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.

ENC-00067: Jun Galloway

73M · MRN61396891 · Hospital Medicine · admitted Sun Nov 08, 2026 06:57 PM · in hospital · attending Dr. Cyrus Ellingham · 172 cm, 128.9 kg

Documented diagnoses (current)

Principal: “community-acquired pneumonia” · J18.9 Pneumonia, unspecified organism
“obesity” · E66.9 Obesity, unspecified
“CKD stage 3b” · N18.32 Chronic kidney disease, stage 3b
“heart failure” · I50.9 Heart failure, unspecified
“stage 4 sacral pressure ulcer” · L89.154 Pressure ulcer of sacral region, stage 4

Illustrative grouping now: MS-DRG 193 Simple pneumonia and pleurisy with MCC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 193.

Queries and events

No queries yet.

All rules applied

Rule Criteria Finding Outcome

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)
Step	Expression	Inputs and thresholds read	Result
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=1.024, t.ratio_s1=1.5, creat_rise_48h=0.04, 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=1.024, t.ratio_s3=3.0, creat_peak=2.11, 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=1.024, 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=0.04, 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)
Step	Expression	Inputs and thresholds read	Result
derived: anaemic	`case(sex == 'M', hgb_nadir < t.hb_m, sex == 'F', hgb_nadir < t.hb_f, null)`	sex=M, hgb_nadir=14.82, 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=False, 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=14.82, anaemic=False	true

Chronic kidney disease

Criteria met

No gap

Supported as documented (N18.32).

Trace

Rule trace (rule ckd v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: chronic	`egfr_n >= 2 and egfr_span_days >= t.chronic_days`	egfr_n=2, egfr_span_days=317, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=39.5, egfr_late=33.4	39.5
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=39.5, t.g2=60, egfr_late=33.4	true
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=39.5, t.g2=60, t.g3a=45, t.g3b=30, t.g4=15	G3b
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=True, egfr_early=39.5, egfr_late=33.4, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=39.5, t.g2=60	false
outcome: g3a	`category == 'G3a'`	category=G3b	false
outcome: g3b	`category == 'G3b'`	category=G3b	true

Heart failure

Criteria met

Specificity gap

Documented “heart failure” (I50.9); criteria support the more specific Acute on chronic diastolic (HFpEF) heart failure (I50.33).

Trace

Rule trace (rule heart_failure v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: np_elevated	`coalesce(bnp_max >= t.bnp, false) or coalesce(ntprobnp_max >= t.ntprobnp, false)`	bnp_max=1086.0, t.bnp=100, ntprobnp_max=unknown, t.ntprobnp=300	true
derived: acute_count	`count(iv_loop_diuretic, np_elevated, new_o2)`	iv_loop_diuretic=True, np_elevated=True, new_o2=False	2
derived: hf_type	`case(lvef <= t.ref, 'systolic', lvef >= t.pres, 'diastolic', 'midrange')`	lvef=59.0, t.ref=40, t.pres=50	diastolic
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=59.0, 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=2, hf_history=True	acute on chronic
outcome: improved_ef	`improved`	improved=False	false
outcome: midrange	`hf_type == 'midrange'`	hf_type=diastolic	false
outcome: sys_aoc	`hf_type == 'systolic' and acuity == 'acute on chronic'`	hf_type=diastolic, acuity=acute on chronic	false
outcome: sys_acute	`hf_type == 'systolic' and acuity == 'acute'`	hf_type=diastolic, acuity=acute on chronic	false
outcome: sys_chronic	`hf_type == 'systolic' and acuity == 'chronic'`	hf_type=diastolic, acuity=acute on chronic	false
outcome: dia_aoc	`hf_type == 'diastolic' and acuity == 'acute on chronic'`	hf_type=diastolic, acuity=acute on chronic	true

Hyponatraemia

Criteria met

Specificity gap

Criteria support Hyponatraemia (profound) (E87.1); no corresponding diagnosis is documented.

Trace

Rule trace (rule hyponatremia v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: severity	`case(na_min < t.profound, 'profound', na_min < t.moderate, 'moderate', na_min < t.low, 'mild', 'none')`	na_min=122.0, t.profound=125, t.moderate=130, t.low=135	profound
outcome: met	`na_min < t.low and na_low_count >= t.repeat and na_treated`	na_min=122.0, t.low=135, na_low_count=6, t.repeat=2, na_treated=True	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)
Step	Expression	Inputs and thresholds read	Result
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 met

Specificity gap

Documented “obesity” (E66.9); criteria support the more specific Obesity, class 3 (E66.813).

