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Exact Dx synthetic data · demonstration
Extended criteria (experimental). This is the broader ten-condition engine, kept as a secondary area. It shows ICD-10-CM codes and illustrative grouping effects for CDI staff. The primary surface is Before you sign (kidney, measurement only). All extended pages.

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ENC-00066: Elena Emberly

74F · MRN15849760 · Pulmonology · admitted Thu Oct 29, 2026 01:56 PM · discharged Fri Nov 06, 2026 02:20 PM · attending Dr. Cyrus Ellingham · resident Dr. Keira Upfield · 162 cm, 60.3 kg

Documented diagnoses (current)

  • Principal: “COPD exacerbation” · J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation
  • “hyperlipidemia” · E78.5 Hyperlipidemia, unspecified

Illustrative grouping now: MS-DRG 192 Chronic obstructive pulmonary disease without CC/MCC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 192.

Queries and events

No queries yet.

All rules applied

Every rule's outcome for this encounter (clean results included)
RuleCriteriaFindingOutcome
Acute kidney injury Criteria not met No gap Not documented and not supported.
Trace
Rule trace (rule aki v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: meets_definition creat_ratio >= t.ratio_s1 or creat_rise_48h >= t.rise_abs or coalesce(uo_hours_lt_0_5 >= t.uo_s1_h, false) creat_ratio=1.06, t.ratio_s1=1.5, creat_rise_48h=0.03, t.rise_abs=0.3, uo_hours_lt_0_5=unknown, t.uo_s1_h=6 false
derived: stage3 meets_definition and (creat_ratio >= t.ratio_s3 or creat_peak >= t.scr_s3 or rrt_started or coalesce(uo_hours_lt_0_3 >= t.uo_s3_h, false) or coalesce(anuria_hours >= t.anuria_h, false)) meets_definition=False, creat_ratio=1.06, t.ratio_s3=3.0, creat_peak=0.71, t.scr_s3=4.0, rrt_started=False, uo_hours_lt_0_3=unknown, t.uo_s3_h=24, anuria_hours=unknown, t.anuria_h=12 false
derived: stage2 creat_ratio >= t.ratio_s2 or coalesce(uo_hours_lt_0_5 >= t.uo_s2_h, false) creat_ratio=1.06, t.ratio_s2=2.0, uo_hours_lt_0_5=unknown, t.uo_s2_h=12 false
derived: stage case(stage3, 3, stage2, 2, meets_definition, 1, 0) stage3=False, stage2=False, meets_definition=False 0
derived: baseline_independent creat_baseline_known or creat_rise_48h >= t.rise_abs or rrt_started creat_baseline_known=True, creat_rise_48h=0.03, t.rise_abs=0.3, rrt_started=False true
outcome: aki_staged stage >= 1 and baseline_independent stage=0, baseline_independent=True false
outcome: aki_presumed_baseline stage >= 1 stage=0 false
outcome: not_met stage == 0 stage=0 true
Acute blood loss anaemia Criteria not met No gap Not documented and not supported.
Trace
Rule trace (rule blood_loss_anemia v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: anaemic case(sex == 'M', hgb_nadir < t.hb_m, sex == 'F', hgb_nadir < t.hb_f, null) sex=F, hgb_nadir=13.39, t.hb_m=13, t.hb_f=12 false
derived: acute_fall hgb_drop >= t.drop_major or prbc_units >= t.prbc_major hgb_drop=0.5, t.drop_major=2.0, prbc_units=0, t.prbc_major=2 false
outcome: met bleeding_documented and anaemic and acute_fall bleeding_documented=True, anaemic=False, acute_fall=False false
outcome: anaemia_only anaemic and hgb_drop < t.drop_min and prbc_units == 0 anaemic=False, hgb_drop=0.5, t.drop_min=1.0, prbc_units=0 false
outcome: not_anaemic present(hgb_nadir) and not anaemic hgb_nadir=13.39, anaemic=False true
Chronic kidney disease Clinical judgement required No gap Not documented; egfr 60 or above; ckd g1-g2 requires markers of kidney damage, which are not assessed here.
Trace
Rule trace (rule ckd v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: chronic egfr_n >= 2 and egfr_span_days >= t.chronic_days egfr_n=2, egfr_span_days=340, t.chronic_days=90 true
