Comprehensive Medical Terms Add-On Reference for SpellCatcher Features OpenMedSpel

Rainmaker Research Inc. has included OpenMedSpel in an add on dictionary for the award winning Spell Catcher line of medical spelling tools.

From Rainmaker Research Inc.

Courtesy of the folks at e-MedTools, we’ve created a Spell Catcher format Learned Words file that includes medical terminology from the MedSpel project. This reference contains over 35,000 medical terms not available in the U.S. English Medical Additional Spellings database. Use this file in conjunction with the standard U.S. English Medical Spellings for a grand total of nearly 60,000 medical terms!

Available for all Spell Catcher products, download the one you need from the appropriate Add-Ons page:

Spell Catcher X
Spell Catcher Plus
Spell Catcher 8

It’s also available on from the Downloads page for each product, and our Languages page.

And best of all, it’s free!

New Pulmonary MedicalTemplate Bundles

The Folks at MedicalTemplates have created 3 new pulmonary MedicalTemplate bundles to meet the needs of any pulmonologist!

Common Pulmonary Problems Bundle
This MedicalTemplate bundle includes the COPD new patient, Sleep, Lung Mass, Asthma, Interstitial Lung Disease and Pulmonary Hypertension templates at a 25% discount. This MedicalTemplate bundle costs 675 + any required taxes for a single user. Click here to order the Common Pulmonary Problems Bundle.


Complete Pulmonary Problem-Specific Bundle
We are offering a 10 template bundle at a 30% discount! That is a $1500 value for just $1050! Templates included in this bundle are Sepsis, Pneumonia, Asthma, COPD New Eval, COPD Follow Up, Pleural Effusion, Pulmonary Artery Hypertension, Interstitial Lung Disease, Lung Mass, and Sleep Disorder Evaluation. To save 30% on a 10 template bundle, click here.

The Everything Pulmonary Bundle
Save 35% on the purchase of 13 pulmonary MedicalTemplates!
A $1950 value for just $1275! That is like getting 4 1/2 templates for free!
Templates included are Pulmonary clinic H&P, Pulmonary Hospital H&P, Pulmonary Hospital Follow Up, Sepsis, Pneumonia, Asthma, COPD New Eval, COPD Follow Up, Pleural Effusion, Pulmonary Artery Hypertension, Interstitial Lung Disease, Lung Mass, and Sleep Disorder Evaluation.

To save 35% on a 13 template bundle, click here!

Dierbergs, Giant Food, and Giant Eagle added to GenericMedList

The GenericMedList database has been expanded to include generic discount programs at Dierbergs, Giant Food, and Giant Eagle pharmacies.

GenericMedList is a free searchable database of generic medication discount programs similar to the well known Walmart $4 per month medication program.

GenericMedList features the following generic medication discount programs

Walmart | Target | KMart | Kroger | Meijer | Schnucks | Publix | Wegmans | Giant Eagle | Dierbergs | Giant Food

COPD Evaluation Medical Template Revised

Our COPD Evaluation MedicalTemplate (Consult note or H&P) has been revised to give expanded space to document a review of systems, assessment and plan, history, and has improved documentation reminders.

When completed, and in conjunction with a supporting level of medical decision making, this MedicalTemplate meets or exceeds the documentation requirements in the 1995 and 1997 Medicare Guidelines for E&M services for the highest level of service, including critical care.

The COPD Evaluation MedicalTemplate contains prompters and space for all the required elements for a E&M encounter such as a H&P or Consult.

History Click here to learn about History Documentation

• Chief complaint
• History of present illness
• COPD symptoms and severity checklist
• Past medical and surgical history
• Social history
• Risk factors for COPD and other respiratory diseases (occupational exposure, smoking, and others)
  
• Family history
• Review of systems
• Yes/No checkboxes for clear and complete documentation

Examination Click here to learn about Physical Exam Documentation

• When completed, represents a comprehensive (highest) level physical exam as defined in 1997 Guidelines.
  
