Cns 3 avpu 3 Glasgow Coma Scale 3 Simplified Motor Score 3 Subarachnoid Hemorrhage 4 Intracerebral Hemorrhage Score 4 Stroke Scores 6 nih stroke Scale 6 Modified Rankin Scale 7 tia score 7 Abbreviated mental test score 8 Airway 8



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Pursuit Score


Final diagnosis:

UA

MI

Age

50

0

0

60

2

3

70

4

6

80

6

9

Male gender

1

1

Angina at rest or with ordinary activity last 6 weeks

2

2

Resting Heart Rate

80

0

0

100

1

2

120

2

5

Systolic BP

120

0

0

100

1

1

80

2

2

Signs of Heart Failure

3

3

ST-Segment Depression Initial EKG

3

3

total







This score predicts 30-day death or AMI in ACS patients without persistent ST-segment elevation. Risk of death or re-infarction within 30 days is associated with the following scores: score of <4 has <2% risk, score of 8, ~5% risk, a score of 12, ~10% risk, and score 16, ~25% risk.13

Killip Classification


Killip Classification of CHF after MI


30 day Mortality

Class I

No clinical signs of heart failure

6%

Class II

Rales or crackles, gallop, elevated JVP

17%

Class III

Frank acute pulmonary edema

38%

Class IV

Cardiogenic shock

81%

Killip T, Kimball JT. Treatment of myocardial infarction in a coronary care unit. Am J Cardio. 1967; 20: 457-464


PULMONARY

 Pneumonia


CURB-65, also known as the CURB criteria, is a clinical prediction rule that has been validated for predicting mortality in community-acquired pneumonia and infection of any site.14 The score is an acronym for each of the risk factors measured. Each risk factor scores one point, for a maximum score of 5:

Confusion

Urea greater than 7 mmol/l (Blood Urea Nitrogen > 19)

Respiratory rate of 30 breaths per minute or greater

Blood pressure less than 90 mmHg systolic or diastolic blood pressure 60 mmHg or less

age 65 or older

The risk of death increases as the score increases:

0—0.7%


1—3.2%

2—13.0%


3—17.0%

4—41.5%


5—57.0%

PORT The pneumonia severity index or PORT Score calculates the probability of morbidity and mortality among adult patients with community acquired pneumonia. The first part of the PORT score determines if a patient is able to be treated as an outpatient. The second part determines if the patient should be admitted as a full inpatient or if the patient may be a candidate for 23 hour observation.

Step 1: In the absence of any of the following Risk Class I criteria, the patient may be treated as an outpatient with oral antibiotics.

Over 50 years of age

Altered mental status

Pulse ≥125/minute

Respiratory rate >30/minute

Systolic blood pressure <90 mm Hg

Temperature <35°C or ≥40°C

History of:

Neoplastic disease

Congestive heart failure

Cerebrovascular disease

Renal disease

Liver disease

If any are present proceed to Step 2



Step 2: Stratify to inpatient care, Risk Class II - V




Demographics

Points Assigned







If Male

+Age (yr)







If Female

+Age (yr) - 10







Nursing home resident

+10




Comorbidity







Neoplastic disease

+30







Liver disease

+20







Congestive heart failure

+10







Cerebrovascular disease

+10







Renal disease

+10




Physical Exam Findings







Altered mental status

+20







Pulse ≥125/minute

+20







Respiratory rate >30/minute

+20







Systolic blood pressure <90 mm Hg

+15







Temperature <35°C or ≥40°C

+10




Lab and Radiographic Findings







Arterial pH <7.35

+30







Blood urea nitrogen ≥30 mg/dl (9 mmol/liter)

+20







Sodium <130 mmol/liter

+20







Glucose ≥250 mg/dl (14 mmol/liter)

+10







Hematocrit <30%

+10







Partial pressure of arterial O2 <60mmHg

+10







Pleural effusion

+10



















<70 = Risk Class II










71-90 = Risk Class III










91-130 = Risk Class IV










>130 = Risk Class V




A Risk Class II-III pneumonia patient may be sent home with IV antibiotics or treated and monitored for 24 hours in hospital. Patients with Risk Class IV-V pneumonia patient should be hospitalized for treatment.15
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