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Revised McGeer Criteria for Urinary Tract Infection Surveillance (UTIs)

The definitions for UTI presented here differ substantially from the original surveillance definitions1 for both (A) residents without an indwelling catheter and (B) residents with an indwelling catheter. The revised definitions take into account the low probability of UTI in residents without indwelling catheters if localizing symptoms are not present, as well as the need for microbiologic confirmation for diagnosis. Continue reading “Revised McGeer Criteria for Urinary Tract Infection Surveillance (UTIs)”

The Sequential Organ Failure Assessment (SOFA) Score

The SOFA system was created in a consensus meeting of the European Society of Intensive Care Medicine in 1994 and further revised in 1996. The SOFA is a six-organ dysfunction/failure score measuring multiple organ failure daily. Each organ is graded from 0 (normal) to 4 (the most abnormal), providing a daily score of 0 to 24 points. The objective in the development of the SOFA was to create a simple, reliable, and continuous score easily obtained in every institution.

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Guidelines for Intensive Care Unit Admission for Severe Community-Acquired Pneumonia (CAP)

The Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) recently reviewed risk factors and developed objective major and minor criteria to identify patients who require direct admission to an Intensive Care Unit (ICU). The most up-to-date definitions use need for invasive mechanical ventilation or septic shock, requiring vasopressors, as absolute indicators for direct admission to an ICU. For patients who do not meet either of these two major criteria, minor criteria have been proposed that are based on CURB-65 and ATS criteria with new additions. For admission to an ICU or high level unit, patients must fulfill at least three of these minor criteria.

Continue reading “Guidelines for Intensive Care Unit Admission for Severe Community-Acquired Pneumonia (CAP)”

Criteria for Brain Death in Adults and Children

Clinical Criteria for Brain Death in Adults and Children

  • Coma
  • Absence of motor responses
  • Absence of pupillary responses to light and pupils at midposition with respect to dilatation (4–6 mm)
  • Absence of corneal reflexes
  • Absence of caloric responses
  • Absence of gag reflex
  • Absence of coughing in response to tracheal suctioning
  • Absence of sucking and rooting reflexes
  • Absence of respiratory drive at a PaCO2 that is 60 mm Hg or 20 mm Hg above normal base-line values*
  • Interval between two evaluations, according to patient’s age Continue reading “Criteria for Brain Death in Adults and Children”

Clinical Criteria for Do-Not-Resuscitate (DNR) Orders in Acute Stroke

A DNR order may be written any time that two of the following clinical criteria are present and the prognosis has become clear for and shared whenever possible between physician(s), patient, and family (or appropriate surrogate).

Continue reading “Clinical Criteria for Do-Not-Resuscitate (DNR) Orders in Acute Stroke”

Criteria for Chronic Respiratory Failure in Infants and Children

Criteria for Chronic Respiratory Failure due to Cardiopulmonary Disorders in Infants and Children

Clinical criteria

  • Decreased inspiratory breath sounds
  • Increased retractions, use of accessory muscles
  • Cyanosis breathing room air
  • Decreased level of normal activity/function
  • Poor weight gain (mass) (IMPORTANT)

Continue reading “Criteria for Chronic Respiratory Failure in Infants and Children”

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