CURB-65 score for pneumonia

Score Description
1 Age 65+
1 New onset confusion
1 Urea >7mmol/l
1 Respiratory rate >30/min
1 SBP <90mmHg / DPB <60mmHg
Additional Hypoxaemia (SaO2 <92% or PaO2 <8 kPa)
adverse regardless of FiO2
prognostic Bilateral or multilobe involvement on CXR
features
 Modified Glasgow Score For Pancreatitis
Parameter score

age >55 1
pO2 <8.0kpa 1

WCC >15 1

Ca2+ (uncorr) <2 1

ALT >100 1

LDH >600 1

glucose >10 1

score > 3 indicates severe pancreatitis

 Rockall scoring system
(Risk of re-bleeding / death after acute UGIB)
Variable Score 0 Score 1 Score 2 Score 3
Age in years <60 60 – 79 >80
Shock None SBP Tachycardia Hypotension
>100, pulse pulse >100, SBP <100,
<100 SBP >100 pulse >100
Co-morbidity Nil major Cardiac Renal or liver
failure, IHD, failure,
other major disseminated
co-morbidity malignancy
Diagnosis Mallory-Weiss All other Malignancy of
tear, no lesion, diagnoses upper GI tract
no stigmata of
recent
haemorrhage
 NICE criteria for immediate head CT (adults)
 GCS <13 on initial assessment in ED
 GCS <15 2 hours after injury / ED assessment
 Suspected open or depressed skull fracture
 Any sign of basal skull fracture
 Post-traumatic seizure
 Focal neurological deficit
 More than one episode of vomiting
 Amnesia for events >30 minutes before impact
 NICE criteria for immediate head CT
(patient experiencing LOC / amnesia since injury)

 >65 years
 Coagulopathy / warfarin
 Dangerous mechanism of injury
 ABCD2 to identify patients at high risk of stroke
following a TIA
Score Description

1 A - Age >=60 years

1 B - Blood pressure at presentation >=140/90 mmHg
2 C - Clinical features of unilateral weakness
1 C - Clinical features of speech disturbance without
weakness
2 D - Duration of symptoms >= 60 minutes
1 D - Duration of symptoms 10-59 minutes
1 Presence of diabetes
Scores range from 0 (low risk) to 7 (high risk)
 Wells score for DVT
Score Description
1 Active cancer (treatment within last 6 months or palliative)

1 Calf swelling >3 cm compared to other calf (measured 10 cm

below tibial tuberosity)
1 Collateral superficial veins (non-varicose)
1 Pitting oedema (confined to symptomatic leg)
1 Swelling of entire leg
1 Localized pain along distribution of deep venous system

1 Paralysis, paresis, or recent cast immobilization of lower

extremities
1 Recently bedridden > 3 days, or major surgery requiring
regional or general anesthetic in past 12 weeks

1 Previously documented DVT

Minus 2 Alternative diagnosis at least as likely
Interpretation
2 or higher:- DVT likely (consider imaging leg veins)
<2:- DVT unlikely (consider XDP to further rule out DVT)
 Asthma Exacerbation Grades (BTS)

Grading of asthma exacerbations

Moderate Acute severe Life threatening Near fatal
Increasing symptoms PEF 33 – 50% best PEF <33% best or Raised PaCO2
or predicted predicted
PEFR >50 – 75% RR > 25 /min SpO2 < 92% Requiring
best or predicted mechanical
ventilation with
raised pressures
No features of acute HR > 110 /min PaO2 <8kpa
severe asthma
Inability to complete Normal PaCO2
sentences in one
breath

Silent chest
Cyanosis
Feeble respiratory effort

Bradycardia, arrhythmia,
hypotension

Exhaustion, confusion,
coma
 New York Association Heart Failure Classification
Class Description

1 No Limitation. Ordinary activity does not cause

undue fatigue, dyspnoea, or palpitations
2 Slight limitation of physical activity. Comfortable at
rest, but ordinary physical activity results in heart
symptoms
3 Marked limitation of physical activities. Comfortable
at rest, but less than ordinary activity causes heart
failure symptoms
4 Symptoms of heart failure are present at rest. If any
physical activity is undertaken, discomfort is
increased
 Sepsis Screening Tool
Score Criteria
1 Temperature > 38°C or < 36°C
1 Heart rate > 90 beats/minute
1 Respiration > 20/min
1 WCC >12 or <4
1 Hyperglycaemia in absence of diabetes >6.6
1 Acutely altered mental state
Ask patient about history suggestive of new infection

Sepsis present in patients presenting with 2 or more criteria

PTO for severe sepsis criteria
 Severe Sepsis Criteria
SBP <90 or MAP <65

Urine output <30mls/hr for 2 consecutive hours

Unexplained metabolic acidosis pH<7.35

Acute change in mental state

New need for O2 to keep SPO2 >90

Plasma lactate >2

Platelets <100

Creatinine >177
 Nexus C-spine rule
Score Parameter

1 Midline c-spine tenderness

1 Evidence of intoxication

1 Altered consciousness

1 Focal neurology

1 Distracting injuries

Score >1 indication for c-spine imaging

 Wells criteria for PE
Score Parameter
3 Clinical signs of DVT
3 Alternative diagnosis less likely
1.5 HR>100
1.5 Immobility / surgery in last 4 weeks
1.5 Previous DVT / PE
1 Haemoptysis
1 Malignancy
Low risk = 1 – 2.5 points
Moderate risk = 3 – 6 points
High risk = 6.5 – 12.5
 AMTS
1 What is your age
1 What is your date of birth
1 What is the year
0 Please remember “42 West Street”
1 What is the time to the nearest hour
1 What is the name of this hospital
1 Can patient recognise 2 people (Dr / nurse)
1 What year did World War II end (1945)
1 Name the present monarch
1 Count backwards from 20 to 1
1 Recount the address you were asked to remember
8 or higher is normal for an elderly patient