derived: staging_egfr max(egfr_early, egfr_late) egfr_early=91.3, egfr_late=91.7 91.7
derived: both_below_60 egfr_early < t.g2 and egfr_late < t.g2 egfr_early=91.3, t.g2=60, egfr_late=91.7 false
derived: category case(staging_egfr >= t.g2, 'G1-G2', staging_egfr >= t.g3a, 'G3a', staging_egfr >= t.g3b, 'G3b', staging_egfr >= t.g4, 'G4', 'G5') staging_egfr=91.7, t.g2=60, t.g3a=45, t.g3b=30, t.g4=15 G1-G2
outcome: duration_not_shown not chronic chronic=True false
outcome: straddles_60 not both_below_60 and min(egfr_early, egfr_late) < t.g2 both_below_60=False, egfr_early=91.3, egfr_late=91.7, t.g2=60 false
outcome: g1_g2 staging_egfr >= t.g2 staging_egfr=91.7, t.g2=60 true
Heart failure Insufficient data No gap Insufficient data: the criteria could not be applied.
Trace
Rule trace (rule heart_failure v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: np_elevated coalesce(bnp_max >= t.bnp, false) or coalesce(ntprobnp_max >= t.ntprobnp, false) bnp_max=unknown, t.bnp=100, ntprobnp_max=unknown, t.ntprobnp=300 false
derived: acute_count count(iv_loop_diuretic, np_elevated, new_o2) iv_loop_diuretic=False, np_elevated=False, new_o2=False 0
derived: hf_type case(lvef <= t.ref, 'systolic', lvef >= t.pres, 'diastolic', 'midrange') lvef=unknown, t.ref=40, t.pres=50 unknown
derived: improved coalesce(lvef_prior_min <= t.ref and lvef > t.ref and lvef - lvef_prior_min >= t.improved_rise, false) lvef_prior_min=unknown, t.ref=40, lvef=unknown, t.improved_rise=10 false
derived: acuity case(acute_count >= 2 and hf_history, 'acute on chronic', acute_count >= 2, 'acute', acute_count == 0 and hf_history, 'chronic', null) acute_count=0, hf_history=False unknown
outcome: improved_ef improved improved=False false
outcome: midrange hf_type == 'midrange' hf_type=unknown unknown
outcome: sys_aoc hf_type == 'systolic' and acuity == 'acute on chronic' hf_type=unknown, acuity=unknown unknown
outcome: sys_acute hf_type == 'systolic' and acuity == 'acute' hf_type=unknown, acuity=unknown unknown
outcome: sys_chronic hf_type == 'systolic' and acuity == 'chronic' hf_type=unknown, acuity=unknown unknown
outcome: dia_aoc hf_type == 'diastolic' and acuity == 'acute on chronic' hf_type=unknown, acuity=unknown unknown
outcome: dia_acute hf_type == 'diastolic' and acuity == 'acute' hf_type=unknown, acuity=unknown unknown
outcome: dia_chronic hf_type == 'diastolic' and acuity == 'chronic' hf_type=unknown, acuity=unknown unknown
outcome: one_indicator acute_count == 1 acute_count=0 false
Hyponatraemia Criteria not met No gap Not documented and not supported.
Trace
Rule trace (rule hyponatremia v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: severity case(na_min < t.profound, 'profound', na_min < t.moderate, 'moderate', na_min < t.low, 'mild', 'none') na_min=137.0, t.profound=125, t.moderate=130, t.low=135 none
outcome: met na_min < t.low and na_low_count >= t.repeat and na_treated na_min=137.0, t.low=135, na_low_count=0, t.repeat=2, na_treated=False false
outcome: untreated na_min < t.low na_min=137.0, t.low=135 false
outcome: not_met na_min >= t.low na_min=137.0, t.low=135 true
Malnutrition Insufficient data No gap Insufficient data: the criteria could not be applied.
Trace
Rule trace (rule malnutrition v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: a_sev_intake intake_pct <= t.a_sev_intake_pct and intake_days >= t.a_sev_intake_days intake_pct=unknown, t.a_sev_intake_pct=50, intake_days=unknown, t.a_sev_intake_days=5 unknown
derived: a_mod_intake intake_pct < t.a_mod_intake_pct and intake_days > t.a_mod_intake_days intake_pct=unknown, t.a_mod_intake_pct=75, intake_days=unknown, t.a_mod_intake_days=7 unknown
