Allan's links

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Allan offered to help us out with the ICD10 documentation. Here are a few links to get started.

specific questions for Allan

Add to this by adding the following to the article:

{{Discuss | who = all, Allan, ... | question = 
* <put your concern here>}}


Automatically generated list

  • current # of questions: 57
 QuestionModification date"Modification date" is a predefined property that corresponds to the date of the last modification of a subject and is provided by Semantic MediaWiki.Last editor is"Last editor is" is a predefined property that contains the page name of the user who created the last revision and is provided by Semantic MediaWiki.
Guideline for coding organ donation after deathWhat are the instructions for this? Would they go through the exercise of declaring such a patient's Brain death or would we capture them as Acquired Diagnosis MAID and Dispo "Death - to OR" or more problematically "Death - to other ICU" ?
  • I had one patient where they withdrew care in the unit then went directly to the OR to harvest the organs. What do we do in this case?--LKolesar 08:03, 2019 June 5 (CDT)


_dev_CFE The following in Correcting suspect links will need to be updated for this:

  • Link suspect dead then alive query
  • Link suspect mismatch to ours incomplete query
    • would it be right to say that these are allowed so long as any diagnosis is Brain death? (not just acquired, since mayyyyybe the pt came from a third site and it's the admit...)
  • As per Allan, "It’s necessary to avoid double counting the death for patients who transfer after brain death".
  • Mortality and readmission report - that page has very limited information. Is this report still done? If so, can we update that and make sure this change won't mess with it?
    • The effect on mortality rate will be negligible if we include or exclude these cases, so it was decided that there is no need to make any change at all in the calculation of the rates. --JMojica 10:30, 2019 July 5 (CDT)
  • Are there other reports that count death rates or mortality? If so we should make a page for it and add it to Category:End-of-life related data and make sure it records how we will address this scenario. Ttenbergen 16:04, 2019 May 21 (CDT)
18 July 2019 12:45:13Ttenbergen
Organ donor (organ/tissue donation by the donor)Why would it not be an Acquired Diagnosis? They may have been admitted for Preparatory care (incl preop optimization), no? Or would they then not be on a ward where we collect because we are not surgical?
  • If I understand Guideline for coding organ donation after death right we will not actually be coding Organ donor (organ/tissue donation by the donor) for deceased patients , since that will always happen elsewhere, and pt won't come back to us after, so not our dx. If I understand that right we should probably put a one-liner here to make that clear since it's a bit counter-intuitive. And likely at that page as well.
  • What date in the Acquired Diagnosis do you put for this code? Do you use the date that they decide the pt will be an organ donor? Or would you prefer the date the patient goes to the OR (which would be the same as the discharge date?
    • These patients go to a different ward after transplant, right? So we would likely not currently track the CCI for this. Maybe transplants are something we should track if they are at the end of stay. I'll flag this for Allan.
      • I am referring to an organ donor (not a transplant recipient). Most donors go to the morgue after donating their organs in the OR. I am not asking about CCI, just the date for the acquire ICD10 code. I am not sure who wrote the above comment.
4 June 2019 13:56:21Ttenbergen
Query check ICD10 mechanism vs traumasee DA above if this has not been addressed before Task.
The outcome of this might cause a change to Template:ICD10 Guideline Iatrogenic and/or Template:ICD10 Guideline Trauma w mechanism
1
21 August 2019 22:04:06Ttenbergen
Combined ICD10 codes
  • See [https://ccmdb.kuality.ca/index.php?title=Task_Team_Meeting_-_Rolling_Agenda_and_Minutes_2019#ICU_Database_Task_Group_Meeting_.E2.80.93_July_16.2C_2019 July 16.19 ICU TASK meeting minutes.
  • Julie and Allan to review.
  • 20 August 2019 17:04:33Dr. Allan Garland
    ICD10 Diagnosis
    • Would it be of value to the program if a code to reflect abnormal coagulation profiles was added? Perhaps: Abnormal Coagulation Profile R79.1? (Pam)
    1 August 2019 16:17:55Ttenbergen
    Depression (major depressive disorder, recurrent depression)


    24 July 2019 20:10:43TOstryzniuk
    Antibiotic Resistant Organism
    • It is awkward to work with/find readily available specific information as to the antibiotics included in the general antibiotic resistant

    articles. Some articles include links to sites that may/may not be that helpful in determination of inclusion antibiotics.

