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-00070: Blake Emberly

52F · MRN63590030 · Cardiology · admitted Sat Oct 31, 2026 03:27 PM · discharged Tue Nov 03, 2026 10:30 AM · attending Dr. Cyrus Ellingham · resident Dr. Priya Thorne · 163 cm, 56.1 kg

Documented diagnoses (current)

Principal: “congestive heart failure” · I50.9 Heart failure, unspecified
“hypoxemia” · R09.02 Hypoxemia
“anemia” · D64.9 Anemia, unspecified
“GERD” · K21.9 Gastro-esophageal reflux disease without esophagitis
“hypertension” · I10 Essential (primary) hypertension

Illustrative grouping now: MS-DRG 293 Heart failure and shock without CC/MCC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 291.

Queries and events

No queries yet.

All rules applied

Rule Criteria Finding Outcome

Acute kidney injury

Criteria met

Specificity gap

Criteria support Acute kidney injury (KDIGO stage 3) (N17.9); no corresponding diagnosis is documented.

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=3.211, t.ratio_s1=1.5, creat_rise_48h=0.63, t.rise_abs=0.3, uo_hours_lt_0_5=30, t.uo_s1_h=6	true
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=True, creat_ratio=3.211, t.ratio_s3=3.0, creat_peak=2.89, t.scr_s3=4.0, rrt_started=True, uo_hours_lt_0_3=30, t.uo_s3_h=24, anuria_hours=0, t.anuria_h=12	true
derived: stage2	`creat_ratio >= t.ratio_s2 or coalesce(uo_hours_lt_0_5 >= t.uo_s2_h, false)`	creat_ratio=3.211, t.ratio_s2=2.0, uo_hours_lt_0_5=30, t.uo_s2_h=12	true
derived: stage	`case(stage3, 3, stage2, 2, meets_definition, 1, 0)`	stage3=True, stage2=True, meets_definition=True	3
derived: baseline_independent	`creat_baseline_known or creat_rise_48h >= t.rise_abs or rrt_started`	creat_baseline_known=True, creat_rise_48h=0.63, t.rise_abs=0.3, rrt_started=True	true
outcome: aki_staged	`stage >= 1 and baseline_independent`	stage=3, baseline_independent=True	true

Acute blood loss anaemia

Criteria met

No gap

Supported as documented (D64.9).

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=F, hgb_nadir=9.93, t.hb_m=13, t.hb_f=12	true
derived: acute_fall	`hgb_drop >= t.drop_major or prbc_units >= t.prbc_major`	hgb_drop=0.3, 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=True, acute_fall=False	false
outcome: anaemia_only	`anaemic and hgb_drop < t.drop_min and prbc_units == 0`	anaemic=True, hgb_drop=0.3, t.drop_min=1.0, prbc_units=0	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)
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=345, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=74.9, egfr_late=76.9	76.9
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=74.9, t.g2=60, egfr_late=76.9	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=76.9, 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=74.9, egfr_late=76.9, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=76.9, t.g2=60	true

Heart failure

Criteria met

Specificity gap

Documented “congestive heart failure” (I50.9); criteria support the more specific Acute diastolic (HFpEF) heart failure (I50.31).

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=2021.0, 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=True	3
derived: hf_type	`case(lvef <= t.ref, 'systolic', lvef >= t.pres, 'diastolic', 'midrange')`	lvef=65.0, 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=65.0, 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=3, hf_history=False	acute
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	false
outcome: sys_acute	`hf_type == 'systolic' and acuity == 'acute'`	hf_type=diastolic, acuity=acute	false
outcome: sys_chronic	`hf_type == 'systolic' and acuity == 'chronic'`	hf_type=diastolic, acuity=acute	false
outcome: dia_aoc	`hf_type == 'diastolic' and acuity == 'acute on chronic'`	hf_type=diastolic, acuity=acute	false
outcome: dia_acute	`hf_type == 'diastolic' and acuity == 'acute'`	hf_type=diastolic, acuity=acute	true

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)
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=138.0, 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=138.0, t.low=135, na_low_count=0, t.repeat=2, na_treated=False	false
outcome: untreated	`na_min < t.low`	na_min=138.0, t.low=135	false
outcome: not_met	`na_min >= t.low`	na_min=138.0, t.low=135	true

Malnutrition

Criteria not met

No gap

Not documented and not supported.

