ICU & Critical Care Scoring — pharmaadvance.in

🏥

ICU & Critical Care Scoring System

pharmaadvance.in · Sepsis, Organ Failure & Critical Care Tools

🦠

Sepsis & Infection

4 tools

🚨

Sepsis-3 / qSOFAQuick SOFA — rapid bedside sepsis screen

⭐ Sepsis-30–3

▾

Suspected infection + ≥2 of the following = high risk of sepsis-related poor outcome:

Respiratory rate ≥ 22 breaths/min+1 Altered mental status (GCS <15, new confusion)+1 Systolic BP ≤ 100 mmHg+1

Septic Shock criteria (Sepsis-3)

Vasopressor required to maintain MAP ≥65 mmHgShock Serum lactate >2 mmol/L despite adequate resuscitationShock

—qSOFA

📋 ICU Note

🏥

SOFA Score (Full)Sequential Organ Failure Assessment — ICU mortality

⭐ Gold Standard0–24

▾

Score each organ system 0–4. Use worst values in the last 24 hours.

🫁 Respiration

PaO₂/FiO₂ ratio (mmHg)

🩸 Coagulation

Platelets (×10³/µL)

🫀 Liver

Bilirubin (mg/dL)

❤️ Cardiovascular

Vasopressor requirement / MAP

🧠 CNS (GCS)

Glasgow Coma Scale

🫘 Renal

Creatinine (mg/dL) or Urine Output

—/ 24

📋 ICU Note

🌡️

SIRS CriteriaSystemic Inflammatory Response Syndrome

0–4

▾

Temperature >38°C or <36°C+1 Heart rate >90 bpm+1 Respiratory rate >20/min or PaCO₂ <32 mmHg+1 WBC >12,000/µL or <4,000/µL or >10% bands+1

—/ 4 criteria

📋 ICU Note

📊

Pitt Bacteraemia ScoreMortality prediction in bacteraemia

0–14Bacteraemia

▾

Temperature

Blood pressure

Mechanical ventilation

Cardiac arrest within 24h

Mental status

—/ 14

📋 ICU Note

🫀

Organ Failure & Severity

3 tools

📐

APACHE IIAcute Physiology & Chronic Health Evaluation

⭐ Standard0–71

▾

Acute Physiology Score (APS) — use worst values in first 24h

Temperature (°C)

Mean Arterial Pressure (mmHg)

Heart Rate (bpm)

Respiratory Rate (/min)

Oxygenation (FiO₂ ≥0.5: use A-aDO₂; <0.5: use PaO₂)

Arterial pH

Serum Sodium (mEq/L)

Serum Potassium (mEq/L)

Serum Creatinine (mg/dL) — double if AKI

Haematocrit (%)

WBC (×10³/µL)

GCS (15 minus actual GCS)

Age Points

Age

Chronic Health Points

Chronic health history

—/ 71

📋 ICU Note

📋

NEWS2 ScoreNational Early Warning Score — deterioration alert

⭐ UK NHS Standard0–20

▾

Respiratory rate (/min)

SpO₂ scale 1 (%)

SpO₂ scale 2 — COPD/hypercapnic (%)

Supplemental oxygen

Systolic BP (mmHg)

Heart rate (bpm)

Temperature (°C)

Level of consciousness (ACVPU)

—/ 20

📋 ICU Note

💀

SAPS II ScoreSimplified Acute Physiology Score

0–163ICU mortality

▾

Age (years)

Heart rate (bpm)

Systolic BP (mmHg)

Temperature ≥39°C

PaO₂/FiO₂ (if ventilated)

Urine output (L/day)

Serum Urea (mmol/L)

WBC (×10³/µL)

Serum Potassium (mEq/L)

Serum Sodium (mEq/L)

Serum Bicarbonate (mEq/L)

Bilirubin (µmol/L)

GCS

Chronic disease

Admission type

—/ 163

📋 ICU Note

🧠

Neurology & Sedation

4 tools

🧠

Glasgow Coma Scale (GCS)Level of consciousness — full component scoring

⭐ Universal3–15

▾

E — Eye opening

V — Verbal response

M — Motor response

—/ 15

📋 ICU Note

💤

RASS — Richmond Agitation-Sedation ScaleICU sedation targeting

⭐ ICU Standard−5 to +4

▾

+4Combative — overtly combative, violent, immediate danger to staff

+3Very agitated — pulls or removes tubes/catheters; aggressive

+2Agitated — frequent non-purposeful movement, fights ventilator

+1Restless — anxious but movements not aggressive or vigorous

0Alert & Calm — target for most ICU patients

−1Drowsy — not fully alert, but sustained awakening to voice (>10 sec)

