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N Z Med J. 2010 Jun 11;123(1316):33-46.

Intensive care triage in Australia and New Zealand.

Author information

1
Intensive Care Unit, Wellington Hospital, Wellington South, New Zealand. paul.young@ccdhb.org.nz

Abstract

AIM:

To compare the attitudes towards common intensive care triage scenarios in New Zealand and Australia and to evaluate Australasian intensive care triage practice.

METHOD:

A web-based survey of Australian and New Zealand intensive care doctors measuring demographics, details of recent triage decisions and attitudes towards various triage scenarios.

RESULTS:

A total of 238 responses were obtained (32.6% response rate). The mean number of triage decisions was 6.3 per clinician per week in New Zealand (95%CI 4.6-8.0) and 8.5 per week in Australia (95% CI 6.6-10.4) (test for difference in means, p=0.08). The mean rate of refusal for the week prior to the survey was 30.8% (95%CI 19.5-42.1) among New Zealand respondents and 25.1% (95% CI 19.7-30.4) among Australian respondents (test for difference in proportions, p=0.35). Australian respondents were more likely than New Zealand respondents to agree that it was appropriate to admit a patient: - with a non-survivable brain injury who may progress to brain death (p=0.0001); - with acute respiratory distress syndrome in the setting of relapsed acute myeloid leukaemia (p=0.0005); - in a persistent vegetative state with pneumonia due to malposition of a feeding tube (p=0.03); However, there were no differences found between Australian and New Zealand respondents on the appropriateness of admitting a patient: - in a persistent vegetative state with pneumonia with a non-iatrogenic cause (p=0.58); - with an infective exacerbation of chronic obstructive pulmonary disease with a background of functional impairment (p=0.060); - of an advanced age who is unable to extubate due to drowsiness and hypoventilation following a laproscopic hernia repair (p=1.00); - suffering from a massive stroke, intubated in a crowded emergency department, but now needing extubation and palliation (p=1.00).

CONCLUSIONS:

New Zealand doctors have more selective views of what constitutes an appropriate admission to intensive care.

PMID:
20648098
[Indexed for MEDLINE]

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