Trace

Rule trace (rule obesity v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
outcome: not_adult	`age < t.adult`	age=73, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=43.6, t.c3=40	true

Pressure injury

Criteria met

Clinical validation gap

Documented “stage 4 sacral pressure ulcer” (L89.154) conflicts with what the criteria support (Pressure injury of sacral region, stage 2, L89.152).

Trace

Rule trace (rule pressure_injury v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: sacral	`wound_site == 'sacral'`	wound_site=sacral	true
outcome: no_wound_note	`not present(wound_stage)`	wound_stage=2	false
outcome: other_site	`wound_site != 'sacral'`	wound_site=sacral	false
outcome: stage1	`sacral and wound_stage == '1'`	sacral=True, wound_stage=2	false
outcome: stage2	`sacral and wound_stage == '2'`	sacral=True, wound_stage=2	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)
Step	Expression	Inputs and thresholds read	Result
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)
Step	Expression	Inputs and thresholds read	Result
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=36.5, t.t_lo=36	false
derived: sirs_hr	`coalesce(hr_max_48h > t.hr, false)`	hr_max_48h=87.0, 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=19.0, 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=7.28, t.wbc_hi=12, wbc_min_48h=6.07, 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=234.0	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=0.48	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=76.0	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=2.11	2
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=2.06	2
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=2, sofa_renal_baseline=2	0
derived: sepsis3	`infection_documented and sofa_delta >= t.sofa_delta`	infection_documented=True, sofa_delta=0, t.sofa_delta=2	false
derived: sepsis2	`infection_documented and sirs_count >= t.sirs_min`	infection_documented=True, 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=True	false
outcome: septic_shock	`shock`	shock=False	false
outcome: both	`sepsis3 and sepsis2`	sepsis3=False, sepsis2=False	false
outcome: sepsis3_only	`sepsis3`	sepsis3=False	false
outcome: definitions_disagree	`sepsis2`	sepsis2=False	false
outcome: neither	`true`	—	true

Structured data

Labs (34)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-002260	Fri Oct 10, 2025 09:15 AM	creatinine	1.79 mg/dL
LAB-002261	Sun Aug 23, 2026 10:05 AM	creatinine	2.06 mg/dL
LAB-002262	Sun Nov 08, 2026 07:57 PM	creatinine	2.07 mg/dL
LAB-002268	Sun Nov 08, 2026 07:57 PM	bnp	1086.0 pg/mL
LAB-002269	Sun Nov 08, 2026 07:57 PM	sodium	124.0 mmol/L
LAB-002275	Sun Nov 08, 2026 07:57 PM	hemoglobin	15.35 g/dL
LAB-002281	Sun Nov 08, 2026 07:57 PM	wbc	6.07 x10^3/uL
LAB-002282	Sun Nov 08, 2026 07:57 PM	platelets	280.0 x10^3/uL
LAB-002293	Sun Nov 08, 2026 07:57 PM	bilirubin	0.48 mg/dL
LAB-002263	Mon Nov 09, 2026 05:00 AM	creatinine	2.11 mg/dL
LAB-002270	Mon Nov 09, 2026 05:00 AM	sodium	122.0 mmol/L
LAB-002276	Mon Nov 09, 2026 05:00 AM	hemoglobin	14.96 g/dL
LAB-002283	Mon Nov 09, 2026 05:00 AM	wbc	7.28 x10^3/uL
LAB-002284	Mon Nov 09, 2026 05:00 AM	platelets	234.0 x10^3/uL
LAB-002264	Tue Nov 10, 2026 05:00 AM	creatinine	2.1 mg/dL
LAB-002271	Tue Nov 10, 2026 05:00 AM	sodium	123.0 mmol/L
LAB-002277	Tue Nov 10, 2026 05:00 AM	hemoglobin	15.17 g/dL
LAB-002285	Tue Nov 10, 2026 05:00 AM	wbc	6.61 x10^3/uL
LAB-002286	Tue Nov 10, 2026 05:00 AM	platelets	254.0 x10^3/uL
LAB-002265	Wed Nov 11, 2026 05:00 AM	creatinine	2.04 mg/dL
LAB-002272	Wed Nov 11, 2026 05:00 AM	sodium	126.0 mmol/L
LAB-002278	Wed Nov 11, 2026 05:00 AM	hemoglobin	14.82 g/dL
LAB-002287	Wed Nov 11, 2026 05:00 AM	wbc	7.47 x10^3/uL
LAB-002288	Wed Nov 11, 2026 05:00 AM	platelets	302.0 x10^3/uL
LAB-002266	Thu Nov 12, 2026 05:00 AM	creatinine	2.06 mg/dL
LAB-002273	Thu Nov 12, 2026 05:00 AM	sodium	128.0 mmol/L
LAB-002279	Thu Nov 12, 2026 05:00 AM	hemoglobin	15.32 g/dL
LAB-002289	Thu Nov 12, 2026 05:00 AM	wbc	6.07 x10^3/uL
LAB-002290	Thu Nov 12, 2026 05:00 AM	platelets	277.0 x10^3/uL
LAB-002267	Fri Nov 13, 2026 05:00 AM	creatinine	2.06 mg/dL
LAB-002274	Fri Nov 13, 2026 05:00 AM	sodium	134.0 mmol/L
LAB-002280	Fri Nov 13, 2026 05:00 AM	hemoglobin	14.91 g/dL
LAB-002291	Fri Nov 13, 2026 05:00 AM	wbc	7.61 x10^3/uL
LAB-002292	Fri Nov 13, 2026 05:00 AM	platelets	277.0 x10^3/uL