• Checkboxes for pertinent negatives and common positive findings
  

Medical Decision Making Click here to learn about MDM Documentation

• Full page for adequate space with complex patients
  
• Easy Documentation with checkboxes
• Review of labs, tests, imaging, old records
• Coordination of care
• Common diagnostic and therapeutic options
  
• Assessment and plan

Chronic Obstructive Pulmonary Disease Evaluation

Publish at Scribd or explore others: Nursing and Health P Medical maintenance exercise inspiratory muscle t

www.e-medtools.com COPD Evaluation Patient Name Review of Systems Yes Constitution Fatigue Malaise Fever or chills Appetite changes ENT/mouth Nose bleed Dental caries Dental abscesses Jaw pain Respiratory Dyspnea Cough Phlegm Hemoptysis Wheeze Cardiovascular Chest pain Diaphoresis Ankle edema Syncope Palpitations Gastrointestinal Nausea or vomiting Weight changes Constipation or Diarrhea Abdominal pain Genitourinary Urinary changes Hematuria Dysuria Urethral discharge Musculoskeletal Myalgias Arthralgias Joint swelling Recent trauma Skin/Breasts Masses New skin lesions Rashes Sensitivity to sun Neurologic Headaches Seizures Muscle weakness Endocrinologic Hair loss Polydipsia Tremors Neck pain Heme/Lymph Bleeding gums Unusual bruising Swollen lymph nodes Allergy/Immunology Sinus problems Recurrent infections No Reset DOB Chief complaint/Reason for consult Date Start time Referring Healthcare Provider Stop time www.e-medtools.com History of Present Illness COPD Symptom Asymptomatic with usual activity Patient is Nonverbal. History obtained from FEV1/FVC >/=70% <70%>80% >79% SEVERITY Family Medical records Chronic Bronchitis symptoms Increased cough Increased dyspnea or wheeze Increased sputum production Change in sputum color/quality Reset At risk Mild Symptomatic with usual activity Symptomatic with minimal activity Symptomatic at rest Reset 50-79% Moderate 30-49% Severe <30%> lb lying / Obese kg Temp standing Grooming appropriate P rate / Reg R Irreg Sats % BP sitting General ENT Neck Cachectic Unkempt appearance Nasal mucosa Dental caries Dentition Gingivitis Oropharynx Mallampati I II III IV Oral Petechiae Oropharyngeal edema or erythema No JVD JVD present Oral ulcers www.e-medtools.com Thyromegaly Thyroid nodules palpable Erythema consistent with radiation dermatitis Normal to palpation Thyroid Neck mass ______________________________ Scarring consistent with old, healed radiation dermatitis No respiratory distress No chest wall defects Resp Clear to auscultation Decreased fremitus Dullness to percussion Bronchial breath sounds Rales Egophony (E to A change) Rhonchi Wheezes Accessory respiratory muscle use Erythema consistent with radiation dermatitis Scarring consistent with old, healed radiation dermatitis Peripheral pulses palpable III IV V No peripheral edema Absent Weak CV GI Clear S1 S2 Murmur No murmur Systolic No gallop No rub I II www.e-medtools.com No palpable masses Hepatomegaly Diastolic Grade VI Peripheral pulses Splenomegaly Liver and spleen not palpable No hepatojugular