derived: a_sev_wt (wt_loss_days <= 7 and wt_loss_pct > 2) or (wt_loss_days <= 31 and wt_loss_pct > 5) or (wt_loss_days <= 92 and wt_loss_pct > 7.5) wt_loss_days=unknown, wt_loss_pct=unknown unknown
derived: a_mod_wt (wt_loss_days <= 7 and wt_loss_pct >= 1) or (wt_loss_days <= 31 and wt_loss_pct >= 5) or (wt_loss_days <= 92 and wt_loss_pct >= 7.5) wt_loss_days=unknown, wt_loss_pct=unknown unknown
derived: c_sev_intake intake_pct <= t.c_intake_pct and intake_days >= t.c_intake_days intake_pct=unknown, t.c_intake_pct=75, intake_days=unknown, t.c_intake_days=30 unknown
derived: c_mod_intake intake_pct < t.c_intake_pct and intake_days >= t.c_intake_days intake_pct=unknown, t.c_intake_pct=75, intake_days=unknown, t.c_intake_days=30 unknown
derived: c_sev_wt (wt_loss_days <= 31 and wt_loss_pct > 5) or (wt_loss_days <= 92 and wt_loss_pct > 7.5) or (wt_loss_days <= 183 and wt_loss_pct > 10) or (wt_loss_days <= 366 and wt_loss_pct > 20) wt_loss_days=unknown, wt_loss_pct=unknown unknown
derived: c_mod_wt (wt_loss_days <= 31 and wt_loss_pct >= 5) or (wt_loss_days <= 92 and wt_loss_pct >= 7.5) or (wt_loss_days <= 183 and wt_loss_pct >= 10) or (wt_loss_days <= 366 and wt_loss_pct >= 20) wt_loss_days=unknown, wt_loss_pct=unknown unknown
derived: n_assessed known(intake_pct, wt_loss_pct, fat_loss, muscle_loss, fluid, grip_reduced) intake_pct=unknown, wt_loss_pct=unknown, fat_loss=unknown, muscle_loss=unknown, fluid=unknown, grip_reduced=unknown 0
derived: n_severe case(nutr_context == 'acute', count(a_sev_intake, a_sev_wt, fat_loss >= 2, muscle_loss >= 2, fluid >= 2, grip_reduced), nutr_context == 'chronic', count(c_sev_intake, c_sev_wt, fat_loss >= 3, muscle_loss >= 3, fluid >= 3, grip_reduced), null) nutr_context=unknown, a_sev_intake=unknown, a_sev_wt=unknown, fat_loss=unknown, muscle_loss=unknown, fluid=unknown, grip_reduced=unknown, c_sev_intake=unknown, c_sev_wt=unknown unknown
derived: n_moderate case(nutr_context == 'acute', count(a_sev_intake or a_mod_intake, a_sev_wt or a_mod_wt, fat_loss >= 1, muscle_loss >= 1, fluid >= 1, grip_reduced), nutr_context == 'chronic', count(c_sev_intake or c_mod_intake, c_sev_wt or c_mod_wt, fat_loss >= 1, muscle_loss >= 1, fluid >= 1, grip_reduced), null) nutr_context=unknown, a_sev_intake=unknown, a_mod_intake=unknown, a_sev_wt=unknown, a_mod_wt=unknown, fat_loss=unknown, muscle_loss=unknown, fluid=unknown, grip_reduced=unknown, c_sev_intake=unknown, c_mod_intake=unknown, c_sev_wt=unknown, c_mod_wt=unknown unknown
outcome: severe n_severe >= 2 n_severe=unknown unknown
outcome: moderate n_moderate >= 2 n_moderate=unknown unknown
outcome: one_characteristic n_moderate == 1 n_moderate=unknown unknown
outcome: not_met n_moderate == 0 and n_assessed >= 2 n_moderate=unknown, n_assessed=0 false
Obesity Criteria not met No gap Not documented and not supported.
Trace
Rule trace (rule obesity v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
outcome: not_adult age < t.adult age=74, t.adult=20 false
outcome: class3 bmi >= t.c3 bmi=23.0, t.c3=40 false
outcome: class2 bmi >= t.c2 bmi=23.0, t.c2=35 false
outcome: class1 bmi >= t.c1 bmi=23.0, t.c1=30 false
outcome: not_met bmi < t.c1 bmi=23.0, t.c1=30 true
Pressure injury Insufficient data No gap Insufficient data: the criteria could not be applied.
Trace
Rule trace (rule pressure_injury v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: sacral wound_site == 'sacral' wound_site=unknown unknown
outcome: no_wound_note not present(wound_stage) wound_stage=unknown true
Acute respiratory failure Criteria not met No gap Not documented and not supported.
Trace
Rule trace (rule respiratory_failure v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: measured present(spo2_min_ra) or present(pao2_min_ra) or present(pf_min) spo2_min_ra=94.0, pao2_min_ra=unknown, pf_min=unknown true