−2Light sedation — briefly awakens with eye contact to voice (<10 sec)

−3Moderate sedation — movement or eye opening to voice (no eye contact)

−4Deep sedation — no response to voice, movement to physical stimulation

−5Unarousable — no response to voice or physical stimulation

—RASS

📋 ICU Note

😵

CAM-ICU (Simplified)Confusion Assessment Method — ICU delirium

DeliriumYes/No

▾

CAM-ICU positive (delirium present) if Features 1 AND 2 AND (3 OR 4):

Feature 1 — Acute onset or fluctuating course of mental status changeRequired Feature 2 — Inattention (RASS not 0, or attention errors on S-A-V-E-A-H-A-A-R-T test)Required Feature 3 — Disorganised thinking (unable to answer or follow simple commands)OR Feature 4 — Altered level of consciousness (RASS other than 0 = alert & calm)OR

—

📋 ICU Note

😣

CPOT — Critical-Care Pain Observation ToolPain assessment in non-verbal ICU patients

0–8Non-verbal pain

▾

Facial expression

Body movements

Muscle tension (passive flexion/extension of arm)

Compliance with ventilator (intubated) OR Vocalisation (extubated)

—/ 8

📋 ICU Note

🫁

Respiratory Failure

3 tools

💨

P/F Ratio & ARDS Classification (Berlin)Oxygenation index — ARDS severity

⭐ Berlin DefinitionARDS

▾

PaO₂ (mmHg) — from ABG

FiO₂ (0.21–1.0) — fraction of inspired O₂

Room air = 0.21; 100% O₂ = 1.0

PEEP ≥5 cmH₂O (for ARDS diagnosis)

Bilateral opacities on CXR/CT

—P/F Ratio

📋 ICU Note

🧮

A-a GradientAlveolar-arterial oxygen difference

mmHgHypoxia cause

▾

PaO₂ (mmHg)

PaCO₂ (mmHg)

FiO₂ (fraction, 0.21–1.0)

Atmospheric pressure (mmHg)

760 mmHg at sea level

PAO₂ = FiO₂ × (Patm − 47) − PaCO₂/0.8 · A-a = PAO₂ − PaO₂

—mmHg

📋 ICU Note

⚙️

Ventilator Tidal Volume CalculatorLung-protective ventilation — IBW-based

6 mL/kg IBWARDSNet

▾

Height (cm)

Sex

IBW: Male = 50 + 0.91×(ht−152.4) kg · Female = 45.5 + 0.91×(ht−152.4) kg

—mL

📋 ICU Note

💉

Shock & Haemodynamics

2 tools

🩸

Shock IndexHR ÷ SBP — rapid haemodynamic instability screen

Ratio

▾

Heart Rate (bpm)

Systolic BP (mmHg)

—SI

📋 ICU Note

💊

Vasopressor Dose CalculatorNoradrenaline / Adrenaline / Dopamine — µg/kg/min

µg/kg/min

▾

Drug

Patient weight (kg)

Concentration (mg/mL)

e.g. 8mg in 80mL = 0.1 mg/mL

Infusion rate (mL/hour)

—µg/kg/min

📋 ICU Note

🩹

Trauma & Burns

2 tools

🚑

Revised Trauma Score (RTS)Field triage — physiological trauma score

0–12Triage

▾

GCS

Systolic BP (mmHg)

Respiratory Rate (/min)

—/ 12

📋 ICU Note

🔥

Parkland Formula — BurnsFluid resuscitation in burns — first 24 hours

BurnsmL Hartmann's

▾

Patient weight (kg)

Total Burn Surface Area — TBSA (%)

Use Rule of Nines: head 9%, each arm 9%, each leg 18%, anterior trunk 18%, posterior trunk 18%

Parkland: 4 mL × weight × TBSA% Hartmann's in 24h · Half in first 8h, half in next 16h

—mL total

📋 ICU Note

📊

ICU Calculations

2 tools

🧪

Anion Gap & Delta-DeltaMetabolic acidosis workup

mEq/LABG

▾

Sodium (mEq/L)

Chloride (mEq/L)

Bicarbonate (mEq/L)

Albumin (g/dL) — for corrected AG

Normal = 4.0 g/dL

—mEq/L

📋 ICU Note

💧

Corrected Sodium for HyperglycaemiaTrue sodium in diabetic emergencies (DKA/HHS)

DKA/HHS

▾

Measured Sodium (mEq/L)

Glucose (mg/dL)

Corrected Na = Measured Na + 1.6 × [(Glucose − 100) ÷ 100]

—mEq/L

📋 ICU Note