Vitals (90)

Vitals
Row	When	Kind	Value	Detail
VIT-006509	Sun Nov 08, 2026 07:17 PM	spo2	97.0	room air
VIT-006510	Sun Nov 08, 2026 07:17 PM	rr	15.0
VIT-006539	Sun Nov 08, 2026 07:17 PM	temp_c	36.9
VIT-006540	Sun Nov 08, 2026 07:17 PM	hr	73.0
VIT-006541	Sun Nov 08, 2026 07:17 PM	map	87.0
VIT-006542	Sun Nov 08, 2026 07:17 PM	gcs	15.0
VIT-006511	Mon Nov 09, 2026 03:17 AM	spo2	95.0	room air
VIT-006512	Mon Nov 09, 2026 03:17 AM	rr	14.0
VIT-006543	Mon Nov 09, 2026 03:17 AM	temp_c	37.5
VIT-006544	Mon Nov 09, 2026 03:17 AM	hr	77.0
VIT-006545	Mon Nov 09, 2026 03:17 AM	map	76.0
VIT-006546	Mon Nov 09, 2026 03:17 AM	gcs	15.0
VIT-006513	Mon Nov 09, 2026 11:17 AM	spo2	94.0	room air
VIT-006514	Mon Nov 09, 2026 11:17 AM	rr	17.0
VIT-006547	Mon Nov 09, 2026 11:17 AM	temp_c	36.5
VIT-006548	Mon Nov 09, 2026 11:17 AM	hr	87.0
VIT-006549	Mon Nov 09, 2026 11:17 AM	map	78.0
VIT-006550	Mon Nov 09, 2026 11:17 AM	gcs	15.0
VIT-006515	Mon Nov 09, 2026 07:17 PM	spo2	98.0	room air
VIT-006516	Mon Nov 09, 2026 07:17 PM	rr	18.0
VIT-006551	Mon Nov 09, 2026 07:17 PM	temp_c	37.5
VIT-006552	Mon Nov 09, 2026 07:17 PM	hr	84.0
VIT-006553	Mon Nov 09, 2026 07:17 PM	map	81.0
VIT-006554	Mon Nov 09, 2026 07:17 PM	gcs	15.0
VIT-006517	Tue Nov 10, 2026 03:17 AM	spo2	98.0	room air
VIT-006518	Tue Nov 10, 2026 03:17 AM	rr	16.0
VIT-006555	Tue Nov 10, 2026 03:17 AM	temp_c	37.4
VIT-006556	Tue Nov 10, 2026 03:17 AM	hr	68.0
VIT-006557	Tue Nov 10, 2026 03:17 AM	map	83.0
VIT-006558	Tue Nov 10, 2026 03:17 AM	gcs	15.0
VIT-006519	Tue Nov 10, 2026 11:17 AM	spo2	94.0	room air
VIT-006520	Tue Nov 10, 2026 11:17 AM	rr	19.0
VIT-006559	Tue Nov 10, 2026 11:17 AM	temp_c	37.5
VIT-006560	Tue Nov 10, 2026 11:17 AM	hr	76.0
VIT-006561	Tue Nov 10, 2026 11:17 AM	map	81.0
VIT-006562	Tue Nov 10, 2026 11:17 AM	gcs	15.0
VIT-006521	Tue Nov 10, 2026 07:17 PM	spo2	98.0	room air
VIT-006522	Tue Nov 10, 2026 07:17 PM	rr	15.0
VIT-006563	Tue Nov 10, 2026 07:17 PM	temp_c	36.9
VIT-006564	Tue Nov 10, 2026 07:17 PM	hr	87.0
VIT-006565	Tue Nov 10, 2026 07:17 PM	map	88.0
VIT-006566	Tue Nov 10, 2026 07:17 PM	gcs	15.0
VIT-006523	Wed Nov 11, 2026 03:17 AM	spo2	97.0	room air
VIT-006524	Wed Nov 11, 2026 03:17 AM	rr	18.0