derived: hypoxemia coalesce(spo2_min_ra < t.spo2_ra, false) or coalesce(pao2_min_ra < t.pao2, false) or coalesce(pf_min < t.pf, false) spo2_min_ra=94.0, t.spo2_ra=88, pao2_min_ra=unknown, t.pao2=60, pf_min=unknown, t.pf=300 false
derived: distress coalesce(rr_max >= t.rr_distress, false) or coalesce(wob_increased, false) or adv_resp_support rr_max=20.0, t.rr_distress=28, wob_increased=unknown, adv_resp_support=False false
outcome: chronic_baseline home_o2 and hypoxemia home_o2=False, hypoxemia=False false
outcome: met hypoxemia and distress hypoxemia=False, distress=False false
outcome: hypoxemia_only hypoxemia hypoxemia=False false
outcome: not_met measured and not hypoxemia and o2_max_lpm <= t.o2_low and not adv_resp_support measured=True, hypoxemia=False, o2_max_lpm=0.0, t.o2_low=2, adv_resp_support=False true
Sepsis Criteria not met No gap Not documented and not supported.
Trace
Rule trace (rule sepsis v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: sirs_temp coalesce(temp_max_48h > t.t_hi, false) or coalesce(temp_min_48h < t.t_lo, false) temp_max_48h=37.5, t.t_hi=38, temp_min_48h=36.9, t.t_lo=36 false
derived: sirs_hr coalesce(hr_max_48h > t.hr, false) hr_max_48h=88.0, t.hr=90 false
derived: sirs_rr coalesce(rr_max_48h > t.rr, false) or coalesce(paco2_min_48h < t.paco2, false) rr_max_48h=20.0, t.rr=20, paco2_min_48h=unknown, t.paco2=32 false
derived: sirs_wbc coalesce(wbc_max_48h > t.wbc_hi, false) or coalesce(wbc_min_48h < t.wbc_lo, false) or coalesce(bands_max_48h > t.bands, false) wbc_max_48h=10.77, t.wbc_hi=12, wbc_min_48h=6.8, t.wbc_lo=4, bands_max_48h=unknown, t.bands=10 false
derived: sirs_count count(sirs_temp, sirs_hr, sirs_rr, sirs_wbc) sirs_temp=False, sirs_hr=False, sirs_rr=False, sirs_wbc=False 0
derived: sofa_resp coalesce(case(pf_min_48h < 100 and adv_resp_support, 4, pf_min_48h < 200 and adv_resp_support, 3, pf_min_48h < 300, 2, pf_min_48h < 400, 1, 0), 0) pf_min_48h=unknown, adv_resp_support=False 0
derived: sofa_coag coalesce(case(platelets_min_48h < 20, 4, platelets_min_48h < 50, 3, platelets_min_48h < 100, 2, platelets_min_48h < 150, 1, 0), 0) platelets_min_48h=207.0 0
derived: sofa_liver coalesce(case(bili_max_48h >= 12, 4, bili_max_48h >= 6, 3, bili_max_48h >= 2, 2, bili_max_48h >= 1.2, 1, 0), 0) bili_max_48h=0.93 0
derived: sofa_cardio coalesce(case(norepi_max_48h > 0.1, 4, norepi_max_48h > 0, 3, map_min_48h < 70, 1, 0), 0) norepi_max_48h=0.0, map_min_48h=75.0 0
derived: sofa_cns coalesce(case(gcs_min_48h < 6, 4, gcs_min_48h < 10, 3, gcs_min_48h < 13, 2, gcs_min_48h < 15, 1, 0), 0) gcs_min_48h=15.0 0
derived: sofa_renal coalesce(case(creat_max_48h >= 5, 4, creat_max_48h >= 3.5, 3, creat_max_48h >= 2, 2, creat_max_48h >= 1.2, 1, 0), 0) creat_max_48h=0.7 0
derived: sofa_renal_baseline coalesce(case(creat_baseline >= 5, 4, creat_baseline >= 3.5, 3, creat_baseline >= 2, 2, creat_baseline >= 1.2, 1, 0), 0) creat_baseline=0.67 0
derived: sofa_delta sofa_resp + sofa_coag + sofa_liver + sofa_cardio + sofa_cns + sofa_renal - sofa_renal_baseline sofa_resp=0, sofa_coag=0, sofa_liver=0, sofa_cardio=0, sofa_cns=0, sofa_renal=0, sofa_renal_baseline=0 0
derived: sepsis3 infection_documented and sofa_delta >= t.sofa_delta infection_documented=False, sofa_delta=0, t.sofa_delta=2 false
derived: sepsis2 infection_documented and sirs_count >= t.sirs_min infection_documented=False, sirs_count=0, t.sirs_min=2 false
derived: shock sepsis3 and norepi_max_48h > 0 and coalesce(lactate_max_48h > t.lactate, false) sepsis3=False, norepi_max_48h=0.0, lactate_max_48h=unknown, t.lactate=2 false
outcome: no_infection not infection_documented infection_documented=False true

