Mark Klimek - Prioritization/Delegation
Prioritization questions will always have:
-Age
-Gender
-Diagnosis
-Modifying Phrase
What is important? - answer IGNORE age/gender
Most important = modifying phrase
Angina Pectoris vs Myocardial Infarction - who is higher priority? - answer MI
Angina Pectoris with unstable BP vs Myocardial Infarction with stable vital signs - who is
higher priority? - answer Angina pectoris with unstable BP
(modifying phrase more important)
*4 rules for prioritization* - answer 1. acute > chronic
2. fresh postop (first 12 hrs) > medical or other surgical
3. Unstable > stable
4. More vital the organ, the higher the priority (organ of the modifying phrase) (only use
this as a tie-breaker)
What is the tie-breaker used for prioritization questions? - answer More vital the organ,
the higher the priority
Vital Organs - order - answer Brain
Lung
Heart
Liver
Kidney
Pancreas
Who is the priority?
COPD
CHF
Appendicitis - answer Appendicitis (acute)
Who is the priority?
COPD
CHF
Appendicitis
2 hour post-op cholecystectomy
3 day post-CABG - answer 2 hour post-op cholecystectomy
, Mark Klimek - Prioritization/Delegation
(fresh post-op within 12 hr)
Who is the highest priority?
A. 23 yr old male with CHF with a potassium of 6.6 and no ECG changes.
B. Chronic Renal Failure with a creatinine of 20.7 and pink, frothy sputum.
C. Acute hepatitis with jaundice and increased ammonia level, who you cannot arouse. -
answer C. Acute hepatitis with jaundice and increased ammonia level, who you cannot
arouse.
Potassium = heart (3rd organ)
Pink, frothy sputum is PE = Lung (2nd organ)
Cannot arouse = brain (1st organ)***
UNSTABLE words - answer -Unstable
-Acute illness
-Post-op <12 hrs
-General anesthesia (12 hrs)
-Lab abnormalities of a C or D
-Not ready for discharge
-Newly admitted
-Newly diagnosed
-Admitted less than 24 hrs ago
-Changed assessments
-Unexpected signs/symptoms
STABLE words - answer -Stable
-Chronic illness
-Post-op >12 hrs
-Local/Regional anesthesia
-Lab abnormalities of an A or B level
-Ready for discharge
-Admitted more than 24 hrs ago
-Unchanged assessment
-Experiencing the typical expected signs/symptoms with which they were diagnosed
Stable or Unstable: Kidney stones with severe colicky pain - answer STABLE because
expected sign
Stable or Unstable: Mild pain while having a chest x-ray - answer UNSTABLE because
unexpected sign
Who is the highest priority patient?
Prioritization questions will always have:
-Age
-Gender
-Diagnosis
-Modifying Phrase
What is important? - answer IGNORE age/gender
Most important = modifying phrase
Angina Pectoris vs Myocardial Infarction - who is higher priority? - answer MI
Angina Pectoris with unstable BP vs Myocardial Infarction with stable vital signs - who is
higher priority? - answer Angina pectoris with unstable BP
(modifying phrase more important)
*4 rules for prioritization* - answer 1. acute > chronic
2. fresh postop (first 12 hrs) > medical or other surgical
3. Unstable > stable
4. More vital the organ, the higher the priority (organ of the modifying phrase) (only use
this as a tie-breaker)
What is the tie-breaker used for prioritization questions? - answer More vital the organ,
the higher the priority
Vital Organs - order - answer Brain
Lung
Heart
Liver
Kidney
Pancreas
Who is the priority?
COPD
CHF
Appendicitis - answer Appendicitis (acute)
Who is the priority?
COPD
CHF
Appendicitis
2 hour post-op cholecystectomy
3 day post-CABG - answer 2 hour post-op cholecystectomy
, Mark Klimek - Prioritization/Delegation
(fresh post-op within 12 hr)
Who is the highest priority?
A. 23 yr old male with CHF with a potassium of 6.6 and no ECG changes.
B. Chronic Renal Failure with a creatinine of 20.7 and pink, frothy sputum.
C. Acute hepatitis with jaundice and increased ammonia level, who you cannot arouse. -
answer C. Acute hepatitis with jaundice and increased ammonia level, who you cannot
arouse.
Potassium = heart (3rd organ)
Pink, frothy sputum is PE = Lung (2nd organ)
Cannot arouse = brain (1st organ)***
UNSTABLE words - answer -Unstable
-Acute illness
-Post-op <12 hrs
-General anesthesia (12 hrs)
-Lab abnormalities of a C or D
-Not ready for discharge
-Newly admitted
-Newly diagnosed
-Admitted less than 24 hrs ago
-Changed assessments
-Unexpected signs/symptoms
STABLE words - answer -Stable
-Chronic illness
-Post-op >12 hrs
-Local/Regional anesthesia
-Lab abnormalities of an A or B level
-Ready for discharge
-Admitted more than 24 hrs ago
-Unchanged assessment
-Experiencing the typical expected signs/symptoms with which they were diagnosed
Stable or Unstable: Kidney stones with severe colicky pain - answer STABLE because
expected sign
Stable or Unstable: Mild pain while having a chest x-ray - answer UNSTABLE because
unexpected sign
Who is the highest priority patient?
