Patient monitors are broadly classified as pre-configured or modular- they come as single parameter or multi-parameter units. The selection criteria needs to take into account the distribution of beds in the ICU in terms of criticality to be managed. This would determine the monitoring parameters amongst other things. If cost is a constraint then one would need to decide on the level of tradeoff between the convenience of shifting modules between monitors (in case of patient / service demand, or in case of module breakdown) or shifting the monitors or even the patients between beds.

In the case of pre-configured monitors, owing to the absence of flexibility it is essential to choose the parameters at the outset. An incorrect decision could render the monitor over specified and underutilised or vice versa. In this case the investment would be considered to be more wasteful than useful! The next question would be to decide on the mix of pre-configured monitors and modular. Once this is decided then one needs to assess the features (full frame freeze: manual / on alarm or split screen; user defined trace positioning; any bed recall facility; multi-trace / multi-lead ECG, auto zero and calibration for the intracardiac pressure transducer; ongoing digital display of monitored parameters even despite freeze frame; etc.) and the accessories to be procured for usage and storage. Finally, the user friendly operation of the equipment, the ease of maintenance and availability of accessories and spares, the interchangeability of these with other equipment from the same stable or other brands etc. constitute the contributive factors to an informed purchase decision.

The Central Monitoring Station is also no small matter as various features and permutation combinations can be applied here: all bed ECG display; multi-parameter display of critical bed on same screen or a slave monitor; arrhythmia detection facilities and the number and types thereof; etc.

Another important component of the ICU equipment is the infusion pump. There are a number of hospitals that still use the conventional intravenous drip form a bedside pole and are quite satisfied with the results. Yet for those hospitals and areas therein that use infusion pumps, the selection of the type and numbers is critical. Though a low-ticket item compared to most of the other ICU equipment, its importance can never be over emphasised. The flow rates available; the types and brands of syringes or tubing sets (volume pumps) it can accommodate; the single bolus option; the type and power of motor being used; the various alarm condition indicators; battery back-up; etc. are important features. Whilst most good infusion pumps have most of these features, the finer print factors govern the ultimate decision. And then the final question: how many pumps considering the prolonged use of each and the high breakdown rate.

There are several other medical devices that need to be considered such as the defibrillator, external pacemaker, ventilator, mobile Xray, flash steriliser and even the patient furniture. Last but not the least the design of the ICU in terms of: area allotted to each bed (often emergency tracheostomy has to be done at the patient's bedside); room for accommodating several equipment in a critical patient room; space for maneuvering large footprint equipment; facility to store standby equipment; airconditioning provided taking into consideration the heat load of the equipment; the requirement for adequate and standby electrical power; etc. are factors that are not all considered in the building of a world standard critical care unit.