Structured data

Labs (48)
Labs (pre-admission rows are outpatient values)
RowWhenTestValue
LAB-002212Tue Oct 07, 2025 09:15 AMcreatinine0.68 mg/dL
LAB-002213Sat Sep 12, 2026 10:05 AMcreatinine0.67 mg/dL
LAB-002214Thu Oct 29, 2026 02:56 PMcreatinine0.7 mg/dL
LAB-002223Thu Oct 29, 2026 02:56 PMsodium142.0 mmol/L
LAB-002232Thu Oct 29, 2026 02:56 PMhemoglobin13.88 g/dL
LAB-002241Thu Oct 29, 2026 02:56 PMwbc7.12 x10^3/uL
LAB-002242Thu Oct 29, 2026 02:56 PMplatelets308.0 x10^3/uL
LAB-002259Thu Oct 29, 2026 02:56 PMbilirubin0.93 mg/dL
LAB-002215Fri Oct 30, 2026 05:00 AMcreatinine0.66 mg/dL
LAB-002224Fri Oct 30, 2026 05:00 AMsodium141.0 mmol/L
LAB-002233Fri Oct 30, 2026 05:00 AMhemoglobin13.73 g/dL
LAB-002243Fri Oct 30, 2026 05:00 AMwbc10.77 x10^3/uL
LAB-002244Fri Oct 30, 2026 05:00 AMplatelets270.0 x10^3/uL
LAB-002216Sat Oct 31, 2026 05:00 AMcreatinine0.67 mg/dL
LAB-002225Sat Oct 31, 2026 05:00 AMsodium137.0 mmol/L
LAB-002234Sat Oct 31, 2026 05:00 AMhemoglobin13.71 g/dL
LAB-002245Sat Oct 31, 2026 05:00 AMwbc6.8 x10^3/uL
LAB-002246Sat Oct 31, 2026 05:00 AMplatelets207.0 x10^3/uL
LAB-002217Sun Nov 01, 2026 05:00 AMcreatinine0.69 mg/dL
LAB-002226Sun Nov 01, 2026 05:00 AMsodium142.0 mmol/L
LAB-002235Sun Nov 01, 2026 05:00 AMhemoglobin13.78 g/dL
LAB-002247Sun Nov 01, 2026 05:00 AMwbc10.9 x10^3/uL
LAB-002248Sun Nov 01, 2026 05:00 AMplatelets184.0 x10^3/uL
LAB-002218Mon Nov 02, 2026 05:00 AMcreatinine0.71 mg/dL
LAB-002227Mon Nov 02, 2026 05:00 AMsodium140.0 mmol/L
LAB-002236Mon Nov 02, 2026 05:00 AMhemoglobin13.39 g/dL
LAB-002249Mon Nov 02, 2026 05:00 AMwbc8.56 x10^3/uL
LAB-002250Mon Nov 02, 2026 05:00 AMplatelets286.0 x10^3/uL
LAB-002219Tue Nov 03, 2026 05:00 AMcreatinine0.68 mg/dL
LAB-002228Tue Nov 03, 2026 05:00 AMsodium137.0 mmol/L
LAB-002237Tue Nov 03, 2026 05:00 AMhemoglobin13.46 g/dL
LAB-002251Tue Nov 03, 2026 05:00 AMwbc8.73 x10^3/uL
LAB-002252Tue Nov 03, 2026 05:00 AMplatelets270.0 x10^3/uL
LAB-002220Wed Nov 04, 2026 05:00 AMcreatinine0.67 mg/dL
LAB-002229Wed Nov 04, 2026 05:00 AMsodium140.0 mmol/L
LAB-002238Wed Nov 04, 2026 05:00 AMhemoglobin13.39 g/dL
LAB-002253Wed Nov 04, 2026 05:00 AMwbc10.34 x10^3/uL
LAB-002254Wed Nov 04, 2026 05:00 AMplatelets306.0 x10^3/uL
LAB-002221Thu Nov 05, 2026 05:00 AMcreatinine0.7 mg/dL
LAB-002230Thu Nov 05, 2026 05:00 AMsodium137.0 mmol/L
LAB-002239Thu Nov 05, 2026 05:00 AMhemoglobin13.77 g/dL
LAB-002255Thu Nov 05, 2026 05:00 AMwbc7.73 x10^3/uL
