|
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| Line 44: |
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| | | | |
| | |} | | |} |
| − |
| |
| − | =Ranges=
| |
| − | == Vital Signs==
| |
| − | [https://medical-dictionary.thefreedictionary.com/vital+signs Definition]
| |
| − |
| |
| − | {| class="wikitable"
| |
| − | |+Vital Signs
| |
| − | ! style="text-align: center; " | Type
| |
| − | ! style="text-align: center; " | Ranges
| |
| − | |-
| |
| − | | [https://medical-dictionary.thefreedictionary.com/temperature Temperature (°C)]
| |
| − | | 36.1 -37.2 (°C)
| |
| − | |-
| |
| − | | [https://medical-dictionary.thefreedictionary.com/heart+rate Heart Rate (bpm)]
| |
| − | | 60-100 (bpm)
| |
| − | |-
| |
| − | | [https://medical-dictionary.thefreedictionary.com/systolic+pressure Systolic Pressure (mm Hg)]
| |
| − | | 90-140 (mm Hg)
| |
| − | |-
| |
| − | | [https://medical-dictionary.thefreedictionary.com/diastolic+pressure Diastolic Pressure (mm Hg)]
| |
| − | | 75-90 (mm Hg)
| |
| − | |-
| |
| − | | [https://medical-dictionary.thefreedictionary.com/respiratory+rate Respiratory Rate (bpm)]
| |
| − | | 16-20 (bpm)
| |
| − | |-
| |
| − | | [https://medical-dictionary.thefreedictionary.com/SpO2 SpO2 (%)]
| |
| − | | >93%
| |
| − | |-
| |
| − | | [https://medical-dictionary.thefreedictionary.com/urine Urine Output (ml/kg/h)]
| |
| − | | Based on Fluid Balance (Intake/ Output)
| |
| − | |}
| |
| − |
| |
| − | Find it in Patient Profile wiki page: [[(Patient_Profile)_Demographics_%26_Status#Add_Vital_Signs_.28Mews.29|[Demographics & Status]]], [[(Patient_Profile)_Patient_Summary#Monitoring_Charts|[Monitoring Charts]]], [[(Patient_Profile)_EHR_-_Daily_Monitoring#Vital_Signs|[Daily Monitoring]]]
| |
| − |
| |
| − | == Arterial Blood Gases (ABG)==
| |
| − | [https://medical-dictionary.thefreedictionary.com/Arterial+Blood+Gas Definition]
| |
| − |
| |
| − | An arterial blood gases (ABG) test measures the acidity (pH) and the levels of oxygen and carbon dioxide in the blood from an artery. This test is used to check how well your lungs are able to move oxygen into the blood and remove carbon dioxide from the blood.
| |
| − |
| |
| − | {| class="wikitable"
| |
| − | |+ Arterial Blood Gases
| |
| − | ! style="text-align: center;" | Type
| |
| − | ! style="text-align: center;" | Ranges
| |
| − | |-
| |
| − | | [https://medical-dictionary.thefreedictionary.com/ph pH]
| |
| − | | 7.35 - 7.45
| |
| − | |-
| |
| − | | [https://medical-dictionary.thefreedictionary.com/HCO3 HCO3 (mEq/L)]
| |
| − | | 22 - 26 (mEq/L)
| |
| − | |-
| |
| − | | [https://medical-dictionary.thefreedictionary.com/PaCO2 PaCO2(mmHg)]
| |
| − | | 35 - 45 (mmHg)
| |
| − | |-
| |
