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− | Find it in Patient Profile wiki page: [[Patient Profile#Vital Signs Chart|[Patient Profile -> Monitoring Charts]]], [[Patient Profile#Vital Signs|[Patient Profile -> Daily Monitoring]]] | + | 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]] |
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| == Arterial Blood Gases (ABG)== | | == Arterial Blood Gases (ABG)== |
In this page all the terms used to describe the health in the Patient Profile screen are presented. Below each term in Ranges and Scores sections you can find links to the locations of the Patient Profile wiki page where the corresponding terms are used. By clicking these links you will be driven to the corresponding parameter's section in the Patient Profile page of this wiki.
Acronyms Finder
Comorbidities
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Symptoms
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Symptoms (cont.)
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Ventilation Treatment
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Ranges
Vital Signs
Definition
Find it in Patient Profile wiki page: Demographics & Status, Monitoring Charts, Daily Monitoring
Arterial Blood Gases (ABG)
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.
Find it in Patient Profile wiki page: [Patient Profile -> Demographics & Status -> Add Assessment], [Patient Profile -> Monitoring Charts], [Patient Profile -> Daily Monitoring]
Laboratory Information System (LIS)
Definition
Process
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Type
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Ranges
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Hematologic
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White blood cells (x109/mL)
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3.5-9.5 (x109/mL)
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Neutrophils (x109/mL)
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1.8-6.3 (x109/mL)
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Lymphocytes (x109/mL)
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1.1-3.2 (x109/mL)
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Monocytes (x109/mL)
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0.1-0.6 (x109/mL)
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Platelets (x109/mL)
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125-350 (x109/mL)
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CD3 (/μL)
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NA
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CD4 (/μL)
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NA
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CD8 (/μL)
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NA
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Biochemical
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Total bilirubin (mg/dL)
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0-26 (mg/dL)
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AST (U/L)
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15-40 (U/L)
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ALT (U/L)
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9-50 (U/L)
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Total protein (g/L)
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65-85 (g/L)
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Albumin (g/L)
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40-55 (g/L)
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Globulin (g/L)
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20-40 (g/L)
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Prealbumin (mg/L)
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200-430 (mg/L)
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Urea (mM)
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3.6-9.5 (mM)
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Creatinine (μM)
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57-111 (μM)
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Glucose (mM)
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3.9-6.1 (mM)
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CK-MB (U/L)
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0-24 (U/L)
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Cholinesterase (U/L)
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5000-12000 (U/L)
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Cystatin C (mg/L)
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0.6-1.55 (mg/L)
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LDH (U/L)
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120-150 (U/L)
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α-HBDH (U/L)
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72-182 (U/L)
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LDL (mM)
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2.1-3.37 (mM)
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Find it in Patient Profile wiki page: [Patient Profile -> Daily Monitoring], [Patient Profile -> Laboratory]
Disease Severity Indicators
Acute Respiratory Distress Syndrome (ARDS) Severity
Definition
The Acute Respiratory Distress Syndrom (ARDS) severity levels are calculated using the Berlin Definition as follows:
- - Mild ARDS: 200mmHg < PaO2/FiO2 ≤ 300 mmHg && (PEEP or CPAP ≥ 5 cmH2O) or non-ventilated.
- - Moderate ARDS: 100mmHg < PaO2/FiO2 ≤ 200 mmHg && PEEP ≥ 5 cmH2O or non-ventilated.
- - Severe ARDS: PaO2/FiO2 ≤ 100 mmHg && PEEP ≥ 5 cmH2O or non-ventilated.
- ARDS when PaO2 not available.
- - SpO2/FiO2 ≤ 315 suggests ARDS (including non-ventilated patients)
Berlin Definition of ARDS
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ARDS Severity
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PaO2/FiO2
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Mild
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>200-300
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Moderate
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>100 - 200
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Severe
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≤100
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*on positive end expiratory pressure (PEEP) ≥ 5 cm H2O
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Find it in Patient Profile wiki page: [Patient Profile -> Demographics & Status]
Modified Early Waring System (MEWS) Score
Definition
To calculate the 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.
