⇒Acute Respiratory Failure/Distress:  The condition of the patient acutely worsens, especially in patients with underlying chronic respiratory diseases (like COPD) or lung cancer and may require advanced respiratory support, such as mechanical ventilation.

⇒Severe Infections (Sepsis):  Severe systemic infections (sepsis or septic shock) resulting in dangerously low blood pressure (hypotension) or multiple organ dysfunction.

⇒Cardiovascular Instability/Organ Failure: Conditions like decompensated heart failure, cardiogenic shock, arrhythmias, or acute kidney/liver failure that may require intensive monitoring and organ support like vasoactive drugs or dialysis.

⇒Neurological Crises: Conditions such as stroke, intracranial haemorrhage requiring ventilation, traumatic brain injury, prolonged or recurrent seizures, or a sudden, significant drop in the level of consciousness (Glasgow Coma Scale score).

⇒Palliative Emergencies: Acute situations causing significant distress, that include cardiac tamponade (fluid around the heart), severe bleeding (hematemesis/haemoptysis), or an adrenal crisis where urgent interventions might provide rapid relief, even if the underlying condition is terminal.

⇒Uncontrolled, Severe Symptoms: For symptoms like intractable pain, extreme nausea/vomiting, or severe breathlessness that cannot be managed effectively in other settings, needing higher nurse-to-patient ratio and advanced resources may be necessary to achieve comfort.

⇒Diagnostic Uncertainty (Time-Limited Trial): In some cases, if the patient’s prognosis is uncertain but a potentially reversible acute issue exists, a time-limited trial of intensive care may be initiated to determine if the patient can recover to an acceptable quality of life.

These conditions may warrant severe interventions, thus would need to shift the patients to an ICU unit within the palliative care unit.