Level of Care Decision Support

• YOU can and SHOULD decide what unit of the hospital can best care for your patient 

• The most common need for escalation of care is SHOCK

  • think about a broader definition of shock: 

    • hypotension that is better only briefly after aggressive fluid resuscitation

    • not just hypotension...shock index?

    • Hypoperfusion as evidence by lactate and tachycardia

• No ICU bed? Still ask for ICU level of care. This will get CCORN to the bedside and ensure the hospital knows what resources are needed (i.e. doesn't give the last ICU bed to another pt)

  • "if you can't get the patient to the ICU, bring the ICU to the patient"

• Call you attending before you're ready for a full sign out and ask for help with LOC. We are on call to help support excellent patient care, including coming in to see PCU/ICU patients

• Does the patient need access (central line) or an airway? 

• Does the patient meet RRT criteria right now? If so, the floor is not the right LOC. 

• When in doubt, escalate to a higher LOC and de-escalate later if appropriate.