PERFORMANCE IMPROVEMENT PROJECTS

							Absolute Neutrophil Count = (10 x WBC) x (PMNs + Bands)
             Neutropenia: ANC < 1500 cells / mm3
             Mild Neutropenia: 1000-1500 cells / mm3
             Moderate Neutropenia: 500-999 cells / mm3
             Severe Neutropenia: < 500 cells / mm3

Cardiac Index: Cardiac Output (CO) / Basal Surface Area (BSA)

ET Size: Age (yrs)/4+4

ET Depth: Age(yrs)/2+2

Follow-up Schedule for Children
      1 week – 2 weeks – 1 month – 2 months – 4 months – 6 months – 12 months
      15 months – 18 months – 2 years – 2 ½ years – 3 years – annually thereafter

IT Ratio = Bands / (Neutrophils + Bands)

Maintenance Fluids
            General Rule:
                   0-10 kg 4 cc/hr      100 cc/24 hrs
                   10-20 kg 2 cc/hr     50 cc/24 hrs
                   >20 kg 1 cc/hr       20 cc/24 hrs
            Na 3-4 meq/day
                   0-10 kg       0.2 NaCl
                   10-20 kg      0.3 NaCl
                   >20 kg        0.45 NaCl
                   >15 yrs old 0.9 NaCl
            K 2-3 meq/day        generally give 20 meq KCl in 1000L

McIsaac Decision Rule (Strep Score)
      1 point each for clinical finding
              Tonsillar exudate
              Tender, anterior cervical adenopathy
              Cough absent
              Fever present
      Modifier
              Age younger than 15 years: +1 point
              Age 15 to 45 years: 0 points
              Age over 45 years: -1 points
      Interpretation
              Score 0: Streptococcus probability 1% (3% in ER)
              Score 1: Streptococcus probability 4% (8% in ER)
              Score 2: Streptococcus probability 9% (18% in ER)
              Score 3: Streptococcus probability 21% (38% in ER)
              Score 4: Streptococcus probability 43% (63% in ER)
      Approach
            Strep Score 4 (or Strep Score 2 if patient unreliable) - antibiotics
            Strep Score 2 to 3: Perform rapid antigen test
                   Antigen test positive: Treat with antibiotics
                   Antigen test negative: Throat Culture
            Strep Score 0 to 1 - Symptomatic Treatment

Mentzer Index = MCV/RBC
      <13 – thalassemia trait
      >13 – iron deficiency anemia

Na Correction
      Corrected Serum Na = Serum Na + ((Serum Glu-100) x 1.6)

Oxygenation Index
      PaO2/F1O2
             normal = 300-500
             <300 abnormal
             <200 severe hypoxemia

QTc
      Qtc = QT (in msec) / sqr (RR in sec)                 (normal <0.44)

Serum Osmolality
      = 2 x Na + Glu (mg/dl)/18 + BUN (mg/dl)/2.8          (normal 275-295)