Table 2 Internists’ practical roles in decisions of admission to intensive care

Recognizes signs of severity

First, [it’s important to] identify the early signs [of a problem] so that the transfer goes smoothly and things can be managed without all the agitation around reanimation and intubation in an extreme emergency. (Med 07)

Calls at the right moment

We have the impression that things are gradually deteriorating and we call the ICU a bit before things become a big catastrophe. (Med 12)

Has the relevant info about the patient

Before calling the ICU, we have to know the case well. That’s why we don’t call right away. Even if the nurses pressure us and say “you need to call the ICU”, we say “No, no, no, wait. Before calling I need to read the patient’s file”. (Med 02)

Determines the goals of care

It’s important to recognize those situations needing palliative care et not just therapeutic treatments. We have to change the conversation, explain to the patient how things are changing, his risk of dying, and accompany him, make him understand that he is in a different situation now, that he has to envision other possibilities, so that he can prepare and organize. (Med 04)

Continues care until arrival of ICU Dr

Having already initiated certain treatments, these internists know how to do it while waiting for the ICU consultant to arrive. (ICU 11)