Journal of Surgical Education
Volume 64, Issue 5 , Pages 289-293 , September 2007

The Surgeon and the Intensivist: Reaching Consensus in Intensive Care Triage

  • S. Peter Stawicki, MD

      Affiliations

    • Division of Traumatology and Surgical Critical Care, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    • Corresponding Author InformationCorrespondence: Inquiries to S. Peter Stawicki, MD, Division of Traumatology and Surgical Critical Care, University of Pennsylvania School of Medicine, 3440 Market Street, Philadelphia, Pennsylvania 19104
    • ,
  • John P. Pryor, MD

      Affiliations

    • Division of Traumatology and Surgical Critical Care, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    • ,
  • Eli S. Hyams, MD

      Affiliations

    • Department of Urology, New York University, New York, New York
    • ,
  • Rajan Gupta, MD

      Affiliations

    • Division of Trauma, Department of Surgery, Dartmouth—Hitchcock Medical Center, Lebanon, New Hampshire
    • ,
  • Vicente H. Gracias, MD

      Affiliations

    • Division of Traumatology and Surgical Critical Care, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    • ,
  • C. William Schwab, MD

      Affiliations

    • Division of Traumatology and Surgical Critical Care, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

References 

  1. Franklin C, Rackow EC, Mamdani B, et al. Triage considerations in medical intensive care. Arch Intern Med. 1990;150:1455–1459
  2. Guidelines for intensive care unit admission, discharge, and triage. Task Force of the American College of Critical Care Medicine. Crit Care Med. 1999;27:633–638
  3. Singer DE, Carr PL, Mulley AG, et al. Rationing intensive care-physician responses to a resource shortage. N Engl J Med. 1983;309:1155–1160
  4. Franklin C, Jackson D. Discharge decision-making in a medical ICU: characteristics of unexpected readmissions. Crit Care Med. 1983;11:61–66
  5. Sprung CL, Eidelman LA. Triage decisions for intensive care in terminally ill patients. Crit Care Med. 1997;23:1011–1014
  6. Dawson JA. Admission, discharge, and triage in critical care: principles and practice. Crit Care Clin. 1993;9:555–574
  7. Kalb PE, Miller DH. Utilization strategies for intensive care units. JAMA. 1989;261:2389–2395
  8. The Society of Critical Care Medicine Ethics Committee. Attitudes of critical care medicine professionals concerning distribution of intensive care resources. Crit Care Med. 1994;22:358–362
  9. Zawacki BE. ICU physician’s ethical role in distributing scarce resources. Crit Care Med. 1985;13:57–60
  10. Shear LM. ICU patient triage ranking: a flawed practice?. Crit Care Med. 1988;16:409
  11. Zimmerman JE, Wagner DP, Draper EA, et al. Improving intensive care unit discharge decisions: supplementing physician judgment with predictions of next day risk for life support. Crit Care Med. 1994;22:1373–1384
  12. Birnbaum M, Walleck CA. Rationing health care (Impact on critical care). Crit Care Clin. 1993;9:585–602
  13. Snow N, Bergin KT, Horrigan TP. Readmission of patients to the surgical intensive care unit: patient profiles and possibilities for prevention. Crit Care Med. 1985;13:961–964
  14. Wallis CB, Davies HT, Shearer AJ. Why do patients die on general wards after discharge from intensive care units?. Anaesthesia. 1997;52:9–14
  15. Daly K, Beale R, Chang RW. Reduction in mortality after inappropriate early discharge from intensive care units: logistic regression triage model. BMJ. 2001;322:1274–1276
  16. Durbin CG, Kopel RF. A case-control study of patients readmitted to the ICU. Crit Care Med. 1993;21:1547–1553
  17. Baigelman W, Katz R, Geary G. Patient readmission to critical care units during the same hospitalization at a community teaching hospital. Intens Care Med. 1983;9:253–256
  18. Rubins HB, Moskowitz MA. Discharge decision-making in a medical intensive care unit: Identifying patients at high risk of unexplained death or unit readmission. Am J Med. 1988;84:863–869

PII: S1931-7204(07)00153-5

doi: 10.1016/j.jsurg.2007.05.008

Journal of Surgical Education
Volume 64, Issue 5 , Pages 289-293 , September 2007

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