The Braswell Project is a set of quick guides for Observation vs. Regular
Observation. Additionally contains cheat sheets on Diagnosis.
Observation Admission Guide
| ABDOMINAL PAIN W/O SPECIFIC DX |
ACUTE RENAL FAILURE/AKI IF
- EGFR DECREASED > 25% FROM BASELINE OR
- CREATININE 1.5-1.9X BASELINE
|
| ACUTE ETOH INTOXICATION/ACUTE ETOH WITHDRAWAL NO SYMPTOMS |
| INFECTION NOT TREATING WITH ANTIBIOTICS (INCLUDING FLU) |
| POST PROCEDURE W/O COMPLICATIONS |
| RESPIRATORY: O2 SATS 90% OR MORE |
ALWAYS ORDER Q4 HR NEURO CHECKS FOR:
| ACUTE ETOH INTOXICATION/ACUTE ETOH WITHDRAWAL NO SYMPTOMS |
| ALTERED MENTAL STATUS |
| ANY NEURO DX-POSSIBLE TIA/CVA, SEIZURE, ETC. |
Full Admission Guide
| ACUTE ETOH WITHDRAWAL (DOCUMENTED SYMPTOMS) CIWA 15-24 STEPDOWN, CIWA 25+ OR ACTIVE DT’S TO ICU |
ACUTE PANCREATITIS (MUST MEET 2 OF 3 CRITERIA FOR DX)
- HISTORY/PRESENTATION C/W DX
- EITHER AMYLASE OR LIPASE 3X UPPER LIMIT OF NORMAL
- RADIOGRAPHIC EVIDENCE ON CT ABD
|
|---|
ACUTE RENAL FAILURE/AKI (MUST MEET 1 OF 2 CRITERIA FOR DX)
- EGFR DECREASED BY 50% BASELINE
- CREATININE ≥2X BASELINE
|
|---|
| BRADYCARDIA (SYMPTOMATIC)-ADMIT TO STEPDOWN OR CRITICAL CARE |
| CHF EXACERBATION- ALWAYS FULL ADMIT, UNLESS SPECIFICALLY TOLD BY UM TO ADMIT OBS |
| GENERAL INFECTION IF TREATING WITH ANTIBIOTICS |
| NSTEMI/STEMI- ADMIT TO STEPDOWN OR CCU |
| OSTEOMYELITIS |
| PNEUMONIA TREATING WITH ANTIBIOTICS |
| PULMONARY EMBOLISM (CONFIRMED NOT SUSPECTED) |
RESPIRATORY WITH ANY OF THE FOLLOWING-SEE OBSERVATION GUIDE FOR GUIDELINES FLOOR, STEPDOWN OR ICU
- O2 SATS 89% OR LESS and LESS THAN BASELINE
- PaO2 30 SECONDS ADMIT TO CCU
- PaO2 <56 mmHg
- PCO2 45-54
- INCREASED WOB WITH USE OF ACCESSORY MUSCLES
|
| SEPSIS |
| STEMI/NTEMI-ADMIT TO STEPDOWN OR CCU |
| SVT/NSVT-IF STABLE ADMIT TO STEPDOWN, SUSTAINED V-TACH >30 SECONDS ADMIT TO CCU |
Principle Diagnosis coming soon...