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Health Status Indicators
There are several scoring systems in intensive care units (ICUs) today. Adult scoring systems * APACHE II was designed to provide a morbidity score for a patient. It is useful to decide what kind of treatment or medicine is given. Methods exist to derive a predicted mortality from this score, but these methods are not too well defined and rather imprecise. **APACHE III is an updated version. * SAPS II was designed to provide a predicted mortality, that does not reflect the expected mortality for a particular patient, but is good for benchmarking. In a rather simple way, it makes it possible to provide a single number that describes the morbidity of a number of patients. * SAPS III was designed to provide a realistic predicted mortality for a particular patient or a particular group of patients. It does this by calibrating against known mortalities on an existing set of patients, for a specific definition of mortality (like 30-days mortality). This way, it can answer questions ...
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Medical Algorithms
A medical algorithm is any computation, formula, statistical survey, nomogram, or look-up table, useful in healthcare. Medical algorithms include decision tree approaches to healthcare treatment (e.g., if symptoms A, B, and C are evident, then use treatment X) and also less clear-cut tools aimed at reducing or defining uncertainty. A medical prescription is also a type of medical algorithm. Scope Medical algorithms are part of a broader field which is usually fit under the aims of medical informatics and medical decision-making. Medical decisions occur in several areas of medical activity including medical test selection, diagnosis, therapy and prognosis, and automatic control of medical equipment. In relation to logic-based and artificial neural network-based clinical decision support systems, which are also computer applications used in the medical decision-making field, algorithms are less complex in architecture, data structure and user interface. Medical algorithms are not ...
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PIM2
PIM2 is a scoring system for rating the severity of medical illness for children, one of several ICU scoring systems. Its name stands for "Paediatric Index of Mortality". It has been designed to provide a predicted mortality for a patient by following a well-defined procedure. Predicted mortalities are good when dealing with several patients, because the average predicted mortality for a group of patients is an indicator for the morbidity of these patients. Just like APACHE II and SAPS II SAPS II is a severity of disease classification system. Its name stands for "Simplified Acute Physiology Score", and is one of several ICU scoring systems. Application SAPS II was designed to measure the severity of disease for patients admitted ..., it does not provide a real-life predicted mortality. The standard is too old, variations in mortality are huge between countries and departments, and the definition of mortality is varying, too. However, PIM2 provides a good way to benchmark dif ...
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Pancreatitis
Pancreatitis is a condition characterized by inflammation of the pancreas. The pancreas is a large organ behind the stomach that produces digestive enzymes and a number of hormones. There are two main types: acute pancreatitis, and chronic pancreatitis. Signs and symptoms of pancreatitis include pain in the upper abdomen, nausea and vomiting. The pain often goes into the back and is usually severe. In acute pancreatitis, a fever may occur, and symptoms typically resolve in a few days. In chronic pancreatitis weight loss, fatty stool, and diarrhea may occur. Complications may include infection, bleeding, diabetes mellitus, or problems with other organs. The two most common causes of acute pancreatitis are a gallstone blocking the common bile duct after the pancreatic duct has joined; and heavy alcohol use. Other causes include direct trauma, certain medications, infections such as mumps, and tumors. Chronic pancreatitis may develop as a result of acute pancreatitis. It is mos ...
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Child–Pugh Score
In medicine, specifically gastroenterology, the Child–Pugh score (or the Child–Turcotte–Pugh (CTP) score or Child Criteria) is used to assess the prognosis of chronic liver disease, mainly cirrhosis. Although it was originally used to predict mortality during surgery, it is now used to determine the prognosis, as well as the required strength of treatment and the necessity of liver transplantation. Scoring The score employs five clinical measures of liver disease. Each measure is scored 1–3, with 3 indicating most severe derangement. Either the prothrombin time or INR should be used to calculate the Child–Pugh score, not both. In primary sclerosing cholangitis (PSC) and primary biliary cholangitis (PBC), some use a modified Child–Pugh score where the bilirubin references are changed to reflect the fact that these diseases feature high conjugated bilirubin levels. The upper limit for 1 point is 68 μmol/L (4 mg/dL) and the upper limit for 2 points is 170 μmol/L ...
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Mortality Probability Model
Mortality is the state of being mortal, or susceptible to death; the opposite of immortality. Mortality may also refer to: * Fish mortality, a parameter used in fisheries population dynamics to account for the loss of fish in a fish stock through death * ''Mortality'' (book), a 2012 collection of essays by Anglo-American writer Christopher Hitchens * Mortality (computability theory), a property of a Turing machine if it halts when run on any starting configuration * Mortality rate, a measure for the rate at which deaths occur in a given population * Mortality/differential attrition, an error in the internal validity of a scientific study See also * Case fatality rate, the proportion of deaths within a designated population of people with a medical condition * Cause of death * Fulminant * Mortality displacement, a (forward) temporal shift in the rate of mortality * Mortality rate or death rate * Mortality salience, awareness of one's eventual death * Mortal (other) * Mor ...