| − | | [https://medical-dictionary.thefreedictionary.com/PaO2 PaO2 (mmHg)]
| |
| − | | 75 - 100 (mmHg)
| |
| − | |-
| |
| − | | [https://medical-dictionary.thefreedictionary.com/SaO2 SaO2 (%)]
| |
| − | | 95% - 100%
| |
| − | |}
| |
| − |
| |
| − | Find it in Patient Profile wiki page: [[(Patient_Profile)_Demographics_%26_Status#Add_Arterial_Blood_Gases_.28ABG.29|[Demographics & Status]]], [[(Patient_Profile)_Patient_Summary#PaO2.2FFiO2_chart|[Monitoring Charts]]], [[(Patient_Profile)_EHR_-_Daily_Monitoring#Arterial_Blood_Gas_.28ABG.29|[Daily Monitoring]]]
| |
| − |
| |
| − | == Laboratory Information System (LIS)==
| |
| − | [https://medical-dictionary.thefreedictionary.com/laboratory+information+system Definition]
| |
| − |
| |
| − | <span id="Infection-relatedIndices&CoagulationFunction"> </span>
| |
| − | {| class="wikitable"
| |
| − | |+Laboratory Information System
| |
| − | ! style="text-align: center; background-color:#efefef;" | Process
| |
| − | ! style="text-align: center; background-color:#efefef;" | Type
| |
| − | ! style="text-align: center; background-color:#efefef;" | Ranges
| |
| − | |-
| |
| − | | rowspan="4" style="text-align: center;" | Infection-related Indices
| |
| − | | [https://medical-dictionary.thefreedictionary.com/hs-CRP hs-CRP (mg/L)]
| |
| − | | 0-5 (mg/L)
| |
| − | |-
| |
| − | | [https://medical-dictionary.thefreedictionary.com/IL-6 IL-6 (pg/L)]
| |
| − | | 0-7 (pg/L)
| |
| − | |-
| |
| − | | [https://medical-dictionary.thefreedictionary.com/ESR ESR (mm/h)]
| |
| − | | 0-15 (mm/h)
| |
| − | |-
| |
| − | | [https://medical-dictionary.thefreedictionary.com/Serum+ferritin Serum ferritin (ng/mL)]
| |
| − | | 21.8-274.66 (ng/mL)
| |
| − | |-
| |
| − | | rowspan="3" | Coagulation Function
| |
| − | | [https://medical-dictionary.thefreedictionary.com/Prothrombin+time PT (s)]
| |
| − | | 10.5-13.5 (s)
| |
| − | |-
| |
| − | | [https://www.thefreedictionary.com/activated%20partial%20thromboplastin%20time APTT (s)]
| |
| − | | 21-37 (s)
| |
| − | |-
| |
| − | | [https://medical-dictionary.thefreedictionary.com/D-dimer D-dimer (μg/mL)]
| |
| − | | 0-1.5 (μg/mL)
| |
| − | |}
| |
| − |
| |
| − | <span id="Hematologic&Biochemical"> </span>
| |
| − | {| class="wikitable"
| |
| − | ! style="font-weight:bold; background-color:#dae8fc;" | Process
| |
| − | ! style="font-weight:bold; background-color:#dae8fc;" | Type
| |
| − | ! style="font-weight:bold; background-color:#dae8fc;" | Ranges
| |
| − | |-
| |
| − | | rowspan="8" | Hematologic
| |
| − | | White blood cells (x10<sup>9</sup>/mL)
| |
| − | | 3.5-9.5 (x10<sup>9</sup>/mL)
| |
| − | |-
| |
| − | | Neutrophils (x10<sup>9</sup>/mL)
| |
| − | | 1.8-6.3 (x10<sup>9</sup>/mL)
| |
| − | |-
| |