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=100.0, t.a_sev_intake_pct=50, intake_days=unknown, t.a_sev_intake_days=5	false
derived: a_mod_intake	`intake_pct < t.a_mod_intake_pct and intake_days > t.a_mod_intake_days`	intake_pct=100.0, t.a_mod_intake_pct=75, intake_days=unknown, t.a_mod_intake_days=7	false
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=100.0, t.c_intake_pct=75, intake_days=unknown, t.c_intake_days=30	false
derived: c_mod_intake	`intake_pct < t.c_intake_pct and intake_days >= t.c_intake_days`	intake_pct=100.0, t.c_intake_pct=75, intake_days=unknown, t.c_intake_days=30	false
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=100.0, wt_loss_pct=unknown, fat_loss=0, muscle_loss=0, fluid=0, grip_reduced=unknown	4
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=acute, a_sev_intake=False, a_sev_wt=unknown, fat_loss=0, muscle_loss=0, fluid=0, grip_reduced=unknown, c_sev_intake=False, c_sev_wt=unknown	0
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=acute, a_sev_intake=False, a_mod_intake=False, a_sev_wt=unknown, a_mod_wt=unknown, fat_loss=0, muscle_loss=0, fluid=0, grip_reduced=unknown, c_sev_intake=False, c_mod_intake=False, c_sev_wt=unknown, c_mod_wt=unknown	0
outcome: severe	`n_severe >= 2`	n_severe=0	false
outcome: moderate	`n_moderate >= 2`	n_moderate=0	false
outcome: one_characteristic	`n_moderate == 1`	n_moderate=0	false
outcome: not_met	`n_moderate == 0 and n_assessed >= 2`	n_moderate=0, n_assessed=4	true

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)
Step	Expression	Inputs and thresholds read	Result
outcome: not_adult	`age < t.adult`	age=52, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=21.1, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=21.1, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=21.1, t.c1=30	false
outcome: not_met	`bmi < t.c1`	bmi=21.1, 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)
Step	Expression	Inputs and thresholds read	Result
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 met

Specificity gap

Documented “hypoxemia” (R09.02); criteria support the more specific Acute respiratory failure with hypoxia (J96.01).

