Difference between revisions of "Train Wreck"

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'''Major Criteria'''
 
'''Major Criteria'''
----
+
 
* Sign out from a colleague on the patient takes more than 5 minutes
+
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”
+
At least 6 consultants on board, one of which is [[2016 Revised Contact Precautions|Infectious Diseases]] or [[DNR|Palliative Care]]
* Someone utters that the patient is a “train wreck”
+
 
 +
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]]
+
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]]
+
Dyad of coded and Full Code
* At least 5 organ systems affected, with at least one still worsening
+
 
* At least 5 hospital days spent in the ICU
+
Triad of renal failure, [[Irregularly Irregular|atrial fibrillation]] requiring a drip, and anemia requiring a [[Blood Transfusion|transfusion]]
* 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
+
At least 5 organ systems affected, with at least one still worsening
* Another service should really be the primary team, but are not
+
 
* Patient without decision-making capacity AND family nowhere to be found
+
At least 5 hospital days spent in the ICU
* Patient’s length of stay > 15 days OR his/her age
+
 
* Social Services has given up on a post-hospital plan of care
+
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]]
+
- [[Batsh*t Crazy]]
* [http://gomerblog.com/2013/08/internal-medicine-resident-calls-rheumatology-fellow-in-at-200-am-for-fibro-storm/ Fibro Storm]
+
 
* [[FUBAR]]
+
- [http://gomerblog.com/2013/08/internal-medicine-resident-calls-rheumatology-fellow-in-at-200-am-for-fibro-storm/ Fibro Storm]
* [[Hot Mess]]
+
 
* [[Intensive Care Unit]]
+
- [[FUBAR]]
* [[Potty Train]]
+
 
* [[Temper Tantrum]]
+
- [[Hot Mess]]
 +
 
 +
- [[Potty Train]]
 +
 
 +
- [[Temper Tantrum]]
  
  
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<references />
 
<references />
  
 +
[[Category:Medical Terminology]]
 
[[Category:Critical Care]]
 
[[Category:Critical Care]]
 
[[Category:Internal Medicine]]
 
[[Category:Internal Medicine]]
[[Category:Phrases & Expressions]]
 

Revision as of 17:56, 30 June 2017

Train Wreck.jpg

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


- Batsh*t Crazy

- Fibro Storm

- FUBAR

- Hot Mess

- Potty Train

- Temper Tantrum


References


  1. Diagnostic Criteria for a “Train Wreck” Patient (Gomerblog)


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