Critical Care Medicine: ICU Utilization
Pulmonary and Critical Care Medicine · Critical Care Medicine 🎯 Practice these cards
There are ____ commonly accepted ICU admission criteria; in practice, clinicians identify patients who require intense resources by recognizing signs of ____.
There are no commonly accepted criteria for admission to the ICU. In practice, clinicians identify patients who require intense resources or are at risk for deterioration by recognizing signs of clinical instability.
The practical triggers for ICU referral are signs of clinical instability — ____, ____, ____, and ____.
The practical triggers for ICU referral are signs of clinical instability — hypotension, hypoxemia, arrhythmias, and changes in mental status — that identify patients who require intense resources or may be at risk for deterioration.
APACHE, SOFA, and SAPS were designed to classify ____ of ICU patients; they are rarely used as ____, but rather to compare disease severity, track progression, and ____.
APACHE, SOFA, and SAPS were designed to classify severity of illness of ICU patients by combining vital signs with risk factors. They are rarely used as admission criteria; instead they are used to compare disease severity, track progression, and benchmark outcomes.
The SOFA score grades dysfunction in ____ organ systems, each scored from ____ (normal) to ____ (severe dysfunction).
The SOFA score grades dysfunction in six organ systems — respiratory (PaO2/FiO2), coagulation (platelets), liver (bilirubin), cardiovascular (MAP/vasopressor dose), CNS (Glasgow Coma Scale), and renal (creatinine or urine output) — each scored from 0 (normal) to 4 (severe dysfunction).
Under the current sepsis consensus definition, an acute SOFA increase of ____ or more points from baseline in the setting of suspected or documented ____ identifies ____.
Under the current sepsis consensus definition, an acute increase of 2 or more SOFA points from baseline in the setting of suspected or documented infection identifies sepsis; a rising SOFA tracked serially (typically daily) correlates with increasing mortality.
qSOFA is positive when at least ____ of three criteria are present: respiratory rate ≥____/min, ____, or systolic blood pressure ≤____ mm Hg.
The quick SOFA (qSOFA) identifies patients with suspected infection at risk for poor outcomes when at least two of three criteria are present: respiratory rate ≥22/min, altered mental status, or systolic blood pressure ≤100 mm Hg.
A negative qSOFA ____ rule out sepsis: qSOFA is ____ but ____ at emergency presentation. qSOFA was developed to screen for risk of ____, not as a diagnostic screening tool for sepsis itself.
A negative qSOFA does not rule out sepsis — qSOFA is specific but insensitive at emergency presentation and misses early deterioration and cryptic shock. It was developed to screen for risk of poor outcomes from sepsis in out-of-ICU settings, not as a diagnostic screening tool for sepsis itself.
____ remains the most commonly used severity-of-illness scoring system in North America; it integrates age, admission type, chronic health problems, and ____ physiologic variables (worst values during the first ____ hours after admission) to predict ____.
APACHE II remains the most commonly used severity-of-illness scoring system in North America. It integrates age, type of ICU admission, chronic health problems, and 12 physiologic variables — the worst values during the first 24 hours after admission — to derive a predicted hospital mortality rate.
____ validated, universally accepted ICU admission or triage criteria exist. The 2026 SCCM crisis-standards guidance made only one conditional recommendation: involve ____ early for patients at high risk of death during shortages.
No validated, universally accepted ICU admission or triage criteria exist; admission decisions are shaped significantly by hospital and unit policies and local resources. The 2026 SCCM crisis-standards guidance issued mostly 'no recommendation' statements, with only one conditional recommendation: involve palliative care early for patients at high risk of death during crisis-level shortages.
The SCCM Task Force on Ethics considers withholding and withdrawing life-sustaining care to be fundamentally ____ acts; physicians are not ethically obligated to provide treatment they deem ____.
The SCCM Task Force on Ethics judged withholding and withdrawing life-sustaining care fundamentally similar acts, ethically sound when requested by the patient or surrogate or when the physician judges the goals of therapy unachievable. Physicians are not ethically obligated to provide treatment they deem futile.
A key element of rapid response systems is that ____ — or ____ — can trigger the team; RRTs have been shown to decrease the incidence of cardiac and respiratory arrests and ____ in adults.
Rapid response teams aim to recognize deteriorating patients promptly, trigger early evaluation and management, and move the patient to a higher level of care. A key element is that any member of the health care team — or a family member — can trigger the team. RRTs decrease cardiac and respiratory arrests and hospital mortality in adults.
ICUs typically require nurse-to-patient ratios of ____ or ____, whereas a progressive care (intermediate, transitional, or step-down) unit may have a ratio as high as ____.
Hospital units designated as ICUs typically have the sickest patients and require nurse-to-patient ratios of 1:1 or 1:2, whereas a progressive care unit (also called an intermediate, transitional, or step-down unit) may have a nurse-to-patient ratio as high as 1:5, reflecting lower acuity.
In a(n) ____ unit, patients are managed by the primary hospital team with or without a critical care consultant; in a(n) ____ unit, the critical care team assumes primary management.
In an open unit, patients are managed by their primary hospital team, which may or may not include a critical care consultant; in a closed unit, the critical care (intensivist) team assumes primary management of each patient.
____-intensity units are always open units in which critical care is consulted as needed; ____-intensity units can be open or closed, but the critical care team is present ____.
Low-intensity units are open units in which critical care is consulted as needed. High-intensity units can be open or closed, but the critical care team is present throughout the day, providing consultation.
Data supporting high-intensity models and continuous intensivist staffing of ICUs have been ____; recent data, however, show a mortality benefit with the ____ ICU model.
Data supporting high-intensity models and continuous staffing of ICUs by intensivists have been conflicting; recent data, however, show a mortality benefit with the closed ICU model, in which a dedicated critical care team assumes primary management.
Tap a card to flip it.