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=83.0, 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=83.0, t.spo2_ra=88, pao2_min_ra=unknown, t.pao2=60, pf_min=unknown, t.pf=300	true
derived: distress	`coalesce(rr_max >= t.rr_distress, false) or coalesce(wob_increased, false) or adv_resp_support`	rr_max=29.0, t.rr_distress=28, wob_increased=unknown, adv_resp_support=False	true
outcome: chronic_baseline	`home_o2 and hypoxemia`	home_o2=False, hypoxemia=True	false
outcome: met	`hypoxemia and distress`	hypoxemia=True, distress=True	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=37.4, t.t_hi=38, temp_min_48h=36.7, t.t_lo=36	false
derived: sirs_hr	`coalesce(hr_max_48h > t.hr, false)`	hr_max_48h=90.0, 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=29.0, t.rr=20, paco2_min_48h=unknown, t.paco2=32	true
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=10.75, t.wbc_hi=12, wbc_min_48h=9.08, 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=True, sirs_wbc=False	1
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=213.0	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=0.97	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=82.0	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=2.89	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=0.9	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=2, sofa_renal_baseline=0	2
derived: sepsis3	`infection_documented and sofa_delta >= t.sofa_delta`	infection_documented=False, sofa_delta=2, t.sofa_delta=2	false
derived: sepsis2	`infection_documented and sirs_count >= t.sirs_min`	infection_documented=False, sirs_count=1, 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 (24)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-002386	Thu Sep 11, 2025 09:15 AM	creatinine	0.92 mg/dL
LAB-002387	Sat Aug 22, 2026 10:05 AM	creatinine	0.9 mg/dL
LAB-002388	Sat Oct 31, 2026 04:27 PM	creatinine	2.26 mg/dL
LAB-002392	Sat Oct 31, 2026 04:27 PM	bnp	2021.0 pg/mL
LAB-002393	Sat Oct 31, 2026 04:27 PM	sodium	141.0 mmol/L
LAB-002397	Sat Oct 31, 2026 04:27 PM	hemoglobin	10.25 g/dL
LAB-002401	Sat Oct 31, 2026 04:27 PM	wbc	10.74 x10^3/uL
LAB-002402	Sat Oct 31, 2026 04:27 PM	platelets	289.0 x10^3/uL
LAB-002409	Sat Oct 31, 2026 04:27 PM	bilirubin	0.97 mg/dL
LAB-002389	Sun Nov 01, 2026 05:00 AM	creatinine	2.89 mg/dL
LAB-002394	Sun Nov 01, 2026 05:00 AM	sodium	138.0 mmol/L
LAB-002398	Sun Nov 01, 2026 05:00 AM	hemoglobin	9.93 g/dL
LAB-002403	Sun Nov 01, 2026 05:00 AM	wbc	10.75 x10^3/uL
LAB-002404	Sun Nov 01, 2026 05:00 AM	platelets	213.0 x10^3/uL
LAB-002390	Mon Nov 02, 2026 05:00 AM	creatinine	2.6 mg/dL
LAB-002395	Mon Nov 02, 2026 05:00 AM	sodium	139.0 mmol/L
LAB-002399	Mon Nov 02, 2026 05:00 AM	hemoglobin	10.22 g/dL
LAB-002405	Mon Nov 02, 2026 05:00 AM	wbc	9.08 x10^3/uL
LAB-002406	Mon Nov 02, 2026 05:00 AM	platelets	230.0 x10^3/uL
LAB-002391	Tue Nov 03, 2026 05:00 AM	creatinine	2.17 mg/dL
LAB-002396	Tue Nov 03, 2026 05:00 AM	sodium	139.0 mmol/L
LAB-002400	Tue Nov 03, 2026 05:00 AM	hemoglobin	10.12 g/dL
LAB-002407	Tue Nov 03, 2026 05:00 AM	wbc	10.72 x10^3/uL
LAB-002408	Tue Nov 03, 2026 05:00 AM	platelets	190.0 x10^3/uL

Vitals (71)