    • Would it be possible to include a listing of common antibiotics in the general antibiotic resistant articles? It would be helpful for collectors to

    have an inclusion list in those articles to use as a quick and easy reference. p:Pam Piche

      • Pam Piche: Question from Allan: I'm not quite sure what you're asking here. Is it which antimicrobials are for which type of bug (bacteria, fungal, etc), or something else?? Please expand on your question.
      • I was thinking along the lines of a listing of inclusion antibiotics such as is available in ICU Pharm flow tab (when hovering over category). I was wondering if such a listing would be helpful in quick determination of inclusion antibiotics?
    23 May 2019 15:42:57Ttenbergen
    Iatrogenic codes in ICD10
    • The instruction for HAP is different here than the Hospital-acquired pneumonia (HAP) in ICD10 page.--Jvelasco 07:56, 2019 July 16
      • this spot here should probably just be a link to that other page, with coding details living there only. Otherwise these will just get out of sync again. Ttenbergen 12:52, 2019 July 18 (CDT)
    18 July 2019 17:52:48Ttenbergen
    Severe sepsis
    • What is the definition of "organ failure" as it pertains to severe sepsis? For example, is an acute rise in Cr (AKI) enough to meet the definition or does the patient have to be on dialysis? Could we have some criteria for the failure of different organs? --Jvelasco 15:32, 2019 May 21 (CDT)
    • AG INFO: This is a very hard issue that everybody around the world is struggling with. The SEPSIS-3 guidelines operationalizes it by defining it as a certain rise in SOFA score from baseline. BUT it's not a very good clinical definition because obtaining the baseline sofa data is a lot of work. So I'll contemplate this.
    20 June 2019 15:16:40Dr. Allan Garland
    Thrombolytic drug, overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    1 December 2018 05:27:56Ttenbergen
    Acetaminophen (tylenol, paracematol), overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    28 November 2018 23:38:25Ttenbergen
    Cocaine, overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    28 November 2018 23:38:43Ttenbergen
    Hormone or hormone agonist NOS, overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    22 December 2018 22:38:36Ttenbergen
    Antiseizure drug NOS, overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    29 November 2018 04:29:40Ttenbergen
    Opioid/narcotic, overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    28 November 2018 23:47:57Ttenbergen
    Calcium channel blocker, overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    29 November 2018 03:19:44Ttenbergen
    Benzodiazepine, overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    28 November 2018 23:39:11Ttenbergen
    Drug or biological substance/agent NOS, overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    28 November 2018 23:38:49Ttenbergen
    Iatrogenic, complication of medical or surgical care NOS
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    6 February 2019 22:14:50Dr. Allan Garland
    Sedative or hypnotic, overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    6 December 2018 01:16:25TOstryzniuk
    Tricyclic antidepressant, overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    29 November 2018 00:16:06Ttenbergen
    Antidepressant drug NOS, overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    29 November 2018 02:31:20Ttenbergen
    Anti-arrythmic, overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    1 May 2019 16:50:34Dr. Allan Garland
    Anesthetic gas, overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    1 December 2018 05:22:41Ttenbergen
    Psychiatric drug NOS, overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    25 June 2019 19:48:14Ttenbergen
    Neuromuscular blocker/paralytic, overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    1 December 2018 05:28:46Ttenbergen
    Antineoplastic/chemotherapy or immunosuppressive drugs, overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    1 December 2018 05:26:50Ttenbergen
    Hallucinogen, overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    21 January 2019 19:31:46Ttenbergen
    Cardiac/cardiovascular drug NOS, overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    29 November 2018 03:57:27Ttenbergen
    Anticoagulant, overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    29 November 2018 03:42:52Ttenbergen
    Antibiotic/antimicrobial, overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    28 November 2018 23:39:22Ttenbergen
    ICD10 Guideline overdose
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    8 August 2019 22:51:09Ttenbergen
    Beta-blocker, overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    29 November 2018 03:15:22Ttenbergen
    Aspirin or other salicylate or NSAID, overdose/toxicity
    • Would appreciate some guidance in priorizing and picking a primary diagnosis in some of these cases.
    • For example, if the patient overdoses on multiple drugs (calcium channel blocker, Ace inhibitor, ETOH, ASA, Tylenol, Ramipril, etc.) and there are many diagnostic issues then how do we priorize this?
    • Do we put the worst drug first? (ie. CCB)
    • Do we put the suicide attempt code first?
    • Do we put the respiratory failure first?
    • Do we put the acidosis first?
      • Other issues:
    • Kidney failure
    • Aspiration pneumonitis
    • Electrolyte disturbances
      • Also when we list all the drugs one by one as overdoses should we use the same priority number for all of them? It is rarely clear the exact quantity of each drug so it is very difficult to know how to priorize this.
    29 November 2018 05:43:17Ttenbergen
    24 Hour Intensivist Presence: A Pilot Study of Effects on ICU Patients, Families, Doctors and Nurses
    • how did the database program support this publication?
    24 April 2019 20:19:25TOstryzniuk
    BacteremiaThis lists as Apache Neuro and is in APACHE Acute Dxs in ICD10 codes because it is in the following range:

    Nonop - Large categories - Neuro NOS - A17. - A69.22 When we touched on this at an Allan's list meeting you agreed that probably wasn't right. Emailed Allan. Ttenbergen 15:42, 2019 June 25 (CDT)
    1

    3 July 2019 18:27:15Ttenbergen
    Check ICD10 some cant be primaryComo Admit Acquired Primary Limits - Category:Mechanism would need to be excluded as well, and so would past history, and quickly the list gets so large again that we are back at discussing Controlling Dx Type for ICD10 codes where we should simply include "Primary"-ability.
  • AG OBSERVATION --- we will just take care of this when we take care of Admit/Comorbid/Acquired
  • 30 April 2019 13:52:12Ttenbergen
    S ICD10 Charlson Como patterns tableComo Admit Acquired Primary Limits - this is part of that discussion - if we want to limit some of these to not being allowed as admits, it will likely have to be done here.
  • AG REPLY --- yes we can and should go through ALL ICD10 codes and indicate which of the 3 Dx Types they're allowed in (ie deal with Controlling Dx Type for ICD10 codes). AG needs to be reminded to deal with this around June 2019
  • 30 April 2019 13:52:12Ttenbergen
    Comorbid DiagnosisComo Admit Acquired Primary Limits - this is part of that discussion - if we limit which admits will count as comos we need to review13 February 2019 19:20:47Ttenbergen
    Admit DiagnosisComo Admit Acquired Primary Limits - this is part of that discussion - if we limit which admits will count as comos we need to review31 December 2018 21:09:29Ttenbergen
    ICD10 Guideline Como vs AdmitComo Admit Acquired Primary Limits - this is part of that discussion - if we limit which admits will count as comos we need to review12 June 2019 15:27:33Dr. Allan Garland
    Controlling Dx Type for ICD10 codesnot needed at go-live; Need to export the list and plan process that includes the extra items below. To export, see S_ICD10_table#Query_to_populate_s_ICD10_table_from_wiki.
    Como Admit Acquired Primary Limits / Dx grouping - this is part of both of those discussion
  • I have emailed Allan the table with all Dxs to set them as Como_allowed, Admit_allowed, Acquired_allowed. Will set up infrastructure to contain this once I have data. Ttenbergen 12:31, 2019 February 13 (CST)
    • Ignore until at least April.
  • 30 April 2019 13:52:12Ttenbergen
    S AP ChronicDx grouping3 January 2019 23:28:16Ttenbergen
    LOS Medicine per ward stayHi Dr. Garland,A thought came up after the last Task meeting related to the discussion on using Service LOS vs. Physical bed LOS (location). We also have A/D/H service patients go to the ward D5. This ward is typically less acute and patients will transfer to D5 from all of the medicine wards (A4/H4/D4/B3/H7). The patients retain their service (A/D/H) while they are on D5, some patients will switch attending (to the D5 Attending), others will stay with the same Attending they had prior to arrival on D5, but the service will remain the same. The Attendings on D5 do not have a specific service and, there is no rule as to which patients switch to the D5 attending. Some patients will be discharged from D5 still under the same Attending that cared for them prior to arrival on D5. When patients leave A4/D4/H4/B3/H7 their profiles are completed (discharged) by the designated ward collector and a new profile is created by the D5 collector.Thanks, Val Penner, May 16.19
    ward LOS vs Service LOS - Val Penner - HSC-D5 follow up from May 7 task meeting- May 16.19
    16 May 2019 21:00:13TOstryzniuk
    Blood Product DataI have made this page to document progress toward this import.9 March 2019 23:28:40Ttenbergen
    Aborted ProcedureI have to find a CCI code for a patient who was given cardiac anaesthesia for a scheduled aortic valve replacement, but upon TEE intraop, was found to not need the procedure. She was brought to ICCS for recovery, weaning & extubation8 August 2019 22:40:13Ttenbergen
    Encephalopathy, toxicSome parts of the following should probably go back in there, emailed Allan.