| − | | Lymphocytes (x10<sup>9</sup>/mL)
| |
| − | | 1.1-3.2 (x10<sup>9</sup>/mL)
| |
| − | |-
| |
| − | | Monocytes (x10<sup>9</sup>/mL)
| |
| − | | 0.1-0.6 (x10<sup>9</sup>/mL)
| |
| − | |-
| |
| − | | Platelets (x10<sup>9</sup>/mL)
| |
| − | | 125-350 (x10<sup>9</sup>/mL)
| |
| − | |-
| |
| − | | CD3 (/μL)
| |
| − | | NA
| |
| − | |-
| |
| − | | CD4 (/μL)
| |
| − | | NA
| |
| − | |-
| |
| − | | CD8 (/μL)
| |
| − | | NA
| |
| − | |-
| |
| − | | rowspan="16" | Biochemical
| |
| − | | Total bilirubin (mg/dL)
| |
| − | | 0-26 (mg/dL)
| |
| − | |-
| |
| − | | AST (U/L)
| |
| − | | 15-40 (U/L)
| |
| − | |-
| |
| − | | ALT (U/L)
| |
| − | | 9-50 (U/L)
| |
| − | |-
| |
| − | | Total protein (g/L)
| |
| − | | 65-85 (g/L)
| |
| − | |-
| |
| − | | Albumin (g/L)
| |
| − | | 40-55 (g/L)
| |
| − | |-
| |
| − | | Globulin (g/L)
| |
| − | | 20-40 (g/L)
| |
| − | |-
| |
| − | | Prealbumin (mg/L)
| |
| − | | 200-430 (mg/L)
| |
| − | |-
| |
| − | | Urea (mM)
| |
| − | | 3.6-9.5 (mM)
| |
| − | |-
| |
| − | | Creatinine (μM)
| |
| − | | 57-111 (μM)
| |
| − | |-
| |
| − | | Glucose (mM)
| |
| − | | 3.9-6.1 (mM)
| |
| − | |-
| |
| − | | CK-MB (U/L)
| |
| − | | 0-24 (U/L)
| |
| − | |-
| |
| − | | Cholinesterase (U/L)
| |
| − | | 5000-12000 (U/L)
| |
| − | |-
| |
| − | | Cystatin C (mg/L)
| |
| − | | 0.6-1.55 (mg/L)
| |
| − | |-
| |
| − | | LDH (U/L)
| |
| − | | 120-150 (U/L)
| |
| − | |-
| |
| − | | α-HBDH (U/L)
| |
| − | | 72-182 (U/L)
| |
| − | |-
| |
| − | | LDL (mM)
| |
| − | | 2.1-3.37 (mM)
| |
| − | |}
| |
| − |
| |
| − | Find it in Patient Profile wiki page: [[(Patient_Profile)_EHR_-_Daily_Monitoring#Infection-related_Indices|[Daily Monitoring]]], [[(Patient_Profile)_EHR_-_Laboratory|[Laboratory]]]
| |
| − |
| |
| − | = Disease Severity Indicators=
| |
| − | ==Acute Respiratory Distress Syndrome (ARDS) Severity==
| |
| − | [https://medical-dictionary.thefreedictionary.com/ARDS Definition]
| |
| − |
| |
| − | The [https://medical-dictionary.thefreedictionary.com/ARDS Acute Respiratory Distress Syndrom (ARDS)] severity levels are calculated using the Berlin Definition as follows:
| |
| − | *ARDS
| |
| − | :- '''Mild ARDS:''' 200mmHg < [[Terminology#Arterial Blood Gases (ABG)|PaO2]]/[[Terminology#FiO2|FiO2]] ≤ 300 mmHg && (PEEP or [[Terminology#CPAP|CPAP]] ≥ 5 cmH2O) or non-ventilated.
| |
| − |
| |
| − | :- '''Moderate ARDS:''' 100mmHg < [[Terminology#Arterial Blood Gases (ABG)|PaO2]]/[[Terminology#FiO2|FiO2]] ≤ 200 mmHg && PEEP ≥ 5 cmH2O or non-ventilated.
| |
| − |
| |
| − | :- '''Severe ARDS:''' [[Terminology#Arterial Blood Gases (ABG)|PaO2]]/[[Terminology#FiO2|FiO2]] ≤ 100 mmHg && PEEP ≥ 5 cmH2O or non-ventilated.
| |
| − | *'''ARDS''' when PaO2 not available.