Vitals
Row	When	Kind	Value	Detail
VIT-006895	Sat Oct 31, 2026 03:47 PM	spo2	83.0	room air
VIT-006896	Sat Oct 31, 2026 03:47 PM	rr	29.0
VIT-006922	Sat Oct 31, 2026 03:47 PM	temp_c	37.0
VIT-006923	Sat Oct 31, 2026 03:47 PM	hr	90.0
VIT-006924	Sat Oct 31, 2026 03:47 PM	map	92.0
VIT-006925	Sat Oct 31, 2026 03:47 PM	gcs	15.0
VIT-006897	Sat Oct 31, 2026 03:57 PM	o2_lpm	6.0	nasal cannula
VIT-006887	Sat Oct 31, 2026 09:27 PM	urine_ml_6h	370.3
VIT-006898	Sat Oct 31, 2026 11:47 PM	spo2	92.0	nasal cannula
VIT-006899	Sat Oct 31, 2026 11:47 PM	rr	20.0
VIT-006900	Sat Oct 31, 2026 11:47 PM	o2_lpm	4.0	nasal cannula
VIT-006926	Sat Oct 31, 2026 11:47 PM	temp_c	37.4
VIT-006927	Sat Oct 31, 2026 11:47 PM	hr	89.0
VIT-006928	Sat Oct 31, 2026 11:47 PM	map	84.0
VIT-006929	Sat Oct 31, 2026 11:47 PM	gcs	15.0
VIT-006888	Sun Nov 01, 2026 03:27 AM	urine_ml_6h	74.1
VIT-006901	Sun Nov 01, 2026 07:47 AM	spo2	92.0	nasal cannula
VIT-006902	Sun Nov 01, 2026 07:47 AM	rr	24.0
VIT-006903	Sun Nov 01, 2026 07:47 AM	o2_lpm	4.0	nasal cannula
VIT-006930	Sun Nov 01, 2026 07:47 AM	temp_c	37.0
VIT-006931	Sun Nov 01, 2026 07:47 AM	hr	80.0
VIT-006932	Sun Nov 01, 2026 07:47 AM	map	82.0
VIT-006933	Sun Nov 01, 2026 07:47 AM	gcs	15.0
VIT-006889	Sun Nov 01, 2026 09:27 AM	urine_ml_6h	74.1
VIT-006890	Sun Nov 01, 2026 03:27 PM	urine_ml_6h	74.1
VIT-006904	Sun Nov 01, 2026 03:47 PM	spo2	94.0	nasal cannula
VIT-006905	Sun Nov 01, 2026 03:47 PM	rr	25.0
VIT-006906	Sun Nov 01, 2026 03:47 PM	o2_lpm	3.0	nasal cannula
VIT-006934	Sun Nov 01, 2026 03:47 PM	temp_c	37.3
VIT-006935	Sun Nov 01, 2026 03:47 PM	hr	69.0
VIT-006936	Sun Nov 01, 2026 03:47 PM	map	84.0
VIT-006937	Sun Nov 01, 2026 03:47 PM	gcs	15.0
VIT-006891	Sun Nov 01, 2026 09:27 PM	urine_ml_6h	74.1
VIT-006907	Sun Nov 01, 2026 11:47 PM	spo2	91.0	nasal cannula
VIT-006908	Sun Nov 01, 2026 11:47 PM	rr	20.0
VIT-006909	Sun Nov 01, 2026 11:47 PM	o2_lpm	4.0	nasal cannula
VIT-006938	Sun Nov 01, 2026 11:47 PM	temp_c	36.7
VIT-006939	Sun Nov 01, 2026 11:47 PM	hr	70.0
VIT-006940	Sun Nov 01, 2026 11:47 PM	map	89.0
VIT-006941	Sun Nov 01, 2026 11:47 PM	gcs	15.0
VIT-006892	Mon Nov 02, 2026 03:27 AM	urine_ml_6h	74.1
VIT-006910	Mon Nov 02, 2026 07:47 AM	spo2	94.0	nasal cannula
VIT-006911	Mon Nov 02, 2026 07:47 AM	rr	25.0
VIT-006912	Mon Nov 02, 2026 07:47 AM	o2_lpm	2.0	nasal cannula
VIT-006942	Mon Nov 02, 2026 07:47 AM	temp_c	37.1
VIT-006943	Mon Nov 02, 2026 07:47 AM	hr	69.0
VIT-006944	Mon Nov 02, 2026 07:47 AM	map	92.0
VIT-006945	Mon Nov 02, 2026 07:47 AM	gcs	15.0
VIT-006893	Mon Nov 02, 2026 09:27 AM	urine_ml_6h	370.3
VIT-006894	Mon Nov 02, 2026 03:27 PM	urine_ml_6h	370.3
VIT-006913	Mon Nov 02, 2026 03:47 PM	spo2	93.0	nasal cannula
VIT-006914	Mon Nov 02, 2026 03:47 PM	rr	22.0
VIT-006915	Mon Nov 02, 2026 03:47 PM	o2_lpm	2.0	nasal cannula
VIT-006946	Mon Nov 02, 2026 03:47 PM	temp_c	36.7
VIT-006947	Mon Nov 02, 2026 03:47 PM	hr	81.0
VIT-006948	Mon Nov 02, 2026 03:47 PM	map	91.0
VIT-006949	Mon Nov 02, 2026 03:47 PM	gcs	15.0
VIT-006916	Mon Nov 02, 2026 11:47 PM	spo2	91.0	nasal cannula
VIT-006917	Mon Nov 02, 2026 11:47 PM	rr	21.0
VIT-006918	Mon Nov 02, 2026 11:47 PM	o2_lpm	2.0	nasal cannula
VIT-006950	Mon Nov 02, 2026 11:47 PM	temp_c	37.5
VIT-006951	Mon Nov 02, 2026 11:47 PM	hr	75.0
VIT-006952	Mon Nov 02, 2026 11:47 PM	map	76.0
VIT-006953	Mon Nov 02, 2026 11:47 PM	gcs	15.0
VIT-006919	Tue Nov 03, 2026 07:47 AM	spo2	91.0	nasal cannula
VIT-006920	Tue Nov 03, 2026 07:47 AM	rr	23.0
VIT-006921	Tue Nov 03, 2026 07:47 AM	o2_lpm	2.0	nasal cannula
VIT-006954	Tue Nov 03, 2026 07:47 AM	temp_c	36.8
VIT-006955	Tue Nov 03, 2026 07:47 AM	hr	72.0
VIT-006956	Tue Nov 03, 2026 07:47 AM	map	78.0
VIT-006957	Tue Nov 03, 2026 07:47 AM	gcs	15.0

