APACHE physiological variable collection

You can not enter 0 for APACHE physiological variables, and you can't leave them blank.

Patient lived

If a specific physiological variable is not available during the first 24 hours when admitted to ICU then select a value closest to the time prior to admission to the unit, (max 24 hrs prior to admission). Make a note in your Notes field and record date time and location this variable was obtained from (e.g. ER or ward).

If no information is available, then assume it was not tested because it was normal. Record the midpoint of the normal range for this value, which will generate a normal APACHE score for this item. The midpoint of each normal range can be found by double-clicking on the Apache score for the field in CCMDB.mdb.

Use of pre-admission ER LAB results

Template:Discussion The following refers to an ongoing discussion, not to a change in collection rules: As discussed in the Critical Care Review Group, the last 4 hours in the ER/OR/ward preceding admission to the ICU may be admissible data for APACHE values only if there is no data is available for the first 24 hours in ICU. Is this a rule we are using? Ttenbergen 13:12, 17 October 2008 (CDT)

• The above seems to be in conflict with the missing value rule below. Is it 4 or 24 hrs prior to admission? Is this really limited to values from the ER?Ttenbergen 15:38, 2 May 2011 (CDT)Ttenbergen 19:00, 2012 September 6 (CDT)
  • anyone? Ttenbergen 14:12, 2014 September 19 (CDT)

Patient DIED shortly after arriving in unit

We don't want values of dead people. For patients who died in the unit and have no data available to record for any one of the physiological variables during their stay on the unit:

1. Select the value that is closest to the time "prior to" unit admission such as ER or ward.

2. If the above is NOT an option then the following applies:

A. For the following vital signs elements-select the lowest limit value on the APACHE score table that will give you the highest score.

• This applies to the following fields:
  • HR - (Heart Rate)
  • BP - (Blood Pressure)
  • RR - (Respiratory Rate)

B. For other APACHE elements-record NORMAL values. Normal values are those items that give you a zero APACHE II point.

• This applied to the following fields:
  • Temperature
  • Serum CO2 - use 25
  • Na -(Sodium)
  • K -(Potassium)
  • CREAT -(Creatinine)
  • HCT -(Hematocrit)
  • WBC -(White Blood Count)