SYSTEM FOR ICU

PATIENTS APS = T: 3+
FORMULA:

MAP: 0
Acute Physiology and HR: 0
Chronic Health Evaluation RR: +1
Arterial pH: 0
(APACHE II) Serum Sodium: 0
APACHE SCORE Serum Creatinine: 0
Hct: +2
 APACHE II was designed to measure the WBC: 0
severity of disease for adult patients GCS: 4
admitted to intensive care units. It has not Serum HCO3: 0
been validated for use in children or young
people aged under 16. TOTAL APACHE SCORE = AP + CHP + APS

 This scoring system is used in many ways: AP: Age Points

1. Some procedures or some medicine
is only given to patients with a certain
APACHE II score.
CHP: Chronic Health Points
APS: Apache Score
TOTAL APACHE SCORE = 0 + 5 + 10 = 15

2. APACHE II score can be used to

describe the morbidity of a patient MEAN ARTERIAL PRESSURE (MAP):
when comparing the outcome with
 It is a measure of the average arterial
other patients.
perfusion pressure, which determines
3. Predicted mortalities are averaged blood flow to the tissues.
for groups of patients in order to
specify the group's morbidity. FORMULA:
 Maximum Score: 71, but it is rare for
patients in the ICU to get a score higher
than 55 either mamatay na sila. MAP= 1/3 PP+DBP or
 The score is not re-calculated during the
stay. MAP=2 (DBP) + SBP
3
 Admission Score, you can only take the
Apache 2 Score upon the admission of
patients to the ICU. For Example: 120/80
Solution:
 If the patient is discharge and re-admitted to 2 (80) + 120
= 93.33 mmHg
the ICU you take again another apache. 3

 Severity of Disease Classification System NORMAL:

70-105 mmHg
 TO CALCULATE THE APACHE II SCORE PRINCIPAL DIAGNOSTIC CATEGORIES
LEADING TO ICU ADMISSION
 Add and find the total of the 12 acute
physiology score, the age points and the NON-OPERATIVE PATIENTS
chronic health points.

 Maximum score is 71 but it is rare for ICU

patients to get higher than 55 points.

 The score is not recalculated during the

stay—it is by definition an admission score. If
a patient is discharged from the ICU and
readmitted, a new APACHE II score is
calculated.

To find the mortality rate based on the

APACHE II score

Mortality Rate of Patient

Using Apache

FORMULA 1

x = (-3.517) + (0.146 x total APS) +

0.603 + Admission Indication
Weight

or

x = (-3.517) + (0.146 x total APS) + 0.603 + Admission

Indication Weight
 POST-OPERATIVE PATIENTS
FOR POST-OPERATIVE PTS. ADMITTED TO
TGE ICU FOR SEPSIS OR POS-ARREST,
USE THE CORRESPONDING WEIGHTS FOR
NON-OPERATIVE PTS
FORMULA 2
y = eˣ
FORMULA 3
Percent y
= x 100
Mortality y+1
The Revised Trauma Score (RTS)
 Is a physiologic scoring system, designed for
use in based on the initial vital signs of a
patient.
 A lower score indicates a higher severity of
injury.
 The Revised Trauma Score is made up of a
three categories:
1. Glasgow Coma Scale
2. Systolic Blood Pressure
3. Respiratory Rate
 The score range is 0-12.
 In triage, a patient with an RTS score of:
 12 is labeled delayed,
 11 is urgent, and
 10-3 is immediate
 Those who have an RTS below 3 are
declared dead and should not receive
certain care because they are highly
unlikely to survive without a significant
amount of resources.
 Values for the RTS are in the range 0 to
7.8408.
 The RTS is heavily weighted towards the
Glasgow Coma Scale to compensate for
major head injury without multisystem injury
or major physiological changes.
 A threshold of RTS < 4 has been proposed to
identify those patients who should be treated
in a trauma centre, although this value may
be somewhat low.
 REVISED TRAUMA SCORE: Level of Consciousness (LOC)  Is a
measurement of a person's arousability and
FORMULA responsiveness to stimuli from the environment.

RTS = 0.9368 + 0.7326 x SBP + Levels:

0.2908 x RR 1. Conscious
 13,14,15
 Oriented to time, place, name and
or date.

RTS = 0.9368 + 0.7326 x SBP + 0.2908 x RR 2. Somnolent

 10,11,12
 Shows excessive drowsiness and
responds to stimuli only with
incoherent mumbles or disorganized
movements.

3. Obtunded
 7,8,9
 Has decreased interest in their
surroundings, slowed responses, and
sleepiness.

4. Stuporous
 5,6
RULES  People with an even lower level of
consciousness, stupor, only respond
1. BE MINDFUL OF GCS: by grimacing or drawing away from
Severe GCS ≤ 8 painful stimuli.
Moderate GCS 9 – 12
Minor GCS ≥ 13 and above 5. Comatose

Light Comatose
 4

Deep Comatose
 3
 Do not even make this response to
stimuli, have no corneal or gag reflex,
and they may have no pupillary
response to light.

2. IF THE PATIENT HAS ACUTE RENAL

FAILURE, DOUBLE THE SERUM
CREATININE
3. APS AND RTS HAS ITS OWN
EQUIVALENT SCORES