VIT-006567	Wed Nov 11, 2026 03:17 AM	temp_c	36.7
VIT-006568	Wed Nov 11, 2026 03:17 AM	hr	69.0
VIT-006569	Wed Nov 11, 2026 03:17 AM	map	89.0
VIT-006570	Wed Nov 11, 2026 03:17 AM	gcs	15.0
VIT-006525	Wed Nov 11, 2026 11:17 AM	spo2	96.0	room air
VIT-006526	Wed Nov 11, 2026 11:17 AM	rr	16.0
VIT-006571	Wed Nov 11, 2026 11:17 AM	temp_c	36.6
VIT-006572	Wed Nov 11, 2026 11:17 AM	hr	69.0
VIT-006573	Wed Nov 11, 2026 11:17 AM	map	77.0
VIT-006574	Wed Nov 11, 2026 11:17 AM	gcs	15.0
VIT-006527	Wed Nov 11, 2026 07:17 PM	spo2	99.0	room air
VIT-006528	Wed Nov 11, 2026 07:17 PM	rr	18.0
VIT-006575	Wed Nov 11, 2026 07:17 PM	temp_c	37.2
VIT-006576	Wed Nov 11, 2026 07:17 PM	hr	87.0
VIT-006577	Wed Nov 11, 2026 07:17 PM	map	81.0
VIT-006578	Wed Nov 11, 2026 07:17 PM	gcs	15.0
VIT-006529	Thu Nov 12, 2026 03:17 AM	spo2	97.0	room air
VIT-006530	Thu Nov 12, 2026 03:17 AM	rr	19.0
VIT-006579	Thu Nov 12, 2026 03:17 AM	temp_c	37.1
VIT-006580	Thu Nov 12, 2026 03:17 AM	hr	76.0
VIT-006581	Thu Nov 12, 2026 03:17 AM	map	92.0
VIT-006582	Thu Nov 12, 2026 03:17 AM	gcs	15.0
VIT-006531	Thu Nov 12, 2026 11:17 AM	spo2	96.0	room air
VIT-006532	Thu Nov 12, 2026 11:17 AM	rr	18.0
VIT-006583	Thu Nov 12, 2026 11:17 AM	temp_c	36.8
VIT-006584	Thu Nov 12, 2026 11:17 AM	hr	68.0
VIT-006585	Thu Nov 12, 2026 11:17 AM	map	83.0
VIT-006586	Thu Nov 12, 2026 11:17 AM	gcs	15.0
VIT-006533	Thu Nov 12, 2026 07:17 PM	spo2	94.0	room air
VIT-006534	Thu Nov 12, 2026 07:17 PM	rr	20.0
VIT-006587	Thu Nov 12, 2026 07:17 PM	temp_c	36.8
VIT-006588	Thu Nov 12, 2026 07:17 PM	hr	72.0
VIT-006589	Thu Nov 12, 2026 07:17 PM	map	83.0
VIT-006590	Thu Nov 12, 2026 07:17 PM	gcs	15.0
VIT-006535	Fri Nov 13, 2026 03:17 AM	spo2	97.0	room air
VIT-006536	Fri Nov 13, 2026 03:17 AM	rr	19.0
VIT-006591	Fri Nov 13, 2026 03:17 AM	temp_c	37.4
VIT-006592	Fri Nov 13, 2026 03:17 AM	hr	79.0
VIT-006593	Fri Nov 13, 2026 03:17 AM	map	80.0
VIT-006594	Fri Nov 13, 2026 03:17 AM	gcs	15.0
VIT-006537	Fri Nov 13, 2026 11:17 AM	spo2	96.0	room air
VIT-006538	Fri Nov 13, 2026 11:17 AM	rr	14.0
VIT-006595	Fri Nov 13, 2026 11:17 AM	temp_c	37.0
VIT-006596	Fri Nov 13, 2026 11:17 AM	hr	80.0
VIT-006597	Fri Nov 13, 2026 11:17 AM	map	80.0
VIT-006598	Fri Nov 13, 2026 11:17 AM	gcs	15.0

