Difference between revisions of "Train Wreck"
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− | [[File:Train Wreck.jpg| | + | [[File:Train Wreck.jpg|300px|thumb|right]] |
− | A '''train wreck''' is a disaster patient that means 1 MAJOR and 2 MINOR criteria below<ref>[https://gomerblog.com/2016/04/diagnostic-criteria-for-a-train-wreck/ Diagnostic Criteria for a “Train Wreck” Patient | + | A '''train wreck''' is a disaster patient that means 1 MAJOR and 2 MINOR criteria below<ref>[https://gomerblog.com/2016/04/diagnostic-criteria-for-a-train-wreck/ Diagnostic Criteria for a “Train Wreck” Patient]</ref>: |
'''Major Criteria''' | '''Major Criteria''' | ||
− | + | ||
− | + | – Sign out from a colleague on the patient takes more than 5 minutes | |
− | + | ||
− | + | – At least 6 consultants on board, one of which is [[2016 Revised Contact Precautions|Infectious Diseases]] or [[DNR|Palliative Care]] | |
− | + | ||
+ | – Someone utters “I have no clue what’s going on” | ||
+ | |||
+ | – Someone utters that the patient is a “train wreck” | ||
'''Minor Criteria''' | '''Minor Criteria''' | ||
− | + | ||
− | + | – 75% of [[Vital Signs|vital signs]] and [[Chloride|lab results]] in [[Comic Sans|red (or abnormal) font]] | |
− | + | ||
− | + | – Dyad of coded and Full Code | |
− | + | ||
− | + | – Triad of renal failure, [[Irregularly Irregular|atrial fibrillation]] requiring a drip, and anemia requiring a [[Blood Transfusion|transfusion]] | |
− | + | ||
− | + | – At least 5 organ systems affected, with at least one still worsening | |
− | + | ||
− | + | – At least 5 hospital days spent in the ICU | |
− | + | ||
− | + | – At least 3 foreign bodies in place (Foley, central line, NG tube, PICC, drain, etc.) | |
+ | |||
+ | – At least 2 active infections, one of which is MRSA or C. diff | ||
+ | |||
+ | – Another service should really be the primary team, but are not | ||
+ | |||
+ | – Patient without decision-making capacity AND family nowhere to be found | ||
+ | |||
+ | – Patient’s length of stay > 15 days OR his/her age | ||
+ | |||
+ | – Social Services has given up on a post-hospital plan of care | ||
'''Related Topics''' | '''Related Topics''' | ||
---- | ---- | ||
− | + | - [[Batsh*t Crazy]] | |
− | + | ||
− | + | - [http://gomerblog.com/2013/08/internal-medicine-resident-calls-rheumatology-fellow-in-at-200-am-for-fibro-storm/ Fibro Storm] | |
− | + | ||
− | + | - [[Hot Mess]] | |
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− | + | - [[Temper Tantrum]] | |
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<references /> | <references /> | ||
+ | [[Category:Medical Terminology]] | ||
[[Category:Critical Care]] | [[Category:Critical Care]] | ||
[[Category:Internal Medicine]] | [[Category:Internal Medicine]] | ||
− |
Revision as of 07:53, 1 March 2017
A train wreck is a disaster patient that means 1 MAJOR and 2 MINOR criteria below[1]:
Major Criteria
– Sign out from a colleague on the patient takes more than 5 minutes
– At least 6 consultants on board, one of which is Infectious Diseases or Palliative Care
– Someone utters “I have no clue what’s going on”
– Someone utters that the patient is a “train wreck”
Minor Criteria
– 75% of vital signs and lab results in red (or abnormal) font
– Dyad of coded and Full Code
– Triad of renal failure, atrial fibrillation requiring a drip, and anemia requiring a transfusion
– At least 5 organ systems affected, with at least one still worsening
– At least 5 hospital days spent in the ICU
– At least 3 foreign bodies in place (Foley, central line, NG tube, PICC, drain, etc.)
– At least 2 active infections, one of which is MRSA or C. diff
– Another service should really be the primary team, but are not
– Patient without decision-making capacity AND family nowhere to be found
– Patient’s length of stay > 15 days OR his/her age
– Social Services has given up on a post-hospital plan of care
Related Topics
- Hot Mess
References