Mark Klimek Lecture 12 Notes
When dealing with prioritization questions, what are you deciding? - ANS-Which patient
is the sickest or healthiest
What are the 4 parts to prioritization questions? - ANS-1. Age
2. Gender
3. Diagnosis
4. Modifying phrase
What 2 parts out of the 4 parts to a prioritization question that do not matter? - ANS-1.
Age
2. Gender
What is the most important part of a prioritization question? - ANS-Modifying phrase
Between a patient who has angina pectoris and a patient who has a myocardial
infarction, who is more important? - ANS-The patient with an MI
(Example of how modifying phrase matters) Between a patient who has angina pectoris
with an unstable BP and a patient who has a myocardial infarction with stable vital
signs, who is more important? - ANS-The patient with angina pectoris and unstable vital
signs
Between acute illness and chronic illness, which is the higher priority? - ANS-Acute
illness
Question: If you had the following patients, who would be the higher priority?
A. COPD
B. CHF
C. Appendicitis - ANS-C. Appendicitis
Between fresh post-op patients (12 hours after surgery) and patients who undergo
medical/surgical procedures, which takes higher priority? - ANS-Fresh post-op
**It doesn't matter how bad the condition sounds, if there is a patient that is under 12
hours post-op, they are not priority over a patient that is 12 hours post-op.
, Question: Who is your highest priority?
A. COPD
B. CHF
C. Appendicitis
D. 2 hours post-cholecystectomy
E. 2nd day post-op coronary artery bypass - ANS-D. 2 hours post-cholecystectomy
What are the 4 rules of prioritization? - ANS-1. Acute conditions are more important
than chronic conditions
2. Fresh post-op (12 hours after surgery) are more important than medical/surgical
procedures
3. Unstable patients are more important than stable patients
4. (This is only used as a tie-breaker) the more vital the organ (of the modifying phrase
not the dx itself), the higher the priority
What words/phrases makes a patient stable? - ANS-1. Stable
2. Chronic illness
3. Post op greater than 12 hours
4. Local or regional anesthesia
5. Lab abnormalities of an A or B level
6. "Ready for discharge", "To be discharged", or "Admitted longer than 24 hours ago"
7. Unchanged assessments meaning the assessment is the same there is nothing new
8. Experiencing typical s/s of the disease they were dx with
What words/phrases makes a patient unstable? - ANS-1. Unstable
2. Acute illness
3. Post op less than 12 hours
4. General anesthesia (only in first 12 hours)
5. Lab abnormalities of a C or D level
6. "Not ready for discharge", "Newly admitted", "Newly diagnosed", or "Admitted less
than 24 hours ago"
7. Changed assessments meaning there is something new
8. Experiencing unexpected s/s related to the dx
Question: Who is the higher priority?
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