| |
| − | :- [[Terminology#SpO2|SpO2]]/[[Terminology#FiO2|FiO2]] ≤ 315 suggests ARDS (including non-ventilated patients)
| |
| − |
| |
| − | {| class="wikitable"
| |
| − | ! colspan="5" style="background-color:#dae8fc;" | Berlin Definition of ARDS
| |
| − | |-
| |
| − | | colspan="2" style="background-color:#ecf4ff;" | ARDS Severity
| |
| − | | colspan="3" style="background-color:#ecf4ff;" | PaO2/FiO2
| |
| − | |-
| |
| − | | colspan="2" | Mild
| |
| − | | colspan="3" | >200-300
| |
| − | |-
| |
| − | | colspan="2" | Moderate
| |
| − | | colspan="3" | >100 - 200
| |
| − | |-
| |
| − | | colspan="2" | Severe
| |
| − | | colspan="3" | ≤100
| |
| − | |-
| |
| − | | colspan="5" | *on positive end expiratory pressure (PEEP) ≥ 5 cm H2O
| |
| − | |}
| |
| − |
| |
| − | Find it in Patient Profile wiki page: [[(Patient_Profile)_Demographics_%26_Status#ARDS_-_Mews_-_Glasgow|[Demographics & Status]]]
| |
| − |
| |
| − | ==Modified Early Waring System (MEWS) Score ==
| |
| − | [https://medical-dictionary.thefreedictionary.com/MEWS Definition]
| |
| − |
| |
| − | To calculate the [https://medical-dictionary.thefreedictionary.com/MEWS Modified Early Warning System (Mews)] score, we rank each one of values of the entries listed in the first column of Table Mews Calculation, based on where they fall in pre-defined ranges and then we sum-up all the ranks.
| |
| − |
| |
| − | {| class="wikitable"
| |
| − | ! style="font-weight:bold; background-color:#dae8fc;" | MEWS Score Range
| |
| − | ! style="font-weight:bold; background-color:#dae8fc;" | Frequency of monitoring
| |
| − | ! style="text-align: left; font-weight:bold; background-color:#dae8fc;" | Clinical Response
| |
| − | |-
| |
| − | | style="text-align: center; font-weight:bold;" | 0-4
| |
| − | | Minimum 12 hours
| |
| − | | Continue to monitor and review MEWS every 12 hours
| |
| − | |-
| |
| − | | style="text-align: center; font-weight:bold; background-color:#ecf4ff;" | 5-6
| |
| − | | style="background-color:#ecf4ff;" | Minimum 4 hours
| |
| − | | style="background-color:#ecf4ff;" | Consider notifying physician of MEWS score Notify charge nurse
| |
| − | Consider placing a consult to Rapid Response Nurses
| |
| − |
| |
| − | Increase MEWS assessment every 4 hours with increased frequency in assessments
| |
| − | |-
| |
| − | | style="text-align: center; font-weight:bold;" | 7+
| |
| − | | Maximum per 2 hours
| |
| − | | Consider calling Physician with current assessment data
| |
| − | Consider calling a Rapid Response
| |
| − | Call RRT Consult nurse
| |
| − | Consider transferring to step-down or ICU
| |
| − | |}
| |
| − |
| |
| − |
| |
| − |
| |
| − | {| class="wikitable"
| |
| − | ! colspan="3" style="text-align: center; font-weight:bold; background-color:#dae8fc;" | Modified Early Warning System (MEWS)
| |
| − | |-
| |
| − | | style="font-weight:bold;" | Feature
| |
| − | | style="font-weight:bold;" | Value Range
| |
| − | | style="font-weight:bold;" | Score
| |
| − | |-
| |
| − | | rowspan="5" style="font-weight:bold; background-color:#ecf4ff;" | Respiratory Rate (bpm)
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | ≤8
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 2
| |
| − | |-
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 9 - 14
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 0
| |
| − | |-
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 15 - 20
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 1
| |
| − | |-
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 21 - 29
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 2
| |
| − | |-
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | >29
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 3
| |
| − | |-
| |
| − | | rowspan="6" style="font-weight:bold;" | Heart Rate (bpm)
| |
| − | | style="text-align: center;" | ≤ 40
| |
| − | | style="text-align: center;" | 2
| |
| − | |-
| |
| − | | style="text-align: center;" | 41 - 50
| |
| − | | style="text-align: center;" | 1
| |
| − | |-
| |
| − | | style="text-align: center;" | 51 - 100