MEWS Score Range
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Frequency of monitoring
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Clinical Response
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0-4
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Minimum 12 hours
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Continue to monitor and review MEWS every 12 hours
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5-6
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Minimum 4 hours
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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
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7+
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Maximum per 2 hours
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Consider calling Physician with current assessment data
Consider calling a Rapid Response
Call RRT Consult nurse
Consider transferring to step-down or ICU
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Modified Early Warning System (MEWS)
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Feature
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Value Range
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Score
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Respiratory Rate (bpm)
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≤8
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2
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9 - 14
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0
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15 - 20
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1
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21 - 29
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2
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>29
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3
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Heart Rate (bpm)
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≤ 40
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2
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41 - 50
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1
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51 - 100
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0
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101 - 110
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1
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111 - 129
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2
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> 129
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3
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Systolic BP (mmHg)
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≤ 70
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3
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71 - 80
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2
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81 - 100
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1
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101 - 199
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0
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≥ 200
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2
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Urine Output (ml/kg/h)
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Nil
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3
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< 0.5
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2
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Temperature (ºC)
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≤ 35
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2
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35.1 - 36
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1
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36.1 - 38
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0
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38.1 - 38.5
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1
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≥ 38.6
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2
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Total:
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Important Assumptions:
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.
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.
Find it in Patient Profile wiki page: [Patient Profile -> Demographics & Status], [Patient Profile -> Demographics & Status -> Add Assessment]
Glasgow Coma Scale Score
Definition
To calculate the 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.
Glasgow Coma Scale
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Behavior
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Response
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Score
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Eye opening
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Spontaneous
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4
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To speech
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3
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To pain
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2
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None
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1
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Verbal response
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Oriented
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5
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Confused
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4
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Words (Inappropriate)
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3
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Sounds (Incomprehensible)
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2
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None
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1
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Motor response
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Obeys commands
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6
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Localizes to pain
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5
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Withdraws from pain
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4
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Flexion to pain (decorticate)
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3
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Extension to pain (decerebrate)
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2
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None
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1
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Assessment
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/15
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Total Score
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Mild
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13-15
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Moderate
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9-12
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Severe
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8 or less
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Find it in Patient Profile wiki page: [Patient Profile-> Demographics & Status], [Patient Profile -> Demographics & Status -> Add Assessment], [Patient Profile -> Daily Monitoring]
Find it in Patient Profile wiki page: [Patient Profile-> Demographics & Status], [Patient Profile -> Demographics & Status -> Add Assessment], [Patient Profile -> Daily Monitoring]
Hscore
Definition
The Hscore generates a probability for the presence of secondary haemophagocytic lymphohistiocytosis (HLH)1.
- Hscores greater that 169 are 93% sensitive and 86% specific for HLH.
Note that bone marrow haemophagocytosis is not mandatory for a diagnosis of HLH.2
Hscore
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Temperature
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<38.4
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0
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38.4-39.4
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33
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>39.4
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49
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Organomegaly
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None
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0
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Hepatomegaly or splenomegaly
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23
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Hepatomegaly and splenomegaly
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38
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Number of cytopenias
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One lineage
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0
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Two lineages
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24
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Three lineages
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34
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Triglycerides (mmoL/L)
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<1.5 mmol/L
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0
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1.5-4.0 mmol/L
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44
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>4 mmol/L
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64
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Fibrinogen (g/L)
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>2.5 g/L
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0
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<=2.5 g/L
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30
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Ferritin ng/ml
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<2000 ng/ml
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0
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2000-6000 ng/ml
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35
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>6000 ng/ml
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50
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Serum aspartate aminotransferase
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<30 IU/L
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0
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>=30 IU/L
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19
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Haemophagocytosis on bone marrow aspirate
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No
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0
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Yes
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35
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Known immunosuppression
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No
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0
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Yes
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18
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Hscore
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1Fardet, 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.
2Mehta, 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-191
Risk Score For Drug-Associated QTc Prolongation2
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Risk Factors
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Points
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Age ≥ 68 years
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1
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Female Sex
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1
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Loop diuretic
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1
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Serum K+ ≤3.5 mEq/L
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2
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Admission QTc ≥ 450 ms
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2
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Acute MI
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2
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≥2 QTc-prolonging drugs
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3
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Sepsis
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3
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Heart failure
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3
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One QTc-prolonging drug
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3
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Maximum Risk Score
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21
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Low Risk
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≤6 points
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Moderate Risk
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7-10 points
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High Risk
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≥11 points
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K+ indicates potassium; and MI, myocardial infarction.
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1Timothy 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
2 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.