It is a busy night in the emer

It is a busy night in the emergency room and the ICU is down totwo open beds. At two in the morning, the ambulance pulls up to theemergency room door with three patients who had been involved in ashoot-out. Apparently, a sting operation had gone bad during a drugdeal, and an undercover policeman and two drug dealers had beenwounded. All three men appear to be in critical condition and needthe services of the ICU (intensive care unit). How would you decidewhich of the men should receive the ICU beds? Given that thepoliceman was hurt in the line of duty, is this a time where socialutility is an appropriate method for micro allocation of scarceresources?



when allocating Intensive care unit (ICU) bedsto patients during high demand, then the ICU beds should not giveto patients who can get littile benefit from Intensive caretreatment instead give ICU beds to critically ill patients.

The following conditions are considered when allocating ICU bedto these patients are:

— Diagnosis of patients condition from gun shot,

–Severity of wound or any damage to organ during shoot out.

–Age of patients,

–Any coexisting disease of patient in past ,

–any recent cardiopulmonary arrest to in any patient,

— Patient who can get benefit or those patients whocannot  recover to accept the  quality of lifeshould not admitted first. Give the ICU beds to those patient whohas hope to recovery.

— actually, age is not consider for admission to ICU but inthis case, doctors should note that increasing age is associatewith more chance to coexisting diseases, and reduced phycologicalreserve in patients,

— Diagonise the patient’s health condition using Triageprotocol and collect the patient medical information , any organfailure assessment on patient and determine critically ill patientand has chance to give ICU bed to critically ill patient.

— diagonise any patient need advanced respiratory support orpatient need in support of organ system then allocating ICU bed tothem first.

–diagonise any patient has impairement of organs or requiresupport for an acute reversible failure of another organ.

—should check any existing patients in the ICU who are out-ofhours discharge , then they should discharge form ICU bed and canallocate this bed to patient in need.

— Step down unit ( SDU) provides intermideate level ofintensive care to patients in between Intensive care unit (ICU) andthe general medical-surgical wards. if Intensive care unit beds arefull, and no existing patients discharge from ICU then shift lesscritical patient to the step down unit with experienced nurses toprovide quality of care.

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