title: Intensive care triage in Australia and New Zealand.
abstract: OBJECTIVE
  To compare the attitudes towards common intensive care triage scenarios in New Zealand and Australia and to evaluate Australasian intensive care triage practice.
  
  
  METHODS
  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.
authors.affiliation: Intensive Care Unit, Wellington Hospital, Wellington South, New Zealand. paul.young@ccdhb.org.nz
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Young
authors.forename: Richard
authors.initials: R
authors.lastname: Arnold
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D003657:Decision Making; D004630:Emergencies / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D010343:Patient Admission; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014218:Triage / Q000458:organization & administration*