reflux Diagnostic Data \____/ / \ ____ / ____ / ____ / \ \ \ Lymph Musc Extrem Skin Neuro No lymphadenopathy Lymphadenopathy Increased Neck Axilla Groin Other ______________________ Muscle tone within normal limits Gait within normal limits No clubbing Clubbing Decreased Shuffle Synovitis Rt Lt _______________________ Ataxia Wide based Cyanosis No cyanosis No rashes, ecchymoses, nodules, ulcers Oriented to person, time, place, situation Affect Periungual telangiectasias 58(Pts with CABP) Splinter hemorrhages Person Time Place NOT ORIENTED to ©MB and RR 2006-2008 Revised13Oct08 Indicates Physician Quality Reporting Initiative (PQRI) Physician Quality Measures Completion of this form meets or exceeds the documentation requirements in the 1997 Guidelines for Evaluation & Management Services www.e-medtools.com COPD Evaluation Patient Name Plan Impression 52 DOB Date Start time Stop time COPD Therapy PRN albuterol “rescue agent” Inhaled corticosteroids Oral steroids Intravenous steroids Long-acting beta agonist Theophylline Long-acting anti-cholinergic Antibiotics for exacerbations Smoking cessation aids Long term oxygen therapy Patient advised to quit smoking Patient advised of risks of alcohol, narcotic and benzodiazepine use Medication Side Effects discussed 52 If no history of glaucoma or urinary retention Patient has completed advanced health care directives 47 HCPOA is Code Status Patient is a FULL CODE DO NOT ATTEMPT RESUSCITATION www.e-medtools.com Mental status changes OR 2 of the following Dyspnea at rest Respiratory rate > 25 Severe COPD exacerbation requiring hospitalization as evidenced by Pulse > 100 Accessory respiratory muscle use 52 www.e-medtools.com Schedule Patient For Bronchoscopy Pulmonary Function Testing Methacholine Challenge 6 Minute Walk Test Bone density evaluation CXR Chest CT 12 lead ECG ECHO with bubble study assess PA pressures Cardiopulmonary Stress Test Sleep Study CT Surgery eval for lung reduction Pulmonary Rehabilitation Pneumococcal vaccine Influenza vaccine with contrast www.e-medtools.com www.e-medtools.com Signature cc Continuous home oxygen therapy Flow rate _______L/min Oxygen concentrator Oxygen tank with conservation valve Nasal cannula with reservoir Portable oxygen tank Gas Liquid Supplemental oxygen therapy during air travel Flow rate _______L/min Home CPAP Flow rate _______ L/min Heater and humidifier Mask type Nasal Oronasal Face Home BiPAP Inspiratory flow _______/Expiratory flow _______ Heater and humidifier Mask type Nasal Oronasal Face ER Notes Old Chart EMS Note ECG Nursing Notes & Vitals log Case Management Labs X Rays MRI Pharmacy US CT Labs CBC BMP CMP BNP LFTs Alpha 1 antitrypsin Cultures Blood Sputum Other www.e-medtools.com Data Reviewed Care Coordinated With ER MD HCPOA Primary Care MD Social Worker ©MB and RR 2006-2008 Revised13Oct08 Indicates Physician Quality Reporting Initiative (PQRI) Physician Quality Measures Completion of this form meets or exceeds the documentation requirements in the 1997 Guidelines for Evaluation & Management Services 