Medications, orders, echo, history (14)

MED-000257 11-08 19:57 ceftriaxone per protocol IV
MED-000258 11-09 05:00 cefepime per protocol IV
MED-000259 11-10 05:00 cefepime per protocol IV
MED-000260 11-08 08:00 furosemide 40 mg IV
MED-000261 11-08 20:00 furosemide 40 mg IV
MED-000262 11-09 08:00 furosemide 40 mg IV
MED-000263 11-09 20:00 furosemide 40 mg IV
MED-000264 11-10 08:00 furosemide 40 mg IV
MED-000265 11-10 20:00 furosemide 40 mg IV
MED-000266 11-08 22:57 sodium chloride 3% 100 mL IV
ORD-000057 11-08 19:27 blood_culture: blood cultures x2
ORD-000058 11-08 21:57 fluid_restriction: fluid restriction 1.2 L/day
ECH-000032 2026-11-09 echo LVEF 59.0%
HX-000025 history: heart failure with preserved ejection fraction

Notes

History and physical · DOC-000231 · Dr. Cyrus Ellingham (attending) · Sun Nov 08, 2026 09:57 PM

Cited facts from this note (1)

infection_source: right lower lobe pneumonia · cited p. 1, line 5 · confidence 0.85

Show source for infection_source

… : Hospital Medicine Attending: Dr. Cyrus Ellingham History of present illness: 73-year-old man admitted with community-acquired pneumonia. Chest x-ray shows right lower lobe pneumonia; blood cultures drawn and ceftriaxone started. Past medical history: heart failure with preserved ejection fraction. Review of systems otherwise negative. Exam …

Source document DOC-000231: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Jun Galloway   MRN: MRN61396891   Admitted: 2026-11-08 18:57
Service: Hospital Medicine   Attending: Dr. Cyrus Ellingham

History of present illness: 73-year-old man admitted with community-acquired pneumonia. Chest x-ray shows right lower lobe pneumonia; blood cultures drawn and ceftriaxone started.
Past medical history: heart failure with preserved ejection fraction.
Review of systems otherwise negative.
Exam: Lungs: scattered crackles at the bases, no distress.
Assessment and plan:
1. Community-acquired pneumonia: antibiotics.
2. CKD stage 3b: renally dose medications.

Wound care note · DOC-000230 · Elena Jessup, RN, CWOCN (wound_nurse) · Mon Nov 09, 2026 08:57 PM

Cited facts from this note (2)

wound_site: sacral · cited p. 1, line 4 · confidence 0.95

Show source for wound_site

WOUND CARE NOTE Patient: Jun Galloway MRN: MRN61396891 Location: sacrum Stage: 2 (NPIAP) Description: partial-thickness skin loss with exposed dermis. Size: 4.9 x 3.0 x 0.8 cm. Plan: offloading every 2 hours, foam dressing, nutriti …
wound_stage: 2 · cited p. 1, line 5 · confidence 0.95

Show source for wound_stage

WOUND CARE NOTE Patient: Jun Galloway MRN: MRN61396891 Location: sacrum Stage: 2 (NPIAP) Description: partial-thickness skin loss with exposed dermis. Size: 4.9 x 3.0 x 0.8 cm. Plan: offloading every 2 hours, foam dressing, nutrition consul …

Source document DOC-000230: Wound care note (synthetic)

WOUND CARE NOTE
Patient: Jun Galloway   MRN: MRN61396891

Location: sacrum
Stage: 2 (NPIAP)
Description: partial-thickness skin loss with exposed dermis.
Size: 4.9 x 3.0 x 0.8 cm.
Plan: offloading every 2 hours, foam dressing, nutrition consult.

Progress note · DOC-000232 · Dr. Cyrus Ellingham (attending) · Fri Nov 13, 2026 01:55 PM

Source document DOC-000232: Progress note (synthetic)

PROGRESS NOTE (Attending)
Patient: Jun Galloway   MRN: MRN61396891   Hospital day 5

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Community-acquired pneumonia: continue current management.
2. Obesity: counsel on weight.
3. Heart failure: diuresis and daily weights; monitor electrolytes.
4. Stage 4 sacral pressure ulcer: wound care following, offloading.

Attending: Dr. Cyrus Ellingham