Prioritization of Admission, Discharge, and Triage of Acutely III Patients in an ICU

TABLE 1—1 Prioritization ofAdmissi rge, andTriage ofAcutely Ill Patients in an ICU

 

Priority for ;
ICU Placement Description of Patient Characteristics

Priority 1 E The patient is acutely ill, unstable, and requires intensive treatment and monitoring that cannot be provided
outside of the ICU (mechanical ventilation, continuous vasoactive drug infusions). There are no limits on the
5 extent of intended interventions Examples may include postoperative or acute respiratory failure patients
E requiring mechanical ventilator support, and shock or hemodynamically unstable patients receiving invasive
monitoring and/or vasoactive drugs.

Priority 2 The patient requires intensive monitoring and may potentially need immediate interventionThere are no
limits on the extent of intended interventions. Examples include patients with chronic comorbid conditions
3 who develop acute severe medical or surgical illness.

Priority 3 S The patient is critically ill and unstable, with a reduced likelihood of recovery because of underlying disease
or the nature of the acute illness.The patient may receive intensive treatment to relieve acute illness;
; however, limits on therapeutic efforts may be set, such as no intubation or cardiopulmonary resuscitation.
5 Examples include patients with metastatic malignancy complicated by infection, cardiac tamponade, or
airway obstruction.

Priority 4 This patient is generally not appropriate for ICU admission. Determination of admission should be made
3 on an individual basis, under unusual circumstances, and at the discretion of the ICU director. Examples
5 include patients with peripheral vascular surgery, stable diabetic ketoacidosis, or conscious drug overdose,
g as well as patients with terminal and irreversible illness facing immediate death.
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Data from ACCM (1999).