LAB-002256Thu Nov 05, 2026 05:00 AMplatelets253.0 x10^3/uL
LAB-002222Fri Nov 06, 2026 05:00 AMcreatinine0.69 mg/dL
LAB-002231Fri Nov 06, 2026 05:00 AMsodium141.0 mmol/L
LAB-002240Fri Nov 06, 2026 05:00 AMhemoglobin13.44 g/dL
LAB-002257Fri Nov 06, 2026 05:00 AMwbc6.75 x10^3/uL
LAB-002258Fri Nov 06, 2026 05:00 AMplatelets235.0 x10^3/uL
Vitals (150)
Vitals
RowWhenKindValueDetail
VIT-006359Thu Oct 29, 2026 02:16 PMspo297.0room air
VIT-006360Thu Oct 29, 2026 02:16 PMrr15.0
VIT-006409Thu Oct 29, 2026 02:16 PMtemp_c37.5
VIT-006410Thu Oct 29, 2026 02:16 PMhr79.0
VIT-006411Thu Oct 29, 2026 02:16 PMmap75.0
VIT-006412Thu Oct 29, 2026 02:16 PMgcs15.0
VIT-006361Thu Oct 29, 2026 10:16 PMspo298.0room air
VIT-006362Thu Oct 29, 2026 10:16 PMrr20.0
VIT-006413Thu Oct 29, 2026 10:16 PMtemp_c36.9
VIT-006414Thu Oct 29, 2026 10:16 PMhr88.0
VIT-006415Thu Oct 29, 2026 10:16 PMmap80.0
VIT-006416Thu Oct 29, 2026 10:16 PMgcs15.0
VIT-006363Fri Oct 30, 2026 06:16 AMspo297.0room air
VIT-006364Fri Oct 30, 2026 06:16 AMrr19.0
VIT-006417Fri Oct 30, 2026 06:16 AMtemp_c37.0
VIT-006418Fri Oct 30, 2026 06:16 AMhr71.0
VIT-006419Fri Oct 30, 2026 06:16 AMmap88.0
VIT-006420Fri Oct 30, 2026 06:16 AMgcs15.0
VIT-006365Fri Oct 30, 2026 02:16 PMspo295.0room air
VIT-006366Fri Oct 30, 2026 02:16 PMrr17.0
VIT-006421Fri Oct 30, 2026 02:16 PMtemp_c37.0
VIT-006422Fri Oct 30, 2026 02:16 PMhr69.0
VIT-006423Fri Oct 30, 2026 02:16 PMmap77.0
VIT-006424Fri Oct 30, 2026 02:16 PMgcs15.0
VIT-006367Fri Oct 30, 2026 10:16 PMspo295.0room air
VIT-006368Fri Oct 30, 2026 10:16 PMrr17.0
VIT-006425Fri Oct 30, 2026 10:16 PMtemp_c37.1
VIT-006426Fri Oct 30, 2026 10:16 PMhr70.0
VIT-006427Fri Oct 30, 2026 10:16 PMmap89.0
VIT-006428Fri Oct 30, 2026 10:16 PMgcs15.0
VIT-006369Sat Oct 31, 2026 06:16 AMspo296.0room air
VIT-006370Sat Oct 31, 2026 06:16 AMrr19.0
VIT-006429Sat Oct 31, 2026 06:16 AMtemp_c37.5
VIT-006430Sat Oct 31, 2026 06:16 AMhr80.0
VIT-006431Sat Oct 31, 2026 06:16 AMmap76.0
VIT-006432Sat Oct 31, 2026 06:16 AMgcs15.0
VIT-006371Sat Oct 31, 2026 02:16 PMspo295.0room air
VIT-006372Sat Oct 31, 2026 02:16 PMrr19.0
VIT-006433Sat Oct 31, 2026 02:16 PMtemp_c37.5
VIT-006434Sat Oct 31, 2026 02:16 PMhr77.0
VIT-006435Sat Oct 31, 2026 02:16 PMmap75.0
VIT-006436Sat Oct 31, 2026 02:16 PMgcs15.0
VIT-006373Sat Oct 31, 2026 10:16 PMspo294.0room air
VIT-006374Sat Oct 31, 2026 10:16 PMrr20.0
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Medications, orders, echo, history (0)

