|
|
| (16 intermediate revisions by 3 users not shown) |
| Line 1: |
Line 1: |
| == 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. |
|
| |
|
| *''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.
| |
|
| |
|
| 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) |
| | *[[RR]] (Respiratory Rate) |
| | *[[Arterial blood gas (APACHE)]] |
| | *[[PH]] |
| | *[[Na]] |
| | *[[K]] |
| | *[[Creatinine (APACHE)]] |
| | *[[HCT]] |
| | *[[WBC]] |
| | *[[GCS]] Glasgow Coma Scale |
|
| |
|
| === Discussion === | | == Elective Surgery see [[Admit Type for APACHE II]]== |
| * where is this data taken from? [[User:Ttenbergen|Ttenbergen]] 22:34, 4 June 2008 (CDT)
| |
| | |
| '''The following refers to an ongoing discussion, not to a change in collection rules:'''
| |
| 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)
| |
| | |
| ==Missing Values Rule for APACHE II==
| |
| If a specific physiological variable in '''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 comments and record date time and location this variable was obtained from (e.g. ER or ward).
| |
| ===Discussion===
| |
| {{Discussion}}
| |
| * Contents of the [[Notes field]] do not get sent with patient data. Is there any sense in taking such a note, then? [[User:Ttenbergen|Ttenbergen]] 23:23, 4 May 2009 (CDT)
| |
| **There is a comment or note section in ACCESS when reviewing files that I use. Do these comments not get sent with the pt data?--[[User:MWaschuk|MWaschuk]] 10:28, 5 May 2009 (CDT)
| |
| ***You caught a hole in documentation here, Mary-Lou. I just made an article for it. No, contents of the Notes field are not sent in. [[User:Ttenbergen|Ttenbergen]] 13:13, 6 May 2009 (CDT)
| |
|
| |
|
| If no information is available, then assume it was not tested because it was normal. Record the normal APACHE values for this item. (normal value is the value that give you zero points from the APACHE II scoring table.
| | ==[[Chronic Health APACHE]]== |
| | |
| | |
| ===Missing Values Rules for APACHE II for patients who DIED shortly after arriving in unit===
| |
| Patients who have died in the unit and have NO data available to record for an APACHE II:
| |
| | |
| 1. select the physiological variable 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:
| |
| **T -[[Temperature]]
| |
| **CO2 -[[serum CO2]] - use 25
| |
| **[[Na]] -(Sodium)
| |
| **[[K]] -(Potassium)
| |
| **[[CREAT]] -(Creatinine)
| |
| **[[HCT]] -(Hematocrit)
| |
| **[[WBC]] -(White Blood Count)
| |
| | |
| | |
| *applies to those patient who have been admitted to ICU and die shortly after admission. The guidelines outlines which apache values to use. No blanks and no zero's. We don't want values of dead people. Choose values closet to the time of admission if there are any, if there are no values, then follow the rules above.
| |
| | |
| == Elective Surgery see [[Admit Type for APACHE II]]== | |
|
| |
|
| ==[[Chronic Health Diagnosis for APACHE II]]== | | ==Acute Renal Failure== |
| | see [[ARF (APACHE)]] |
|
| |
|
| == [[:Category:APACHE II Physiological Variables | 12 Physiological Variables]] == | | == Related articles == |
| #[[Temperature]]
| | {{Related Articles}} |
| #[[Mean BP]] mean blood pressure
| |
| #[[HR]]( Heart Rate)
| |
| #[[RR]] (Respiratory Rate)
| |
| #[[:Category: ABG | ABG]] No ABG Available Rule? use [[serum CO2]]
| |
| #[[PH]]
| |
| #[[Na]]
| |
| #[[K]]
| |
| #[[CREAT]]
| |
| #[[HCT]]
| |
| #[[WBC]]
| |
| #[[GCS]] Glasgow Coma Scale
| |
|
| |
|
| NOTE: If values for labs are beyond the pre set limits in access, put in the highest or lowest value allowed and then, after sending the profile, contact Pagasa to put in the correct value. The rationale for this is that the pre set limits are important to prevent errors and will not be changed for extreme outliers.
| |
| [[Category:APACHE II]] | | [[Category:APACHE II]] |
| [[Category:Critical Care Review Group]]
| |
| **I can't remember if access gives you an error if you enter an extreme value. If not, what are the pre-sent limits so the collectors know when to contact Pagasa? Is this in wiki somewhere?--[[User:MWaschuk|MWaschuk]] 12:27, 12 July 2010 (CDT)
| |