| |
| − | | style="text-align: center;" | 0
| |
| − | |-
| |
| − | | style="text-align: center;" | 101 - 110
| |
| − | | style="text-align: center;" | 1
| |
| − | |-
| |
| − | | style="text-align: center;" | 111 - 129
| |
| − | | style="text-align: center;" | 2
| |
| − | |-
| |
| − | | style="text-align: center;" | > 129
| |
| − | | style="text-align: center;" | 3
| |
| − | |-
| |
| − | | rowspan="5" style="font-weight:bold; background-color:#ecf4ff;" | Systolic BP (mmHg)
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | ≤ 70
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 3
| |
| − | |-
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 71 - 80
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 2
| |
| − | |-
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 81 - 100
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 1
| |
| − | |-
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 101 - 199
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 0
| |
| − | |-
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | ≥ 200
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 2
| |
| − | |-
| |
| − | | rowspan="2" style="font-weight:bold;" | Urine Output (ml/kg/h)
| |
| − | | style="text-align: center;" | Nil
| |
| − | | style="text-align: center;" | 3
| |
| − | |-
| |
| − | | style="text-align: center;" | < 0.5
| |
| − | | style="text-align: center;" | 2
| |
| − | |-
| |
| − | | rowspan="5" style="font-weight:bold; background-color:#ecf4ff;" | Temperature (ºC)
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | ≤ 35
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 2
| |
| − | |-
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 35.1 - 36
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 1
| |
| − | |-
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 36.1 - 38
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 0
| |
| − | |-
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 38.1 - 38.5
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 1
| |
| − | |-
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | ≥ 38.6
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 2
| |
| − | |-
| |
| − | | colspan="2" style="text-align: center; font-weight:bold;" | Total:
| |
| − | | style="text-align: center;" |
| |
| − | |}
| |
| − |
| |
| − | '''Important Assumptions: <span style="color:#FF0000> <br>1. When Urine Output is not inserted (i.e., NULL value), then the MEWS score is still computed assigning zero (0) points to Urine Output. <br>2. To compute the Urine Output per hour we calculate the time difference between the present Urine Output entry and the last non-NULL entry.</span>'''
| |
| − |
| |
| − | Find it in Patient Profile wiki page: [[(Patient_Profile)_Demographics_%26_Status|[Demographics & Status]]], [[(Patient_Profile)_EHR_-_Daily_Monitoring#Vital_Signs|[Daily Monitoring]]]
| |
| − |
| |
| − | == Glasgow Coma Scale Score==
| |
| − | [https://en.wikipedia.org/wiki/Glasgow_Coma_Scale Definition]
| |
| − |
| |
| − | To calculate the [https://en.wikipedia.org/wiki/Glasgow_Coma_Scale Glasgow Coma Scale] score, we rank each one of values of the entries listed in the first column of Table Gasgow Calculation, based on where they fall in pre-defined ranges and then we sum-up all the ranks.
| |
| − |
| |
| − | {| class="wikitable"
| |
| − | ! colspan="3" style="text-align: center; font-weight:bold; background-color:#f8a102;" | Glasgow Coma Scale
| |
| − | |-
| |
| − | | style="text-align: center; font-weight:bold; background-color:#ffffff;" | Behavior
| |
| − | | style="text-align: center; font-weight:bold; background-color:#ffffff;" | Response
| |
| − | | style="text-align: center; font-weight:bold; background-color:#ffffff;" | Score
| |
| − | |-
| |
| − | | rowspan="4" style="text-align: center; font-weight:bold; background-color:#ecf4ff;" | Eye opening
| |
| − | | style="background-color:#ecf4ff;" | Spontaneous
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 4
| |
| − | |-
| |
