Difference between revisions of "Train Wreck"
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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]</ref>: | ||
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– 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 Infectious Diseases or Palliative Care | + | – 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 “I have no clue what’s going on” | ||
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'''Minor Criteria''' | '''Minor Criteria''' | ||
| − | – 75% of vital signs and lab results in 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 | – Dyad of coded and Full Code | ||
| − | – Triad of renal failure, atrial fibrillation requiring a drip, and anemia requiring a transfusion | + | – 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 organ systems affected, with at least one still worsening | ||
Revision as of 17:28, 1 October 2016
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
References
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Fun Stuff
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