy and nutrients, so eating a balanced, nourishing diet is essential. (Freepik) 1. Increased caloric needs: Breastfeeding typically requires an additional 300–500 calories per day. These should come from healthy, nutrient-rich foods rather than processed or sugary items. Instead of high-sugar or fried snacks, focus on wholesome options like homemade laddoos with nuts, khichdi, roasted makhana, or fruit with curd. 2. Hydration is key: Adequate fluid intake is essential to maintain milk supply. Mothers should drink plenty of water, buttermilk, coconut water, or jeera/saunf-infused water, especially during summer. 3. Focus on a balanced diet: Traditional Indian meals can be highly nutritious. Therefore, in their diet, mothers should include: Proteins: Moong dal, toor dal, eggs, chicken, fish, paneer Whole grains: Brown rice, millets (ragi, bajra), whole wheat chapatis Vegetables: Gourd vegetables, spinach, carrots, pumpkin Healthy fats: Ghee in moderation, nuts, seeds, cold-pressed oils 4. Iron and calcium: Iron-rich foods (like dates, jaggery, and green leafy vegetables) help combat post-delivery fatigue. Calcium is vital for bone health—consume milk, curd, sesame seeds (til) and ragi. 5. Spices and digestives: Indian kitchens offer beneficial spices like ajwain, jeera, haldi, and methi, known to aid digestion and milk production. However, spicy and oily foods should be consumed in moderation to prevent discomfort for both mother and baby. 6. Traditional foods: Postpartum foods like panjiri, halim (garden cress seeds), and gond laddoo can be nourishing but should be homemade and portion-controlled. 7. Supplements: Doctors may recommend iron, calcium, or vitamin D supplements depending on dietary intake and blood levels. Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
