Difference between revisions of "Train Wreck"
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| − | [[File:Train Wreck.jpg| | + | [[File:Train Wreck.jpg|600px|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]</ref>: | + | 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 (Gomerblog)]</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 | ||
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| − | + | '''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] | |
| − | + | * [[FUBAR]] | |
| − | + | * [[Hot Mess]] | |
| − | + | * [[Intensive Care Unit]] | |
| − | + | * [[Potty Train]] | |
| − | + | * [[Temper Tantrum]] | |
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<references /> | <references /> | ||
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[[Category:Critical Care]] | [[Category:Critical Care]] | ||
[[Category:Internal Medicine]] | [[Category:Internal Medicine]] | ||
| + | [[Category:Phrases & Expressions]] | ||
Latest revision as of 08:06, 4 August 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
References
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Fun Stuff
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