OpenMedSpel for OpenOffice.org 3.0

OpenMedSpel has been updated for OpenOffice.org 3.0 and higher, and is listed on OpenOffice.org Extensions!.

OpenMedSpel includes nearly 50,000 medical terms ranging from abdominis to zygomatic, which allows you to concentrate on your work instead of looking up words in a medical dictionary that are not in the built-in USA English OpenOffice.org spelling dictionary.

OpenMedSpel is free and open source medical spelling software released under a GPL license.

Medical Decision Making Calculator - Google Desktop

e-MedTools released a free Medical decision making calculator for Google Desktop.

Medical decision making (MDM) is a required component for all Evaluation and Management services (E&M), which include most clinic and hospital patient encounters.

This calculator is an excellent learning tool for clinicians that want to improve the accuracy of billing for E&M services, and is based on the MDM assessment method used by most Medicare carriers nationwide.




Health care providers working in Delaware, Maryland, Texas, Virginia, or the District of Columbia should use the method developed by TrailblazerHealth (the Medicare carrier in the states mentioned above) to evaluate the Medical Decision Making portion of the E&M service, which is not included in the current version of this calculator.

Pulmonary Hospital H&P or Consult Note Updated

Our Pulmonary/Critical Care Hospital H&P or Consult note has been revised to give expanded space to document an assessment and plan, history, and has improved documentation reminders.

When completed, and in conjunction with a supporting level of medical decision making, this MedicalTemplate meets or exceeds the documentation requirements in the 1995 and 1997 Medicare Guidelines for E&M services for the highest level of service, including critical care.

The pulmonary/critical care new patient evaluation MedicalTemplate contains prompters and space for all the required elements for a E&M encounter such as a H&P or Consult.

History Click here to learn about History Documentation

• Chief complaint
• History of present illness
• Past medical and surgical history
• Social history
• Risk factors for respiratory disease (occupational exposure, smoking, and others)
  
• Family history
• Review of systems
• Yes/No checkboxes for clear and complete documentation

Examination Click here to learn about Physical Exam Documentation

• When completed, represents a comprehensive (highest) level physical exam as defined in 1997 Guidelines.
  
• Respiratory Single System Exam OR General Multisystem Exam
• Checkboxes for pertinent negatives and common positive findings
  

Medical Decision Making Click here to learn about MDM Documentation

• Full page for adequate space with complex patients
  
• Easy Documentation with checkboxes
• Review of labs, tests, imaging, old records
• Coordination of care
• Common diagnostic and therapeutic options
  
• Assessment and plan

Follow this link for a concise review of the medical documentation requirements for E&M services.



