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| == When to collect, which value to use == | | == Physiological variables == |
| *Select the physiological values that reflect the '''worst''' deviation from normal in the '''first 24 hours''' in ICU.
| | See [[APACHE physiological variable collection]] for collection instructions. |
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| *''Worst'' value could be '''high''' or '''low''', depending which gives the [[APACHE Scoring table#Chemistry_values|most points]].
| | See [[APACHE Scoring table]] for a list of variables. |
| Keep in mind the diagnosis and try not to include iatrogenically enhanced symptoms, e.g. BP severely high due to inotropes or decreased LOC due to sedation.
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| If the length of stay in ICU is less than 24, use those values only.
| | *[[Temperature]] |
| *NOTE: The Higher the APACHE score, the sicker the patient. | | *[[Mean BP]] mean blood pressure |
| | | *[[HR]]( Heart Rate) |
| === Discussion ===
| | *[[RR]] (Respiratory Rate) |
| * where is this data taken from? [[User:Ttenbergen|Ttenbergen]] 22:34, 4 June 2008 (CDT)
| | *[[Arterial blood gas (APACHE)]] |
| | | *[[PH]] |
| '''The following refers to an ongoing discussion, not to a change in collection rules:'''
| | *[[Na]] |
| As discussed in the [[:Category:Critical Care Review Group|Critical Care Review Group]], the last 4 hours in the ER preceeding admission to the ICU may be admissible data for APACHE values if no data is available for the first 24 hours ''in'' ICU. Is this a rule we are using? [[User:Ttenbergen|Ttenbergen]] 13:12, 17 October 2008 (CDT)
| | *[[K]] |
| | | *[[Creatinine (APACHE)]] |
| == Missing Value Rule ==
| | *[[HCT]] |
| | | *[[WBC]] |
| | | *[[GCS]] Glasgow Coma Scale |
| === For patients who '''"died" in ICU'''===
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| For patients who '''"died" in ICU''' and have '''no''' data available in ICU to record for an APACHE select the APACHE data that is closest to the time 'prior to' ICU admission ( values from ER, ward, etc.).
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| If these are NOT available then:
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| 1. For vital signs ('''[[HR]], [[BP]] mean, [[RR]] only'''), select the lowest limit value on the APACHE table that will give you the highest score.
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| 2. Record '''normal''' values for: [[temperature]], [[Serum CO2]], [[Na]], [[K]], [[Creatinine]], [[HCT]] and [[WBC]].
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| == Elective Surgery see [[Admit Type for APACHE II]]== | | == Elective Surgery see [[Admit Type for APACHE II]]== |
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| == Chronic Health-see [[Chronic Health Diagnosis for APACHE II]]== | | ==[[Chronic Health APACHE]]== |
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| == Physiological Variable ==
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| === [[Temperature]] ===
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| === mean arterial [[BP]] ===
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| === [[RR]] (Respiratory Rate) ===
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| === [[HR]]( Heart Rate) ===
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| === [[:Category: ABG | ABG]] & [[PH]] ===
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| **No ABG Available Rule? use [[serum CO2]]
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| ===[[HCT]]===
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| ===[[Na]]===
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| ===[[K]]===
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| ===[[Creatinine]]===
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| ===[[WBC]]===
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| == Neurological Assessment==
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| === Glasgow Coma Scale ===
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| For Head traumas select the '''worst''' score in the first 24 hours in ICU. If sedated or paralyzed select the '''best''' score in the first 24 hours in ICU prior to sedation.
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| For non neuro & post operative patients who are sedated or paralyzed, please record a '''normal''' neuro score, unless there is a neurological problem. If this is the case, you must select the select the '''worst''' values prior to sedation or “best guess” based on history prior to sedation.
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| Sedation does not allow us to accurately assess Neuro status, therefore we use alternative information that was documented prior to OR or sedation or we use our “best guess” base on chart notes.
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| ==== to do before de-stubbing ====
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| * what does "best score" mean in this context? Best to make the patient score a high APACHE, or best to let him live?
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| * in case of sedation or OR, what is the precedence of "alternative" information vs. chart? Are the two not the same?
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| == Legacy Data Information == | | ==Acute Renal Failure== |
| *Collected for the '''ICU Program''' since '''June 15, 1988''' and continues to date.
| | see [[ARF (APACHE)]] |
| *Collected for the '''Medicine Program''' from October 1, 2003 to December 31, 2006.
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| | == Related articles == |
| | {{Related Articles}} |
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| [[Category:APACHE II]] | | [[Category:APACHE II]] |
| [[Category:Critical Care Review Group]]
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