Selection and timing of APACHE components: Difference between revisions

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This page explains how to select [[APACHE physiological variable collection|physiological]] or [[GCS]] values for entry into the fields used for [[APACHE physiological variable collection]] in [[CCMDB.accdb]].

~~{{TT |~~

== Collection Instructions ==

* [[ALERT Scale timing of assessment]] uses slightly different definition, but it is closer than it used to be now that we start Apache at accept rather than arrive. Can we combine? [[User:Ttenbergen|Ttenbergen]] 14:26, 2020 December 23 (CST)

Choose the '''''worst''''' value that occurs '''within the 24 hours after the first [[Service tmp entry]] DtTm'''.

** Discussed with Allan: No, this has to remain different for ALERT and APACHE because the two are different; I need to integrate this better. And make a category or something for counterintuitive differences between Med and CC. [[User:Ttenbergen|Ttenbergen]] 13:32, 2021 February 22 (CST)

}}

== Instructions ==

Choose the '''''worst''''' value that occurs '''within the 24 hours after [[~~Accept DtTm~~]]'''.

The '''''worst''''' value could be '''high''' or '''low''', depending which gives the most [[APACHE Scoring table#Chemistry_values| points]].

~~{{DiscussTask |~~

See [[APACHE physiological variable collection]] for what to do if there are no values available in the first 24 hours.

*Does ICU start there APACHE and TISS from the ER accept time or ICU admit time. Currently we collect from the ER accept time only when the patient is boarded in the ER for greater than 2 hours. [[~~User:Gthomson2|Gthomson2~~]] ~~10:43, 2020 October 20 (CDT)~~

*****Since Oct.15th, I have been using the 24 hour period after the accept time, which means that I am including the applicable Vitals from ER if ~~the patient was from the ER. I wasn't at the task meeting yesterday, so I don't know if this was discussed, but this was my understanding of how we~~ are ~~supposed to collect apache[[User:Mlagadi|Mlagadi]] 11:02, 2020 October 23 (CDT)~~

*** Gail, where does this 2 hour delay rule come from? Is there anything on wiki about it? [[User:Ttenbergen|Ttenbergen]] 14:49, 2020 December 23 (CST)}}

~~== Iatrogenically changed~~ values ==

~~Keep~~ in ~~mind~~ the ~~diagnosis and try not to include iatrogenically modified values, e.g. BP severely high due to inotropes or decreased LOC due to sedation~~.

~~However, if a value is assessed as part of testing whether an intervention works, that value is not necessarily ineligible (e.g. see [[Arterial_blood_gas_(~~APACHE~~)#ABGs_as_part_of_apnea_tests]]).~~

== Log ==

2020-~~?? (possibly Oct~~ 15)

* 2020-10-15 - used to start at "Arrive DtTm", now starts at "Accept DtTm"; it is possible that there used to be a rule "currently we collect from the ER accept time only when the patient is boarded in the ER for greater than 2 hours" but it no longer applies.

* used to start at [[Arrive DtTm]], now starts at [[Accept DtTm]]

== Related articles ==

[[Category: APACHE II]]

[[Category:APACHE II]]

@@ Line 1: / Line 1: @@
 This page explains how to select [[APACHE physiological variable collection|physiological]] or [[GCS]] values for entry into the fields used for [[APACHE physiological variable collection]] in [[CCMDB.accdb]].
-{{TT |
+== Collection Instructions ==
-* [[ALERT Scale timing of assessment]] uses slightly different definition, but it is closer than it used to be now that we start Apache at accept rather than arrive. Can we combine? [[User:Ttenbergen|Ttenbergen]] 14:26, 2020 December 23 (CST)
+Choose the '''''worst''''' value that occurs '''within the 24 hours after the first [[Service tmp entry]] DtTm'''.
-** Discussed with Allan: No, this has to remain different for ALERT and APACHE because the two are different; I need to integrate this better. And make a category or something for counterintuitive differences between Med and CC. [[User:Ttenbergen|Ttenbergen]] 13:32, 2021 February 22 (CST)
-}}
-== Instructions ==
-Choose the '''''worst''''' value that occurs '''within the 24 hours after [[Accept DtTm]]'''.
 The '''''worst''''' value could be '''high''' or '''low''', depending which gives the most [[APACHE Scoring table#Chemistry_values| points]].
-{{DiscussTask |
+See [[APACHE physiological variable collection]] for what to do if there are no values available in the first 24 hours.
-*Does ICU start there APACHE and TISS from the ER accept time or ICU admit time. Currently we collect from the ER accept time only when the patient is boarded in the ER for greater than 2 hours. [[User:Gthomson2|Gthomson2]] 10:43, 2020 October 20 (CDT)
-*****Since Oct.15th, I have been using the 24 hour period after the accept time, which means that I am including the applicable Vitals from ER if the patient was from the ER. I wasn't at the task meeting yesterday, so I don't know if this was discussed, but this was my understanding of how we are supposed to collect apache[[User:Mlagadi|Mlagadi]] 11:02, 2020 October 23 (CDT)
-*** Gail, where does this 2 hour delay rule come from? Is there anything on wiki about it? [[User:Ttenbergen|Ttenbergen]] 14:49, 2020 December 23 (CST)}}
-== Iatrogenically changed values ==
-Keep in mind the diagnosis and try not to include iatrogenically modified values, e.g. BP severely high due to inotropes or decreased LOC due to sedation.
-However, if a value is assessed as part of testing whether an intervention works, that value is not necessarily ineligible (e.g. see [[Arterial_blood_gas_(APACHE)#ABGs_as_part_of_apnea_tests]]).
+{{Timing for ALERT vs APACHE}}
 == Log ==
--?? (possibly Oct 15)
+* 2020-10-15 - used to start at "Arrive DtTm", now starts at "Accept DtTm"; it is possible that there used to be a rule "currently we collect from the ER accept time only when the patient is boarded in the ER for greater than 2 hours" but it no longer applies.
-* used to start at [[Arrive DtTm]], now starts at [[Accept DtTm]]
 == Related articles ==
 {{Related Articles}}
-[[Category: APACHE II]]
+[[Category:APACHE II]]