MDCalc » Pulmonology http://www.mdcalc.com click, diagnose, treat. Sun, 21 Mar 2010 00:42:53 +0000 http://wordpress.org/?v=2.9.2 en hourly 1 PERC Rule for Pulmonary Embolism http://www.mdcalc.com/perc-rule-for-pulmonary-embolism http://www.mdcalc.com/perc-rule-for-pulmonary-embolism#comments Wed, 11 Feb 2009 14:42:47 +0000 admin http://gpro.local:8888/mdcalc/wordpress/?p=347 94%? Yes No Prior History of DVT/PE? Yes No Recent Trauma or Surgery? Yes No Hemoptysis? Yes No Exogenous Estrogen? Yes No Clinical Signs Suggesting DVT? Yes Score points Kline JA, et al. Clinical criteria to prevent [...]]]>
Age < 50? Yes
HR < 100? Yes
O2 Sat on Room Air >94%? Yes
No Prior History of DVT/PE? Yes
No Recent Trauma or Surgery? Yes
No Hemoptysis? Yes
No Exogenous Estrogen? Yes
No Clinical Signs Suggesting DVT? Yes
Score points
]]> http://www.mdcalc.com/perc-rule-for-pulmonary-embolism/feed 0 CURB-65 Severity Score for Community-Acquired Pneumonia http://www.mdcalc.com/curb-65-severity-score-community-acquired-pneumonia http://www.mdcalc.com/curb-65-severity-score-community-acquired-pneumonia#comments Tue, 10 Feb 2009 13:16:18 +0000 admin http://gpro.local:8888/mdcalc/wordpress/?p=324
Confusion? Yes +1
BUN > 19 mg/dL (7 mmol/L)? Yes +1
Respiratory Rate ≥ 30? Yes +1
Systolic BP < 90 mmHg
or
Diastolic BP ≤ 60 mmHg? 		Yes +1
Age ≥ 65? Yes +1
Score
]]> http://www.mdcalc.com/curb-65-severity-score-community-acquired-pneumonia/feed 0 Well’s Criteria for Pulmonary Embolism / PE http://www.mdcalc.com/wells-criteria-for-pulmonary-embolism-pe http://www.mdcalc.com/wells-criteria-for-pulmonary-embolism-pe#comments Fri, 02 Jan 2009 04:35:11 +0000 admin http://localhost:8888/mdcalc/wordpress/?p=115 100? Yes +1.5 Immobilization at least 3 days, or Surgery in the Previous 4 weeks Yes +1.5 Previous, objectively diagnosed PE or DVT? Yes +1.5 Hemoptysis? Yes +1 Malignancy w/ Treatment within 6 mo, or palliative? Yes +1 Score [...]]]>
Clinical Signs and Symptoms of DVT? Yes +3
PE Is #1 Diagnosis, or Equally Likely Yes +3
Heart Rate > 100? Yes +1.5
Immobilization at least 3 days, or Surgery in the Previous 4 weeks Yes +1.5
Previous, objectively diagnosed PE or DVT? Yes +1.5
Hemoptysis? Yes +1
Malignancy w/ Treatment within 6 mo, or palliative? Yes +1
Score
]]> http://www.mdcalc.com/wells-criteria-for-pulmonary-embolism-pe/feed 2 Oxygenation Index http://www.mdcalc.com/oxygenation-index http://www.mdcalc.com/oxygenation-index#comments Fri, 02 Jan 2009 04:21:39 +0000 admin http://localhost:8888/mdcalc/wordpress/?p=80
FiO2 %
Mean Airway Pressure cm H20
ParterialO2 mmHg
Oxygenation Index

Oxygenation Index = (FiO2 * Mean Airway Pressure) / PaO2

]]> http://www.mdcalc.com/oxygenation-index/feed 0 PSI/PORT Score: Pneumonia Severity Index for Adult CAP http://www.mdcalc.com/psi-port-score-pneumonia-severity-index-adult-cap http://www.mdcalc.com/psi-port-score-pneumonia-severity-index-adult-cap#comments Fri, 02 Jan 2009 03:40:39 +0000 admin http://localhost:8888/mdcalc/wordpress/?p=33 29? Yes +20 Systolic blood pressure < 90? Yes +20 Temperature < 35C (95F) or > 39.9C (103.8F)? Yes [...]]]>

If unsure, leave it blank.

Age years old 1 point per year
Female? Yes -10
Nursing home resident? Yes +10
Neoplastic disease history? Yes +30
Liver disease? Yes +20
CHF? Yes +10
Cerebrovascular disease? Yes +10
Renal disease? Yes +10
Altered mental status? Yes +20
Respiratory rate > 29? Yes +20
Systolic blood pressure < 90? Yes +20
Temperature < 35C (95F) or > 39.9C (103.8F)? Yes +15
Pulse > 124? Yes +10
pH < 7.35? Yes +30
BUN > 29? Yes +20
Sodium < 130? Yes +20
Glucose > 249 (US) or > 13.8 (SI) ? Yes +10
Hematocrit < 30%? Yes +10
Partial pressure of Oxygen < 60? Yes +10
Pleural effusion on x-ray? Yes +10
Score points
]]> http://www.mdcalc.com/psi-port-score-pneumonia-severity-index-adult-cap/feed 0 A-a O2 Gradient http://www.mdcalc.com/a-a-o2-gradient http://www.mdcalc.com/a-a-o2-gradient#comments Fri, 02 Jan 2009 03:20:34 +0000 admin http://localhost:8888/mdcalc/?p=4
Atmospheric Pressure (760 mm Hg or 101.33 kPa @ sea level) mm Hg
PaO2 (arterial O2) mm Hg
PaCO2 (arterial CO2) mm Hg
FIO2 (fraction inspired O2 - room air is 21%) %
Age (for calculating normal A-a Gradient) years
A-a O2 Gradient (Alveolar - Arterial) mm Hg
Expected A-a Gradient Based on Age mm Hg
A-a O2 Gradient = [ (FiO2) * (Atmospheric Pressure - H2O Pressure) - (PaCO2/0.8) ] - PaO2 from ABG

Normal Gradient Estimate = (Age/4) + 4
The 5 Causes of Hypoxemia, #1-3 have an elevated A-a Gradient:
  1. V/Q Mismatch (ex: PNA, CHF, ARDS, atelectasis, etc)
  2. Shunt (ex: PFO, ASD, PE, pulmonary AVMs)
  3. Alveolar Hypoventilation (ex: interstitial lung dz, environmental lung dz, PCP PNA)
  4. Hypoventilation (ex: COPD, CNS d/o, neuromuscular dz, etc)
  5. Low FiO2 (ex: high altitude)
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