Have Your Attending (Not The Trainee) Decide If Intensive Care Is Futile

intensive_care   In this extensive single-center study, critical care attendings and fellows generated more than 10,000 assessments regarding the futility of care provided to their ICU patients.  Attendings were much less likely than fellows (7% vs. 17%) to deliver an assessment that care was futile.  Six months later, 61.5% of patients assessed by fellows as receiving futile care had died, as opposed to 84.6% of patients so assessed by attendings.  Not only were attendings more accurate, they also took more time (4 days vs. 2 days of patient interaction) to come to this assessment. — Laura Willett, MD

Neville TH, Wiley JF, Holmboe ES, Tseng CH, Vespa P, Kleerup EC, Wenger NS. Differences Between Attendings’ and Fellows’ Perceptions of Futile Treatment in the Intensive Care Unit at One Academic Health Center: Implications for Training. Acad Med. 2014 Dec.

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