| Basic Activities | 2 | Hourly Vital Signs (TISS Item) | Hourly vital Signs (BP, HR, RR) and intake & output (hourly means more than 2 consecutive hours) | 5 | | 1900-01-01 | 2020-10-01 |
| Basic Activities | 3 | Lab Specimen Collection (TISS Item) | Any lab specimen collection by RN | 1 | | 1900-01-01 | 2020-10-01 |
| Basic Activities | 4 | Any medication any route (TISS Item) | Any medication given by any route | 2 | | 1900-01-01 | 2020-10-01 |
| Basic Activities | 5 | Two or more IV Meds (TISS Item) | Two or more IV medications given any time (continuous or intermittent) | 3 | | 1900-01-01 | 2020-10-01 |
| Basic Activities | 6 | Dressings 2 or less (TISS Item) | Dressings 2 or less per day, takes 10 mins or less each | 1 | | 1900-01-01 | 2020-10-01 |
| Basic Activities | 7 | Dressings 3 or more (TISS Item) | Dressings 3 or more per day, OR takes more than 10 mins each | 1 | | 1900-01-01 | 2020-10-01 |
| Basic Activities | 8 | Care of drainage tubes (TISS Item) | Care of any drainage tubes (excluding NG or OG tubes) | 3 | | 1900-01-01 | 2020-10-01 |
| Cardiovascular Support | 12 | More than 5 liters IV fluid per day (TISS Item) | More than 5L per day of IV fluids given in the ICU only
- includes: crystalloids, albumin and artificial volume expanders
| 4 | | 1900-01-01 | 2020-10-01 |
| Respiratory Support | 19 | Spontaneous breathing via ETT without PEEP/CPAP, with or without supplemental O2 (TISS Item) | Spontaneous breathing via ETT or Trach (no ventilator attached) | 2 | Row 18-21: If more than one is marked, get one with the highest points. | 1900-01-01 | 2020-10-01 |
| Respiratory Support | 24 | Chest Physio (TISS Item) | Chest Physio (pummeling &/or vibes &/or DB+C) | 1 | Row 24-27 If more than one is marked, point=1 only | 1900-01-01 | 2020-10-01 |
| Respiratory Support | 25 | Incentive Spirometry (TISS Item) | Incentive Spirometry | 1 | Row 24-27: If more than one is marked, point=1 only | 1900-01-01 | 2020-10-01 |
| Respiratory Support | 26 | Inhalation therapy (TISS Item) | Inhalation Therapy (nebulizers, puffers) | 1 | Row 24-27: If more than one is marked, point=1 only | 1900-01-01 | 2020-10-01 |
| Respiratory Support | 27 | Intratracheal suctioning (TISS Item) | Intratracheal Suctioning (via ETT, Trach, nasal trumpet, oral) | 1 | Row 24-27: If more than one is marked, point=1 only | 1900-01-01 | 2020-10-01 |
| Renal Support | 30 | Measurement of urinary output (TISS Item) | Measurement of urinary output (with or without a Foley) | 2 | | 1900-01-01 | 2020-10-01 |
| Renal Support | 31 | Substantial IV diuretics (TISS Item) | continuous or intermittent-Total daily dose of:
IV Lasix more than 30mg/day &/or
IV Bumex more than 0.75mg/day | 3 | | 1900-01-01 | 2020-10-01 |
| Metabolic Support | 35 | Treatment of metabolic acidosis or alkalosis (TISS Item) | e.g. NaHCO3 or Diamox for pH | 4 | | 1900-01-01 | 2020-10-01 |
| Metabolic Support | 37 | Tube feeds (TISS Item) | bolus or continuous, (NG, J-tube, G-tube) | 2 | don't include free water as tube feed | 1900-01-01 | 2020-10-01 |
| Other | 39 | Emergency Surgery (TISS Item) | Patient had EMERGENCY surgery in the last 24 hrs | 3 | Row 39-44:
Single intervention: 3 points.
Two or more interventions: 5 points | 1900-01-01 | 2020-10-01 |
| Specific Interventions (in the ICU only) | 41 | Cardioversion (TISS Item) | Cardioversion only (not defibrillation) in the ICU | 3 | Row 39-44:
Single intervention: 3 points.
Two or more interventions: 5 points | 1900-01-01 | 2020-10-01 |
| Specific Interventions (in the ICU only) | 42 | Pacemaker insertion (TISS Item) | Pacemaker insertion (only transvenous) in the ICU | 3 | Row 39-44:
Single intervention: 3 points.
Two or more interventions: 5 points | 1900-01-01 | 2020-10-01 |
| Specific Interventions (in the ICU only) | 43 | Endoscopy (TISS Item) | Endoscopy (any type of scope) in the ICU | 3 | Row 39-44:
Single intervention: 3 points.
Two or more interventions: 5 points | 1900-01-01 | 2020-10-01 |
| Specific Interventions (in the ICU only) | 44 | Gastric Lavage (TISS Item) | Gastric Lavage for upper GI bleed in the ICU | 3 | Row 39-44:
Single intervention: 3 points.
Two or more interventions: 5 points | 1900-01-01 | 2020-10-01 |
| Specific Interventions (outside the ICU) | 45 | RN Accompanied Trip (TISS Item) | RN accompanied trips out of the ICU (any reason except ward transfers) | 5 | | 1900-01-01 | 2020-10-01 |
| At 2300 Hours | 46 | Central Venous Catheter at 2300 (TISS Item) | Central Venous Catheter (includes Cordis, PICC, Vascath, etc) | 0 | See TISS at 2300 Hours | 1900-01-01 | 2020-10-01 |
| At 2300 Hours | 47 | Tracheostomy tube at 2300hrs (TISS Item) | Tracheostomy tube | 0 | See TISS at 2300 Hours | 1900-01-01 | 2020-10-01 |
| At 2300 Hours | 48 | Invasive mechanical ventilation at 2300 hrs (TISS Item) | Invasive mechanical ventilation via ETT or trach (AC, SIMV, PSV) | 0 | See TISS at 2300 Hours | 1900-01-01 | 2020-10-01 |
| At 2300 Hours | 49 | BIPAP at 2300 (TISS Item) | BIPAP (non-invasive - nasal or face mask) not CPAP | 0 | See TISS at 2300 Hours | 1900-01-01 | 2020-10-01 |