Pulmonary / Critical Care New Patient Evaluation

Get your own at Scribd or explore others: Health Medical Medical Religion

Pulmonary Evaluation Date Time Yes Constitution Fatigue Malaise Fever or chills Appetite changes Eyes Vision changes New pain Scotomas ENT/mouth Nose bleed Dental caries Dental abscesses Jaw pain Respiratory Dyspnea Cough Phlegm Hemoptysis Wheeze Cardiovascular Chest pain Diaphoresis Ankle edema Syncope Palpitations Gastrointestinal Nausea or vomiting Weight changes Constipation or Diarrhea Abdominal pain Genitourinary Urinary changes Hematuria Dysuria Urethral discharge Musculoskeletal Myalgias Arthralgias Joint swelling Recent trauma Skin/Breasts Masses New skin lesions Rashes Sensitivity to sun Neurologic Headaches Seizures Muscle weakness Endocrinologic Hair loss Polydipsia Tremors Neck pain Heme/Lymph Bleeding gums Unusual bruising Swollen lymph nodes Allergy/Immunology Sinus problems Recurrent infections Psychologic Mood changes Agitation Hallucinations Patient _________________________________________ DOB _____ / _____ / _____ MRN _____________________ Chief complaint/Reason for consult No Reset www.e-medtools.com Referring MD History of Present Illness Patient is Nonverbal. History obtained from Family Medical records Elements of HPI: Location, quality, severity, timing, duration, context, modifying factors, associated signs and symptoms Reset www.e-medtools.com Reset Reset Medications Medications reviewed Medications reconciled with Nursing Home or Hospital discharge Information Allergies Allergy List reviewed 46 No food or drug allergies Past Medical, Family Social History Reset www.e-medtools.com Asthma Cerebral Artery Disease Bronchiectasis Congestive Heart Failure COPD Coronary Artery Disease COP (BOOP) Diabetes Cystic Fibrosis GERD Histiocytosis Hepatic Dysfunction Tuberculosis HIV/AIDS PAH Hypertension Sarcoidosis Inflam bowel disease Wegener’s Malignancy Obstructive Sleep Apnea CPAP BiPAP Malignancy Adrenal Colon Melanoma Renal cell Reset Reset www.e-medtools.com Thyroid Neuromuscular weakness Occupational exposures Osteoporosis Pancreatitis Peripheral Artery Disease Scleroderma Seizure Disorder Sjogren’s Renal dysfunction/ failure Rheumatoid Arthritis Thrombotic Disease Thyroid disease Breast Lung Chemotherapy Colonoscopy ECHO/Stress Test Mammogram PFTs PapSmear Prior Intubations Radiation exposure Sleep Study Steroid use Prostate Testicular Surgeries Reset Social History / Risk factors Denies Denies Denies Yes Ever smoker ___ # Packs X ____ # Yrs Yes Chews tobacco Yes Quit tobacco use Quit date _________ Patient is unwilling to quit Patient willing to consider quitting Patient quit, but resumed smoking Patient willing to quit within 1 month Yes Yes Yes Yes Feels safe at home or work Tattoos High risk sexual behavior Recreational drug use Inhalational Injectable Denies Reset Yes Patient has tried smoking cessation aids Nicotine replacement Buproprion or nortriptyline Nicotine receptor blockade Reset www.e-medtools.com Denies Denies Denies Denies Denies Ingestible Reset Denies Denies Denies Denies Denies Yes Yes Yes Yes Yes Alcohol use ___ Drinks per day week Felt the need to cut down on drinking? Annoyed by others criticizing drinking? Guilt associated with drinking? Eye opener needed? Yes Drug dependence Narcotics Benzodiazepines Occupational and Exposure History Reset www.e-medtools.com Reset Inorganic dusts i.e., quarries, sandblasting, cement, stone carving, welding, plumbing, shipyard work, firefighter Organic dusts i.e., farming, building inspection, woodworking, remodeling, handling vegetable matter or animals Noxious fumes i.e., spray painting, autobody work, working with dyes or glues, manufacturing plastic Hot tub or Jacuzzi or High Pressure washings Pets or feathers Chemicals or fires Family Medical History Reset Asthma CHF COPD Coronary Artery Dis Thrombotic disorder Thyroid Disease Malignancy in first degree relatives, specify Pancreatitis Peripheral Artery Disease Renal Dysfunction ©MB and RR 2006-2008 Revised 31Oct08 e-medtools.com Indicates Physician Quality Reporting Initiative (PQRI) Physician Quality Measures Completion of this form meets or exceeds the documentation requirements in the 1997 Guidelines for Evaluation & Management Services