| − | | style="background-color:#ecf4ff;" | To speech
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 3
| |
| − | |-
| |
| − | | style="background-color:#ecf4ff;" | To pain
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 2
| |
| − | |-
| |
| − | | style="background-color:#ecf4ff;" | None
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 1
| |
| − | |-
| |
| − | | rowspan="5" style="text-align: center; font-weight:bold; background-color:#ffffff;" | Verbal response
| |
| − | | style="background-color:#ffffff;" | Oriented
| |
| − | | style="text-align: center; background-color:#ffffff;" | 5
| |
| − | |-
| |
| − | | style="background-color:#ffffff;" | Confused
| |
| − | | style="text-align: center; background-color:#ffffff;" | 4
| |
| − | |-
| |
| − | | style="background-color:#ffffff;" | Words (Inappropriate)
| |
| − | | style="text-align: center; background-color:#ffffff;" | 3
| |
| − | |-
| |
| − | | style="background-color:#ffffff;" | Sounds (Incomprehensible)
| |
| − | | style="text-align: center; background-color:#ffffff;" | 2
| |
| − | |-
| |
| − | | style="background-color:#ffffff;" | None
| |
| − | | style="text-align: center; background-color:#ffffff;" | 1
| |
| − | |-
| |
| − | | rowspan="6" style="text-align: center; font-weight:bold; background-color:#ecf4ff;" | Motor response
| |
| − | | style="background-color:#ecf4ff;" | Obeys commands
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 6
| |
| − | |-
| |
| − | | style="background-color:#ecf4ff;" | Localizes to pain
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 5
| |
| − | |-
| |
| − | | style="background-color:#ecf4ff;" | Withdraws from pain
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 4
| |
| − | |-
| |
| − | | style="background-color:#ecf4ff;" | Flexion to pain (decorticate)
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 3
| |
| − | |-
| |
| − | | style="background-color:#ecf4ff;" | Extension to pain (decerebrate)
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 2
| |
| − | |-
| |
| − | | style="background-color:#ecf4ff;" | None
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 1
| |
| − | |-
| |
| − | | colspan="2" style="text-align: center; font-weight:bold; background-color:#f8a102;" | Assessment
| |
| − | | style="text-align: center; background-color:#f8a102;" | /15
| |
| − | |-
| |
| − | | rowspan="3" style="font-weight:bold; background-color:#ffffff;" | Total Score
| |
| − | | style="font-weight:bold; background-color:#ffffff;" | Mild
| |
| − | | style="text-align: center; background-color:#ffffff;" | 13-15
| |
| − | |-
| |
| − | | style="font-weight:bold; background-color:#ffffff;" | Moderate
| |
| − | | style="text-align: center; background-color:#ffffff;" | 9-12
| |
| − | |-
| |
| − | | style="font-weight:bold; background-color:#ffffff;" | Severe
| |
| − | | style="text-align: center; background-color:#ffffff;" | 8 or less
| |
| − | |}
| |
| − |
| |
| − | Find it in Patient Profile wiki page: [[(Patient_Profile)_Demographics_%26_Status|[Demographics & Status]]], [[(Patient_Profile)_EHR_-_Daily_Monitoring#Glasgow_Coma_Scale_Measures|[Daily Monitoring]]]
| |
| − |
| |
| − | == Hscore==
| |
| − | [http://saintantoine.aphp.fr/score/ Definition]
| |
| − |
| |
| − | The [http://saintantoine.aphp.fr/score/ Hscore] generates a probability for the presence of secondary [https://encyclopedia.thefreedictionary.com/Hemophagocytic+lymphohistiocytosis haemophagocytic lymphohistiocytosis (HLH)]<sup>1</sup>.
| |
| − | *Hscores greater that 169 are 93% sensitive and 86% specific for HLH.
| |
| − |
| |
| − | *Hscores can be calculated using the [http://saintantoine.aphp.fr/score/ online calculator].
| |
| − | Note that bone marrow haemophagocytosis is not mandatory for a diagnosis of HLH.<sup>2</sup>
| |
| − |
| |
| − | {| class="wikitable"
| |
| − | ! colspan="2" style="text-align: center; font-weight:bold; background-color:#dae8fc;" | Hscore
| |
| − | |-
| |
| − | | style="background-color:#ecf4ff;" | Temperature
| |
| − | | style="text-align: right; font-weight:bold; background-color:#ecf4ff;" |
