Blair Pemberly · Notes · Demo Health Record (demonstration)

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Demo Health Record Riverbend Community Hospital (fictional) synthetic data · demonstration

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Hospital day 2 progress note

Unsigned draft

Type: Progress note
Date: 2026-11-12 16:00
Author: Dr. Tobias Wren
Status: Unsigned draft
Drafted by: Clinician-typed

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Hospital day 2 progress note. S: Cough improving, afebrile overnight. O: T 37.2, BP 112/66, SpO2 95% on 2 L. Right lower lobe crackles. A/P: 1. Community-acquired pneumonia: continue ceftriaxone and azithromycin, day 2. 2. Deconditioning: physical therapy evaluation.

The note does not mention this.

Visit diagnoses (as entered by the clinician)

None entered yet for this visit.

Exact Dx Before you sign

Clinician-typed This draft, as declared by the source system

2 to look at before you sign · 4 checked

Needs a look Creatinine change during this stay

Creatinine rose by 0.4 mg/dL within 24 hours during this stay (peak 1.6 mg/dL); the note doesn't mention a change in kidney function.

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Not assessable Kidney function over time

Could not check kidney function: there is no usable creatinine result outside an acute change.

Where in the note? Show the results

The note does not mention this.
Needs a look Potassium Draft · pending review

Potassium 5.8 mmol/L on 2026-11-12 15:00 meets the published definition's criteria for the category “'mild' band (5.5 to 5.9 mmol/L)” (ukka2026_hyperkalaemia@1.0). The note doesn't mention this.

Published bodies disagree on these thresholds; another definition may give a different answer.

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Published definition and source

Clinical Practice Guidelines: Treatment of Acute Hyperkalaemia in Adults
ukka2026_hyperkalaemia@1.0

It is further classified by severity into mild (5.5-5.9 mmol/l), moderate (6.0-6.4 mmol/l) or severe (≥ 6.5 mmol/l).

UK Kidney Association · edition updated July 2026 · Introduction, document page 9 (PDF page 10) · opened 2026-11-14 · source

Threshold for this category (ukka2026_hyperkalaemia@1.0): potassium ≥ 5.5 mmol/L and potassium < 6 mmol/L.

Draft definition: pending clinical and coding review.

Dismiss with a reason

Reason in your words (needed for "Other")

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1 more, grouped by what was measured. At most three are shown above at once.

Lactate Needs your clinical judgement

Needs your clinical judgement Lactate Draft · pending review

Lactate 2.6 mmol/L on 2026-11-11 15:10: the record shows these values; this needs your clinical judgement (sepsis3_septic_shock_lactate@1.0 uses them as one part of a wider clinical picture, category “lactate above 2 mmol/L”).

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Published definition and source

The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)
sepsis3_septic_shock_lactate@1.0

persisting hypotension requiring vasopressors to maintain MAP ≥65 mm Hg and having a serum lactate level >2 mmol/L (18mg/dL) despite adequate volume resuscitation

Society of Critical Care Medicine and European Society of Intensive Care Medicine task force (JAMA 2016;315:801-810) · edition 2016 · Box 3 'New Terms and Definitions' · opened 2026-11-14 · source

Threshold for this category (sepsis3_septic_shock_lactate@1.0): lactate > 2 mmol/L.

Draft definition: pending clinical and coding review.

Details

Thresholds

Creatinine change during this stay: Threshold: creatinine up by 0.3 mg/dL within 48 hours, or to 1.5 times an earlier value. Urine output is not checked.
Kidney function over time: Threshold: filtering rate below 60 on two results at least 90 days apart, none of 60 or more between them.

Rules and published sources

ckd_epi_2009@1.0 Levey et al., Ann Intern Med 2009;150:604-12 (2009 eGFR equation, drift check) · source
ckd_epi_2021@1.0 Inker et al., N Engl J Med 2021;385:1737-49 (2021 race-free eGFR equation) · source
kdigo_aki_2012@1.1 KDIGO 2012 guideline, Kidney Int Suppl 2012;2:1-138 (Rec 2.1.1-2.1.2, Table 2) · source
kdigo_ckd_2024@1.1 KDIGO 2024 guideline, Kidney Int 2024;105(4S):S117-S314 (G/A categories, >3 months) · source
kidney_compare@1.1 Two-sided comparison (this tool); ICD-10-CM guideline I.A.19; ACDIS/AHIMA compliant query practice, 2026 update · source
kidney_exclusions@1.0 KDIGO 2024 guideline, limitations of creatinine-based eGFR (muscle mass, pregnancy, kidney replacement); local list · source
lab_units@1.1 KDIGO 2012 and 2024 guidelines, unit conversion (creatinine 1 mg/dL = 88.4 umol/L; ACR 1 mg/mmol = 8.84 mg/g) · source
ukka2026_hyperkalaemia@1.0 draft, pending review · source
sepsis3_septic_shock_lactate@1.0 draft, pending review · source

Record

Check RUN-00015 · kidney-engine 2.0 · replay 8f35978ee484…. Data for this sidebar (JSON).

Library check LRUN-00015 · library_default_set@1.0 · library-engine 1.0 · replay 7ec5fd4e26dc….

Decision support only: you decide and you write the note. Exact Dx 1.0.0 · data as of Fri Nov 13, 2026 04:55 PM