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]]
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”
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
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
Triad of renal failure, [[Irregularly Irregular|atrial fibrillation]] requiring a drip, and anemia requiring a [[Blood Transfusion|transfusion]]
+
* 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 5 organ systems affected, with at least one still worsening
+
* At least 2 active infections, one of which is MRSA or C. diff
 
+
* Another service should really be the primary team, but are not
At least 5 hospital days spent in the ICU
+
* Patient without decision-making capacity AND family nowhere to be found
 
+
* Patient’s length of stay > 15 days OR his/her age
At least 3 foreign bodies in place (Foley, central line, NG tube, PICC, drain, etc.)
+
* Social Services has given up on a post-hospital plan of care
 
 
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]
- [http://gomerblog.com/2013/08/internal-medicine-resident-calls-rheumatology-fellow-in-at-200-am-for-fibro-storm/ Fibro Storm]
+
* [[FUBAR]]
 
+
* [[Hot Mess]]
- [[FUBAR]]
+
* [[Intensive Care Unit]]
 
+
* [[Potty Train]]
- [[Hot Mess]]
+
* [[Temper Tantrum]]
 
 
- [[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]]

Latest revision as of 09:06, 4 August 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



References


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


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