| |
| − | |-
| |
| − | | <38.4
| |
| − | | style="text-align: right; font-weight:bold;" | 0
| |
| − | |-
| |
| − | | 38.4-39.4
| |
| − | | style="text-align: right; font-weight:bold;" | 33
| |
| − | |-
| |
| − | | >39.4
| |
| − | | style="text-align: right; font-weight:bold;" | 49
| |
| − | |-
| |
| − | | style="background-color:#ecf4ff;" | Organomegaly
| |
| − | | style="text-align: right; font-weight:bold; background-color:#ecf4ff;" |
| |
| − | |-
| |
| − | | None
| |
| − | | style="text-align: right; font-weight:bold;" | 0
| |
| − | |-
| |
| − | | Hepatomegaly or splenomegaly
| |
| − | | style="text-align: right; font-weight:bold;" | 23
| |
| − | |-
| |
| − | | Hepatomegaly and splenomegaly
| |
| − | | style="text-align: right; font-weight:bold;" | 38
| |
| − | |-
| |
| − | | style="background-color:#ecf4ff;" | Number of cytopenias
| |
| − | | style="text-align: right; font-weight:bold; background-color:#ecf4ff;" |
| |
| − | |-
| |
| − | | One lineage
| |
| − | | style="text-align: right; font-weight:bold;" | 0
| |
| − | |-
| |
| − | | Two lineages
| |
| − | | style="text-align: right; font-weight:bold;" | 24
| |
| − | |-
| |
| − | | Three lineages
| |
| − | | style="text-align: right; font-weight:bold;" | 34
| |
| − | |-
| |
| − | | style="background-color:#ecf4ff;" | Triglycerides (mmoL/L)
| |
| − | | style="text-align: right; font-weight:bold; background-color:#ecf4ff;" |
| |
| − | |-
| |
| − | | <1.5 mmol/L
| |
| − | | style="text-align: right; font-weight:bold;" | 0
| |
| − | |-
| |
| − | | 1.5-4.0 mmol/L
| |
| − | | style="text-align: right; font-weight:bold;" | 44
| |
| − | |-
| |
| − | | >4 mmol/L
| |
| − | | style="text-align: right; font-weight:bold;" | 64
| |
| − | |-
| |
| − | | style="background-color:#ecf4ff;" | Fibrinogen (g/L)
| |
| − | | style="text-align: right; background-color:#ecf4ff;" |
| |
| − | |-
| |
| − | | >2.5 g/L
| |
| − | | style="text-align: right; font-weight:bold;" | 0
| |
| − | |-
| |
| − | | <=2.5 g/L
| |
| − | | style="text-align: right; font-weight:bold;" | 30
| |
| − | |-
| |
| − | | style="background-color:#ecf4ff;" | Ferritin ng/ml
| |
| − | | style="text-align: right; font-weight:bold; background-color:#ecf4ff;" |
| |
| − | |-
| |
| − | | <2000 ng/ml
| |
| − | | style="text-align: right; font-weight:bold;" | 0
| |
| − | |-
| |
| − | | 2000-6000 ng/ml
| |
| − | | style="text-align: right; font-weight:bold;" | 35
| |
| − | |-
| |
| − | | >6000 ng/ml
| |
| − | | style="text-align: right; font-weight:bold;" | 50
| |
| − | |-
| |
| − | | style="background-color:#ecf4ff;" | Serum aspartate aminotransferase
| |
| − | | style="text-align: right; font-weight:bold; background-color:#ecf4ff;" |
| |
| − | |-
| |
| − | | <30 IU/L
| |
| − | | style="text-align: right; font-weight:bold;" | 0
| |
| − | |-
| |
| − | | >=30 IU/L
| |
| − | | style="text-align: right; font-weight:bold;" | 19
| |
| − | |-
| |
| − | | style="background-color:#ecf4ff;" | Haemophagocytosis on bone marrow aspirate
| |
| − | | style="text-align: right; font-weight:bold; background-color:#ecf4ff;" |
| |
| − | |-
| |
| − | | No
| |
| − | | style="text-align: right; font-weight:bold;" | 0
| |
| − | |-
| |
| − | | Yes
| |
| − | | style="text-align: right; font-weight:bold;" | 35
| |
| − | |-
| |
| − | | style="background-color:#ecf4ff;" | Known immunosuppression
| |
| − | | style="text-align: right; font-weight:bold; background-color:#ecf4ff;" |
| |
| − | |-
| |
| − | | No
| |
| − | | style="text-align: right; font-weight:bold;" | 0
| |
| − | |-
| |
| − | | Yes
| |
| − | | style="text-align: right; font-weight:bold;" | 18
| |
| − | |-
| |
| − | | style="font-weight:bold;" | Hscore
| |
| − | |
| |
| − | |}
| |
| − |
| |
| − | [https://onlinelibrary.wiley.com/doi/full/10.1002/art.38690<sup>1</sup>Fardet, L., Galicier, L., Lambotte, O., Marzac, C., Aumont, C., Chahwan, D., Coppo, P. and Hejblum, G., 2014. Development and validation of the HScore, a score for the diagnosis of reactive hemophagocytic syndrome. Arthritis & Rheumatology, 66(9), pp.2613-2620.]