    incl drug-induced (also code drug if known) except

    19 July 2019 15:33:44Dr. Allan Garland
    Pneumonia, ventilator-associated (VAP)where is that list of sources, did it get lost in an edit?
    There is often a difficulty in trying to apply this criteria in the neuro population, as they will have elevation in both T and WBC for very long periods which are not related to infection, and obviously already have a change in LOC. How should we deal with this issue? (Joyce)
    31 July 2019 15:29:49Ttenbergen
    Abdomen or lower back or pelvis, soft tissues, open wound, injury/traumaWhat would be used for non-surg wound infection? Soft Tissue Infection (includes Cellulitis)?
    but how would one then code those?
    25 July 2019 17:54:11Ttenbergen
    ICUotherServiceWhen a CICU pt is in MICU under MICU service we do not have an option in the drop down for this (this occasionally happens when they have no beds). We also do not have an option for an MICU pt in CICU under CICU service (although I do not know if this ever happens but I suppose it could happen).--LKolesar 14:02, 2019 May 3 (CDT)10 May 2019 00:56:50Ttenbergen
    Query check ICD10 ESRD and AKI only if transplantWould the past history really allow for this? i think only a CCI makes it OK to have both an ESRD and an AKI dx in same patient.18 June 2019 22:01:08Ttenbergen
    S ICD10 APACHE Dx patterns tabledx grouping

    if you have a reference, ideally online, for what you used to make the APACHE comorbid ranges, please add it here.

    • AG NOTE TO SELF -- you have to go through and confirm the ICD10/CCI codes to automatically code for the AP2 comorbs
    But mainly I used this ref: https://rstudio-pubs-static.s3.amazonaws.com/231351_940f14aa51a6427a9e92d5a04daefc3e.html
    24 July 2019 16:56:25Dr. Allan Garland
    Cardiac pacemaker or defibrillator, adjustment/managementis this code intended just for adjustments to permanent pacemakers or should the adjustments made to temporary pacing via epicardial wires be included here?8 August 2019 22:44:19Ttenbergen
    Transition to Database Serverq
    • Would you be able to get an account on the REDCap test server for Tina to check if this would be an option for us?
    • You were going meet with Dr. Renner to find out if he can help us make this a priority for either Digital Health or CHI.
    31 July 2019 15:27:34Ttenbergen
    Query check ICD10 only 1 stage of renal failureq

    According to our collection instructions for Admit Diagnosis and Comorbid Diagnosis, and the instructions for these codes (e.g. Chronic kidney disease (chronic renal insufficiency, uremia) Stage 1, GFR GT 90, the diagnoses could be coded as both an Admit Diagnosis and Comorbid Diagnosis. Right now this cross check prevents that.

    • Do we want to be able to code these as both admit and como?
    • Would both need to be the same code?
    31 July 2019 19:42:38Ttenbergen
    Cardiac arrestq I seem to remember discussing at task that, specifically, don't code it if no CPR occurs. If I remember that correctly we should specify that and the rationale here, since we don't usually not-code diagnoses just because they are not treated.1 August 2019 18:56:01Ttenbergen
    Bed borrowwe want to unify this concept; started discussion today
    • pre-admission bed borrow vs post-admission bed borrow (vs current Off ward field check box
    • also consider ECIP Ttenbergen 14:33, 2019 April 9 (CDT)
    • also related is our old concept Moves for Medicine
      we want to unify this concept; started discussion today Ttenbergen 14:33, 2019 April 9 (CDT)
    • we are seeing at Grace, a number of patients that are admitted from a GRA ward into the GRA ER under ICU care until bed is available in Grace ICU. Unlike CON or OAKs, that if patient needs ICU, and no bed, they go to ER, under ER service care until ICU bed available. At Grace, this is a bed borrow by ICU service in ER dept, but our TMP project does not have to ITEM for GRA ER for this purpose. As discussed in Task, we will likely be seeing more of this and we need to find out if ICU would like to know how much time patients spends in ER like this. We need to decide how we are going to capture this.
    • GRA_MICU-10422
    • GRA_MICU-10458
    • UPDATE: on May 2.19 we added GRA ER as item in TMP for Project Borrow arrive. At a later time we also added GRA_MICU
    • UPDATE: June 12.19 - planned changes - not yet active - Boarding Loc
    • UPDATE: July 18.19 - target start date - Sept 1.19 for new admits. Please see Boarding Loc article.
    23 July 2019 16:27:15TOstryzniuk


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