Pulmonary Evaluation Exam Patient _________________________________________ DOB _____ / _____ / _____ MRN _____________________ General Multisystem requires performing ALL of ≥9 organ systems, AND ≥2 elements documented in each organ system www.e-medtools.com Height ___________ in cm To qualify as a comprehensive exam: Respiratory Single Organ System Exam requires documentation of ALL highlighted organ system elements, AND ≥1 element in every other organ system is expected lb kg Regular Irregular Ventilator, IV Medications & Labs Ventilator Mode PRVC Rate AC SIMV PC Constitutional (≥ 3 vitals) Body habitus and Grooming required of General Multisystem but not Organ System Exam Weight ___________ Pulse Rate __________ Temperature __________ AND Rhythm Other ____________ __________ www.e-medtools.com Blood Pressure lying Respiratory Rate__________ Body habitus wnl Cachectic Unkempt Obese Blood Pressure sitting __________ / __________ OR standing __________ / __________ __________ / __________ Optional Sats _____ % Cardiac Output _____ SVR _____ Tidal Vol __________ PEEP PS FiO2 __________ __________ __________ ENT Grooming wnl Nasal mucosa, septum, and turbinates wnl PO2/FiO2__________ Plateau __________ NonInvasive Ventilator CPAP BiPAP Dentition and gums wnl Oropharynx wnl Dental caries Gingivitis Oral ulcers Oral Petechiae www.e-medtools.com Mallampati Oropharyngeal edema or erythema I II III IV Neck Neck wnl Thyroid wnl Dose Rate Erythema or scarring consistent with Thyromegaly Recent Old radiation dermatitis Neck mass ___________________________ Thyroid nodules palpable IV Medications Pressors Jugular Veins wnl JVD present a, v or cannon a waves present ____________________________ ____________________________ Antihypertensives Resp Chest is free of defects, expands normally and symmetrically Erythema consistent with radiation dermatitis Scarring consistent with old, healed radiation dermatitis Respiratory effort is wnl Accessory respiratory muscle use Intercostal retractions ____________________________ Diuretics ____________________________ Antibiotics www.e-medtools.com Chest percussion wnl Tactile exam wnl Dullness to percussion Tactile fremitus Increased Clear to auscultation Bronchial breath sounds Rub present ________________________ Paradoxic diaphragmatic movements Lt Rt Hyperresonance Lt Rt ____________________________ ____________________________ Sedation Decreased _____________________________________ Egophony (E to A) Rales Rhonchi Wheezes ____________________________ Narcotics CV Clear S1 S2 Murmur present No murmur, rub or gallop Systolic Gallop I Rub II III IV V VI Weak Pulsatile Diastolic Grade No peripheral edema LUQ RUQ Liver Axilla Groin ____________________________ Heparin Peripheral pulses palpable Peripheral pulses LLQ Absent ____________________________ Insulin GI ____________________________ Antiarrhythmics www.e-medtools.com Lymph node exam wnl Areas examined Lymphadenopathy noted in Neck Axilla Abdominal exam wnl Mass present RLQ ____________________ Liver Spleen ____________________________ Steroids Liver and spleen palpation wnl Unable to palpate Lymph (≥2 areas must be examined) Neck Spleen Enlarged Groin Other ___________________ ____________________________ Paralytic Other ___________________ Musc Muscle tone within normal limits, and no atrophy noted Tone is Increased Decreased Atrophy present ____________________________ Thrombolytic ____________________________ TPN Gait and station wnl Labs \____/ / \ ____ / ____ / ____ / \ \ \ www.e-medtools.com Extrem Skin No rashes, ecchymoses, nodules, ulcers Exam wnl Clubbing Cyanosis Ataxia Wide based gait Shuffle Patient leaning Petechiae Synovitis Rt Rt Lt Front Back Lt ________________________ Splinter hemorrhages Person Depressed Time Place Periungual telangiectasias Neuro Oriented 58(Pts with Community Acquired Bacterial Pneumonia) NOT oriented to Anxious Affect is within normal limits OR Patient appears Glasgow Coma Score E _____ V _____ M _____ Agitated APACHE II Score __________ ©MB and RR 2006-2008 Revised 31Oct08 e-medtools.com Indicates Physician Quality Reporting Initiative (PQRI) Physician Quality Measures Completion of this form meets or exceeds the documentation requirements in the 1997 Guidelines