: The automatic application of computerized guidelines and protocols in intensive care is not simple, given the high volume of data which must be processed and the need to offer advice on a continuous basis. However most of this data is available automatically and there is therefore the real possibility of improving the quality of care by providing timely advice without placing any additional load on the clinicians. In this paper we describe a prototype system which demonstrates the feasibility of doing this. We then discuss specific issues which arise in applying guidelines for such environments.