Train Wreck

From Gomerpedia
Jump to: navigation, search
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


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

Fun Stuff

Try a random entry.
Push me button.jpg
this post with your friends

Random Gomerpedia Entries

Need More Gomer?