for Evaluation & Management Services Pulmonary Evaluation Data Reviewed ER Notes Old medical records Labs Radiology data ECHO ECG Stress Test Pulmonary Function Test Nursing Notes/Vitals log Patient _________________________________________ DOB _____ / _____ / _____ MRN _____________________ Impression Code Status Patient is a FULL CODE DO NOT ATTEMPT RESUSCITATION Patient has completed advanced health care directives 47 HCPOA is _______________________________________ www.e-medtools.com www.e-medtools.com Care Coordinated with Patient HCPOA / Surrogate PCP Consultant Case Management or Social Worker Pharmacy Nursing Physical Therapist Occupational Therapist Speech Therapist www.e-medtools.com Recommended Actions Aggressive pulmonary toilet DVT prophylaxis Stress ulcer prophylaxis Daily sedation vacation and neurologic assessment Head of bed elevated > 30 Degrees at all times Intense glycemic control Insulin infusion Central line change or removal (send tip for culture) Physical therapy Enteral/Parenteral feeds Smoking cessation aids Pneumonia vaccine prior to discharge Influenza vaccine prior to discharge www.e-medtools.com Recommended Diagnostics PPD Testing 12-lead EKG Echocardiogram Sputum culture Bacterial Blood culture Urine culture CSF culture CBC with differential PT, PTT, INR BMP (with calcium) HIV Hepatitis panel Fungal AFB www.e-medtools.com www.e-medtools.com Signature ________________________________________ cc __________________________________ ©MB and RR 2006-2008 Revised 31Oct08 e-medtools.com Indicates Physician Quality Reporting Initiative (PQRI) Physician Quality Measures Completion of this form meets or exceeds the documentation requirements in the 1997 Guidelines for Evaluation & Management Services Pulmonary and Critical Care New Patient Evaluation Template Definitions Sepsis Positive blood culture AND Heart rate >⁄= 90 Temp <⁄= 36 C or >⁄= 38 C Resp rate >⁄= 20 OR PCO2 <⁄= 32 on ABG WBC <⁄=4000 OR >⁄= 12000 OR >⁄= 10% Bands Without a positive blood culture, the above findings are consistent with Systemic Inflammatory Response Syndrome (SIRS) www.e-medtools.comStart time Date Stop time Physiologic Score Temp ______ HR MAP RR Oxygenation >181 <40>49 <6>105.7 93.2-96.7 Heart Rate 70-109 n/a 110-139 140-179 >161 55-69 40-54 <>70 130-139 61-70 150-154 155-159 120-129 2.5-2.9 200-349 130-159 35-49 Serum Na Serum K Severe Sepsis The patient must meet the above criteria AND have hypotension, hypoperfusion or organ dysfunction. Hypotension is defined as SBP <>/= 40 mmHg Oxygenation If FiO2 > 49%, A-a If FiO2 <>500 <54>179 <>7.1 <>3.4 >7.69 <7.15>39 <1.0>59 <20 score =" 15" score =" Acute" 45 ="0" 54 =" 2" 64 =" 3" 74 =" 5">74 =6 Age Score ______ Predicted Mortality Based on APACHE II Score Score 5-9 10-14 15-19 20-24 25-29 30-34 over 34 Interpretation ~4% death rate ~8% death rate ~15% death rate ~25% death rate ~40% death rate ~55% death rate ~75% death rate ~85% death rate Ventilator Strategies (www.ihi.org) www.e-medtools.com 4 5 15-29 <15>/= 30 degrees Stages of chronic kidney disease 2. Daily sedation vacation AND Stage GFR (mL/min/1.73m2 ) Action assessment of ability to wean from 1 >89 Diagnosis and treatment. Treat comorbid conditions. Slow progression. ventilator 2 60-89 Estimate progression 3. Stress ulcer prophylaxis 3 38-59 Evaluate and treat complications 4. Deep Venous Thrombosis prophylaxis Oxygen Coverage PO2<⁄=55 OR Sats <⁄=90% PO2 56-59 OR Sats 89% WITH CHF Cor pulmonale P wave >2mm lead II, III or AVF Hct >56% Sats <⁄=88% for >5 minutes during sleep NOT COVERED PO2 >59 OR Sats >89% The National Kidney Foundation recommends estimating GFR by use of the Cockcroft-Gault or MDRD equations General Acid-Base Rules Acidosis Acute Resp ∆pH = -0.008 x ∆PCO2 ∆HCO3 = 0.1 x ∆PCO2 (+/-3) www.e-medtools.com Chronic Resp PCO2 = 2.4(HCO3) – 22 ∆HCO3 = 0.35 x ∆PCO2 (+/-4) Metabolic PCO2 = 1.5(HCO3) + 8 +/-2 PCO2 ~ last 2 digits pH ∆PCO2 = 1.2 x ∆HCO3 Alkalosis ∆pH = 0.008 x ∆PCO2 ∆HCO3 = -0.2 x ∆PCO2 (usually not to less than 18 mEq/L) ∆HCO3 = -0.4 x ∆PCO2 (usually not to less than 18 mEq/L) PCO2 = 0.9(HCO3) + 9 +/-2 ∆PCO2 = 0.6 x ∆HCO3 ©MB and RR 2006, 2007 Revised 13Nov07 www.e-medtools.com Indicates 2007 Physician Quality Reporting Initiative (PQRI) Physician Quality Measures