<h1><span id='assessment-of-the-critically-ill-patient' class='anchor-heading'><a href='#assessment-of-the-critically-ill-patient'>Assessment of the Critically Ill Patient</a></span></h1>

<ul>
<li>Pts. usually show signs of deteriorating organ function days before organ failure actually develops</li>
<li>If these signs are picked up and acted upon, the need for organ support may be prevented ==&gt; reduced morbidity</li>
<li>The greater your physiological reserve, the later these signs develop, thus have a low threshold of suspicion in the young</li>
<li>Signs can form part of an early warning score to both alert and trigger action by the admitting / ITU outreach team</li>
</ul>
<h1><span id='signs-include' class='anchor-heading'><a href='#signs-include'>Signs include :</a></span></h1>

<ul>
<li>HR &gt; 90, &lt;50 bpm</li>
<li>SBP &lt; 90 mmHg</li>
<li>RR &lt; 8, &gt; 20 per min.</li>
<li>Temp &lt; 36, &gt; 38 deg C</li>
<li>GCS &lt; 15 or AVPU </li>
<li>(Awake, responds to Voice, Pain, Unresponsive)</li>
<li>UO &lt; 0.5ml/kg/hr</li>
<li>O2 sats in air &lt; 94%</li>
<li>Get increased score for each sign depending on degree of perturbation from normal</li>
</ul>
<h1><span id='respiratory-status' class='anchor-heading'><a href='#respiratory-status'>Respiratory Status</a></span></h1>

<ul>
<li>Assess for evidence of airway compromise 

<ul>
<li>Stridor, tracheal tug</li>
<li>Resting respiratory rate &gt; 25 is the most sensitive indicator of physiological compromise</li>
</ul></li>
</ul>
<h1><span id='neurological' class='anchor-heading'><a href='#neurological'>Neurological</a></span></h1>

<ul>
<li>Confusion also early sign of significant physiological compromise</li>
</ul>
<h1><span id='scoring' class='anchor-heading'><a href='#scoring'>Scoring</a></span></h1>

<ul>
<li>CURB-65 score useful for pts with pneumonia / Sepsis :

<ul>
<li>Confusion</li>
<li>elevated Urea</li>
<li>Respiratory rate</li>
<li>low Blood pressure</li>
<li>age &gt; 65 yrs</li>
</ul></li>
</ul>


# Assessment of the Critically Ill Patient

* Pts. usually show signs of deteriorating organ function days before organ failure actually develops
* If these signs are picked up and acted upon, the need for organ support may be prevented ==> reduced morbidity
* The greater your physiological reserve, the later these signs develop, thus have a low threshold of suspicion in the young
* Signs can form part of an early warning score to both alert and trigger action by the admitting / ITU outreach team

# Signs include :

* HR > 90, <50 bpm
* SBP < 90 mmHg
* RR < 8, > 20 per min.
* Temp < 36, > 38 deg C
* GCS < 15 or AVPU 
* (Awake, responds to Voice, Pain, Unresponsive)
* UO < 0.5ml/kg/hr
* O2 sats in air < 94%
* Get increased score for each sign depending on degree of perturbation from normal

# Respiratory Status

* Assess for evidence of airway compromise 
 - Stridor, tracheal tug
 * Resting respiratory rate > 25 is the most sensitive indicator of physiological compromise

# Neurological

* Confusion also early sign of significant physiological compromise

# Scoring

* CURB-65 score useful for pts with pneumonia / Sepsis :
 * Confusion
 * elevated Urea
 * Respiratory rate
 * low Blood pressure
 * age > 65 yrs