Adult - inclusion criteria | Adult - exclusion criteria | Paediatric - inclusion criteria | Paediatric - exclusion criteria |
|---|
Any acute trauma not amenable to treatment in primary care, eg suspected fractures, major lacerations | Any acute trauma amenable to treatment in primary and community care eg minor lacerations, grazes, sprains, strains | Any acute trauma not amenable to treatment in primary care, eg suspected fractures, major lacerations | Any acute trauma amenable to treatment in primary and community care eg minor lacerations, grazes, sprains, strains |
Any acute surgical emergency where the cause or a co-morbidity is not within the exclusion criteria and where acute surgical intervention is required, eg suspected appendicitis, bowel obstruction | Admission for 'social' issues | Any acute surgical emergency where the cause or a co-morbidity is not within the exclusion criteria and where acute surgical intervention is required, eg suspected appendicitis | Admission for 'social' issues, ensure child protection issues addressed |
Any acute medical emergency where the cause or a co-morbidity is not within the exclusion criteria, eg acute myocardial infarction, sepsis, gastro-intestinal bleeds | Cardiac arrest - unwitnessed, witnessed but not responsive to electrical therapy, recurrent cardiac arrest | Any acute medical emergency where the cause or a co-morbidity is not within the exclusion criteria, eg sepsis | Cardiac arrest - unwitnessed, witnessed but not responsive to electrical therapy, recurrent cardiac arrest |
Known, severe, progressive baseline cognitive impairment requiring respiratory support | Known, severe, progressive baseline cognitive impairment requiring respiratory support |
Known, advanced, untreatable neuromuscular disease requiring respiratory support | Known, advanced, untreatable neuromuscular disease requiring respiratory support |
Known, advanced metastatic malignant disease | Known, advanced metastatic malignant disease |
Known, advanced and irreversible immunocompromise requiring respiratory support | Known, advanced and irreversible immunocompromise requiring respiratory support |
Severe and irreversible neurological event or condition | Severe and irreversible neurological event or condition |
Elective palliative surgery | Elective palliative surgery |
Adult - inclusion criteria | Adult - exclusion criteria | Paediatric - inclusion criteria | Paediatric - exclusion criteria |
|---|
Any acute trauma not amenable to treatment in A&E or where conservative management would compromise the outcome, eg compound fracture, fractured neck of femur, ruptured spleen | Acute trauma amenable to conservative treatment in the A&E department, eg manipulation of Colles' fracture and splintage in A&E rather than pinning | Any acute trauma not amenable to treatment in A&E or where conservative management would compromise the outcome, eg compound fracture, ruptured spleen | Acute trauma amenable to conservative treatment in the A&E department, eg manipulation of fracture and splintage in A&E rather than pinning |
Any acute surgical emergency where the cause or a co-morbidity is not within the exclusion criteria and where acute surgical intervention is required, eg suspected appendicitis, 'acute abdomen', gynaecological emergencies | Admission for 'social' issues | Any acute surgical emergency where the cause or a co-morbidity is not within the exclusion criteria and where acute surgical intervention is required, eg suspected appendicitis | Admission for 'social' issues - ensure child protection issues addressed |
Any acute medical emergency where the cause or a co-morbidity is not within the exclusion criteria, eg acute myocardial infarction, sepsis, gastro-intestinal bleeds | Cardiac arrest - unwitnessed, witnessed but not responsive to electrical therapy, recurrent cardiac arrest | Any acute medical emergency where the cause or a co-morbidity is not within the exclusion criteria, eg sepsis | Cardiac arrest - unwitnessed, witnessed but not responsive to electrical therapy, recurrent cardiac arrest |
Known, severe, progressive baseline cognitive impairment requiring respiratory support | Known, severe, progressive baseline cognitive impairment requiring respiratory support |
Known, advanced, untreatable neuromuscular disease requiring respiratory support | Known, advanced, untreatable neuromuscular disease requiring respiratory support |
Known, advanced metastatic malignant disease | Known, advanced metastatic malignant disease |
Known, advanced and irreversible immunocompromise requiring respiratory support | Known, advanced and irreversible immunocompromise requiring respiratory support |
Severe and irreversible neurological event or condition | Severe and irreversible neurological event or condition |
Elective palliative surgery | Elective palliative surgery |
Adult - inclusion criteria | Adult - exclusion criteria | Paediatric - inclusion criteria | Paediatric - exclusion criteria |
|---|
Requirement for invasive ventilatory support: refractory hypoxaemia SaO2 <90% on non-rebreathe mask or FiO2 >0.85: respiratory acidosis (pH <7.2): clinical evidence of impending respiratory failure: inability to protect or maintain airway | Severe trauma | Requirement for invasive ventilatory support | Severe trauma |
Hypotension (systolic blood pressure: <90mmHg or relative hypotension) with clinical evidence of shock (altered level of consciousness, decreased urine output, or other evidence of end-stage organ failure) | Severe burns with any two of the following: age >60, >40% of total surface area affected, inhalational injury | Hypotension with evidence of shock | Severe burns |
SOFA score = 7 or single organ failure | Cardiac arrest - unwitnessed, witnessed but not responsive to electrical therapy, recurrent cardiac arrest | Cardiac arrest - unwitnessed, witnessed but not responsive to electrical therapy, recurrent cardiac arrest |
Known, severe, progressive baseline cognitive impairment | Known, severe, progressive baseline cognitive impairment |
Known, advanced, untreatable neuromuscular disease | Known, advanced, untreatable neuromuscular disease |
Known, advanced, metastatic malignant disease | Known, advanced, metastatic malignant disease |
Known, advanced and irreversible immunocompromise | Known, advanced and irreversible immunocompromise |
Severe and irreversible neurological event or condition | Severe and irreversible neurological event or condition |
SOFA score >11 | |
End-stage organ failure meeting the following criteria: - Heart: New York Heart Association ( NYHA) class III or IV
- Chronic obstructive pulmonary disease with FEV1 <25% predicted, baseline PaO2 <7.33k pascal, or secondary pulmonary hypertension
- Cystic fibrosis with post-bronchodilator FEV1 <30% or baseline PaO2 <7.33k pascal
- Pulmonary fibrosis with VC or TLC <60% predicted, baseline PaO2 <7.33k pascal
- Primary pulmonary hypertension with NYHA class III or IV heart failure, right atrial pressure >10mmHg, or mean pulmonary arterial pressure >50mmHg
- Liver - Child - Pugh score >7
| End-stage heart, lung or liver failure. |