Pneumonia, ventilator-associated (VAP): Difference between revisions

Line 47:

=== 2 - Infection ===

~~Has~~ '''at least ONE''' of the following 3 things:

*If not immunocomprised, has '''at least ONE''' of the following 3 things:

*Fever > 38.0

**Fever > 38.0

*WBC<4000 or >12,000

**WBC<4000 or >12,000

*If >70 years old, altered mental status without another recognized cause

**If >70 years old, altered mental status without another recognized cause

*These are different for immunocompromised patients

**Immunocomprise for this purpose defined as any of:

***neutropenia defined as absolute neutrophil count or total white blood cell count (WBC) <500/mm3

***leukemia, lymphoma or who are HIV positive with CD4 count <200

***have had a splenectomy

***history of solid organ or hematopoietic stem cell transplant

***on cytotoxic chemotherapy

***on steroids (excluding inhaled steroids) daily for >2 weeks on the date of event

**For these patients, must have '''at least ONE''' of the following 8 things:

***Fever (>38.0°C)

**If >70 years old, altered mental status without another recognized cause

***New onset of purulent sputum, or change in character ofsputum, or increased respiratory secretions, or increased suctioning requirements

**New onset or worsening cough, or dyspnea, or tachypnea

**Rales or bronchial breath sounds

**•Worsening gas exchange (for example: O2 desaturations, increased oxygen requirements, or increased ventilator demand)

**Hemoptysis

**Pleuritic chest pain

=== 3 - CXR indicators ===

@@ Line 47: / Line 47: @@
 === 2 - Infection ===
-Has '''at least ONE''' of the following 3 things:
+*If not immunocomprised, has '''at least ONE''' of the following 3 things:
-*Fever > 38.0
+**Fever > 38.0
-*WBC<4000 or >12,000
+**WBC<4000 or >12,000
-*If >70 years old, altered mental status without another recognized cause
+**If >70 years old, altered mental status without another recognized cause
+*These are different for immunocompromised patients
+**Immunocomprise for this purpose defined as any of:
+***neutropenia defined as absolute neutrophil count or total white blood cell count (WBC) <500/mm3
+***leukemia, lymphoma or who are HIV positive with CD4 count <200
+***have had a splenectomy
+***history of solid organ or hematopoietic stem cell transplant
+***on cytotoxic chemotherapy
+***on steroids (excluding inhaled steroids) daily for >2 weeks on the date of event
+**For these patients, must have '''at least ONE''' of the following 8 things:
+***Fever (>38.0°C)
+**If >70 years old, altered mental status without another recognized cause
+***New onset of purulent sputum, or change in character ofsputum, or increased respiratory secretions, or increased suctioning requirements
+**New onset or worsening cough, or dyspnea, or tachypnea
+**Rales or bronchial breath sounds
+**•Worsening gas exchange (for example: O2 desaturations, increased oxygen requirements, or increased ventilator demand)
+**Hemoptysis
+**Pleuritic chest pain
 === 3 - CXR indicators ===