| |
| − | [https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30628-0/fulltext <br> <sup>2</sup>Mehta, P., McAuley, D.F., Brown, M., Sanchez, E., Tattersall, R.S. and Manson, J.J., 2020. COVID-19: consider cytokine storm syndromes and immunosuppression. The Lancet.]
| |
| − |
| |
| − | ==Ventricular Arrhythmia Risk==
| |
| − | '''Ventricular Arrhythmia Risk Due to Hydroxychloroquine-Azithromycin Treatment For COVID-19<sup>1</sup>'''
| |
| − |
| |
| − | {| class="wikitable"
| |
| − | ! colspan="2" style="font-weight:bold; background-color:#dae8fc;" | Risk Score For Drug-Associated QTc Prolongation<sup>2</sup>
| |
| − | |-
| |
| − | | style="font-weight:bold; background-color:#dae8fc;" | Risk Factors
| |
| − | | style="text-align: center; font-weight:bold; background-color:#dae8fc;" | Points
| |
| − | |-
| |
| − | | Age ≥ 68 years
| |
| − | | style="text-align: center;" | 1
| |
| − | |-
| |
| − | | style="background-color:#ecf4ff;" | Female Sex
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 1
| |
| − | |-
| |
| − | | Loop diuretic
| |
| − | | style="text-align: center;" | 1
| |
| − | |-
| |
| − | | style="background-color:#ecf4ff;" | Serum K+ ≤3.5 mEq/L
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 2
| |
| − | |-
| |
| − | | Admission QTc ≥ 450 ms
| |
| − | | style="text-align: center;" | 2
| |
| − | |-
| |
| − | | style="background-color:#ecf4ff;" | Acute MI
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 2
| |
| − | |-
| |
| − | | ≥2 QTc-prolonging drugs
| |
| − | | style="text-align: center;" | 3
| |
| − | |-
| |
| − | | style="background-color:#ecf4ff;" | Sepsis
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 3
| |
| − | |-
| |
| − | | Heart failure
| |
| − | | style="text-align: center;" | 3
| |
| − | |-
| |
| − | | style="background-color:#ecf4ff;" | One QTc-prolonging drug
| |
| − | | style="text-align: center; background-color:#ecf4ff;" | 3
| |
| − | |-
| |
| − | | style="font-weight:bold;" | Maximum Risk Score
| |
| − | | style="text-align: center; font-weight:bold;" | 21
| |
| − | |-
| |
| − | | style="background-color:#ffffff;" | Low Risk
| |
| − | | style="background-color:#ffffff;" | ≤6 points
| |
| − | |-
| |
| − | | style="background-color:#ffffff;" | Moderate Risk
| |
| − | | style="background-color:#ffffff;" | 7-10 points
| |
| − | |-
| |
| − | | style="background-color:#ffffff;" | High Risk
| |
| − | | style="background-color:#ffffff;" | ≥11 points
| |
| − | |-
| |
| − | | K+ indicates potassium; and MI, myocardial infarction.
| |
| − | | style="text-align: center;" |
| |
| − | |}
| |
| − |
| |
| − | [https://www.acc.org/latest-in-cardiology/articles/2020/03/27/14/00/ventricular-arrhythmia-risk-due-to-hydroxychloroquine-azithromycin-treatment-for-covid-19 <sup>1</sup>Timothy F. Simpson, Richard J. Kovacs, and Eric C. Stecker, Ventricular Arrhythmia Risk Due to Hydroxychloroquine-Azithromycin Treatment For COVID-19, Cardiology Magazine, Mar. 29, 2020]
| |
| − |
| |
| − | [https://www.ahajournals.org/doi/full/10.1161/circoutcomes.113.000152<sup>2</sup> Tisdale JE, Jayes HA, Kingery JR, et al. Development and validation of a risk score to predict QT interval prolongation in hospitalized patients. Circ Cardiovasc Qual Outcomes. 2013;6:479-487.]
| |