Lock It In
Priority Frameworks
Priority setting begins with the threat to physiology, not the order in which requests arrived.
Priority setting begins with the threat to physiology, not the order in which requests arrived. ABCs first: airway obstruction, breathing failure, and circulation compromise take priority over routine care. A patient who cannot maintain an airway, is developing respiratory failure, or has inadequate perfusion may deteriorate within minutes; a delayed bath, routine vital-sign collection, or nonurgent teaching can wait. Maslow’s hierarchy provides a second filter: address physiological needs such as oxygenation, circulation, and fluid balance before safety, belonging, esteem, or self-actualization needs. This does not mean psychosocial concerns are unimportant. It means they cannot displace an immediate threat to life. Acute before chronic: a new symptom in a patient with a chronic disease is treated as an acute problem until assessed. New chest pressure in a patient with diabetes, sudden confusion in a patient with dementia, or a new oxygen requirement in a patient with chronic lung disease may represent a dangerous change rather than the expected baseline. Life-threatening before non-life-threatening: postoperative bleeding with falling blood pressure takes priority over a stable postoperative patient awaiting routine vital signs. Severe pain...