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Level Of Consciousness
An altered level of consciousness is any measure of arousal other than normal. Level of consciousness (LOC) is a measurement of a person's arousability and responsiveness to stimuli from the environment. A mildly depressed level of consciousness or alertness may be classed as lethargy; someone in this state can be aroused with little difficulty. People who are obtunded have a more depressed level of consciousness and cannot be fully aroused. Those who are not able to be aroused from a sleep-like state are said to be stuporous. Coma is the inability to make any purposeful response. Scales such as the Glasgow coma scale have been designed to measure the level of consciousness. An altered level of consciousness can result from a variety of factors, including alterations in the chemical environment of the brain (e.g. exposure to poisons or intoxicants), insufficient oxygen or blood flow in the brain, and excessive pressure within the skull. Prolonged unconsciousness is unde ...
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FOUR Score
The FOUR Score is a clinical grading scale designed for use by medical professionals in the assessment of patients with impaired level of consciousness. It was developed by Dr. Eelco F.M. Wijdicks and colleagues in Neurocritical care at the Mayo Clinic in Rochester, Minnesota. "FOUR" in this context is an acronym for "Full Outline of UnResponsiveness". The FOUR Score is a 17-point scale (with potential scores ranging from 0 - 16). Decreasing FOUR Score is associated with worsening level of consciousness. The FOUR Score assesses four domains of neurological function: eye responses, motor responses, brainstem reflexes, and breathing pattern. The rationale for the development of the FOUR Score constituted creation of a clinical grading scale for the assessment of patients with impaired level of consciousness that can be used in patients with or without endotracheal intubation. The main clinical grading scale in use for patients with impaired level of consciousness has historically bee ...
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Central Nervous System
The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain and spinal cord. The CNS is so named because the brain integrates the received information and coordinates and influences the activity of all parts of the bodies of bilaterally symmetric and triploblastic animals—that is, all multicellular animals except sponges and diploblasts. It is a structure composed of nervous tissue positioned along the rostral (nose end) to caudal (tail end) axis of the body and may have an enlarged section at the rostral end which is a brain. Only arthropods, cephalopods and vertebrates have a true brain (precursor structures exist in onychophorans, gastropods and lancelets). The rest of this article exclusively discusses the vertebrate central nervous system, which is radically distinct from all other animals. Overview In vertebrates, the brain and spinal cord are both enclosed in the meninges. The meninges provide a barrier to chemicals dissolv ...
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Glasgow Coma Scale
The Glasgow Coma Scale (GCS) is a clinical scale used to reliably measure a person's level of consciousness after a brain injury. The GCS assesses a person based on their ability to perform eye movements, speak, and move their body. These three behaviours make up the three elements of the scale: eye, verbal, and motor. A person's GCS score can range from 3 (completely unresponsive) to 15 (responsive). This score is used to guide immediate medical care after a brain injury (such as a car accident) and also to monitor hospitalised patients and track their level of consciousness. Lower GCS scores are correlated with higher risk of death. However, the GCS score alone should not be used on its own to predict the outcome for an individual person with brain injury. Scoring The Glasgow Coma Scale is used for people above the age of two and composed of three tests: eye, verbal, and motor responses. The scores for each of these tests are indicated in the table below. The Glasgow Com ...
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SOFA Score
The sequential organ failure assessment score (SOFA score), previously known as the sepsis-related organ failure assessment score, is used to track a person's status during the stay in an intensive care unit (ICU) to determine the extent of a person's organ function or rate of failure. The score is based on six different scores, one each for the respiratory, cardiovascular, hepatic, coagulation, renal and neurological systems. The score tables below only describe points-giving conditions. In cases where the physiological parameters do not match any row, zero points are given. In cases where the physiological parameters match more than one row, the row with most points is picked. The quick SOFA score (qSOFA) assists health care providers in estimating the risk of morbidity and mortality due to sepsis. Medical use The SOFA scoring system is useful in predicting the clinical outcomes of critically ill patients. According to an observational study at an Intensive Care Unit (ICU) in ...
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Calibration
In measurement technology and metrology, calibration is the comparison of measurement values delivered by a device under test with those of a calibration standard of known accuracy. Such a standard could be another measurement device of known accuracy, a device generating the quantity to be measured such as a voltage, a sound tone, or a physical artifact, such as a meter ruler. The outcome of the comparison can result in one of the following: * no significant error being noted on the device under test * a significant error being noted but no adjustment made * an adjustment made to correct the error to an acceptable level Strictly speaking, the term "calibration" means just the act of comparison and does not include any subsequent adjustment. The calibration standard is normally traceable to a national or international standard held by a metrology body. BIPM Definition The formal definition of calibration by the International Bureau of Weights and Measures (BIPM) is the fo ...
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Intensive Care Unit
220px, Intensive care unit An intensive care unit (ICU), also known as an intensive therapy unit or intensive treatment unit (ITU) or critical care unit (CCU), is a special department of a hospital or health care facility that provides intensive care medicine. Intensive care units cater to patients with severe or life-threatening illnesses and injuries, which require constant care, close supervision from life support equipment and medication in order to ensure normal bodily functions. They are staffed by highly trained physicians, nurses and respiratory therapists who specialize in caring for critically ill patients. ICUs are also distinguished from general hospital wards by a higher staff-to-patient ratio and access to advanced medical resources and equipment that is not routinely available elsewhere. Common conditions that are treated within ICUs include acute respiratory distress syndrome, septic shock, and other life-threatening conditions. Patients may be referred dire ...
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