Notes

History and physical · DOC-000227 · Dr. Keira Upfield (resident) · Thu Oct 29, 2026 04:56 PM

Cited facts from this note (1)
bleeding_source
bleeding · cited p. 1, line 7 · confidence 0.50
Show source for bleeding_source
… Attending: Dr. Cyrus Ellingham History of present illness: 74-year-old woman admitted with COPD exacerbation. Past medical history: hyperlipidemia. Denies bleeding, chest pain or fever. Exam: Lungs: clear to auscultation bilaterally. Assessment and plan: 1. COPD exacerbation: bronchodilators and steroids.
Source document DOC-000227: History and physical (synthetic)
HISTORY AND PHYSICAL
Patient: Elena Emberly   MRN: MRN15849760   Admitted: 2026-10-29 13:56
Service: Pulmonology   Attending: Dr. Cyrus Ellingham

History of present illness: 74-year-old woman admitted with COPD exacerbation. 
Past medical history: hyperlipidemia.
Denies bleeding, chest pain or fever.
Exam: Lungs: clear to auscultation bilaterally.
Assessment and plan:
1. COPD exacerbation: bronchodilators and steroids.

Progress note · DOC-000228 · Dr. Keira Upfield (resident) · Sat Oct 31, 2026 05:56 PM

Source document DOC-000228: Progress note (synthetic)
PROGRESS NOTE (Resident)
Patient: Elena Emberly   MRN: MRN15849760   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. COPD exacerbation: continue current management.

Resident: Dr. Keira Upfield   Attending cosign: completed

Discharge summary · DOC-000229 · Dr. Cyrus Ellingham (attending) · Fri Nov 06, 2026 02:20 PM

Source document DOC-000229: Discharge summary (synthetic)
DISCHARGE SUMMARY
Patient: Elena Emberly   MRN: MRN15849760
Admitted 2026-10-29; discharged 2026-11-06.

Discharge diagnoses:
- COPD exacerbation
- hyperlipidemia

Disposition: home with follow-up.