Medications, orders, echo, history (8)

MED-000273 10-31 08:00 furosemide 40 mg IV
MED-000274 10-31 20:00 furosemide 40 mg IV
MED-000275 11-01 08:00 furosemide 40 mg IV
MED-000276 11-01 20:00 furosemide 40 mg IV
MED-000277 11-02 08:00 furosemide 40 mg IV
MED-000278 11-02 20:00 furosemide 40 mg IV
ORD-000060 11-01 08:00 dialysis: hemodialysis catheter and session
ECH-000034 2026-11-01 echo LVEF 65.0%

Notes

History and physical · DOC-000241 · Dr. Priya Thorne (resident) · Sat Oct 31, 2026 06:27 PM

Source document DOC-000241: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Blake Emberly   MRN: MRN63590030   Admitted: 2026-10-31 15:27
Service: Cardiology   Attending: Dr. Cyrus Ellingham

History of present illness: 52-year-old woman admitted with congestive heart failure. 
Past medical history: GERD, hypertension.
Review of systems otherwise negative.
Exam: Lungs: labored respirations.
Assessment and plan:
1. Congestive heart failure: diuresis and daily weights; monitor electrolytes.

Nutrition assessment · DOC-000240 · Viggo Ravensworth, RD (dietitian) · Sun Nov 01, 2026 07:27 PM

Cited facts from this note (5)

fat_loss: none · cited p. 1, line 7 · confidence 0.90

Show source for fat_loss

… MRN: MRN63590030 Context: acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. Assessment: well nourished; no malnutrition identified.
fluid_accumulation: none · cited p. 1, line 7 · confidence 0.90

Show source for fluid_accumulation

… e: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. Assessment: well nourished; no malnutrition identified.
intake_pct: 100 · cited p. 1, line 5 · confidence 0.90

Show source for intake_pct

NUTRITION ASSESSMENT (Registered Dietitian) Patient: Blake Emberly MRN: MRN63590030 Context: acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. …
muscle_loss: none · cited p. 1, line 7 · confidence 0.90

Show source for muscle_loss

… acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. Assessment: well nourished; no malnutrition identified.
nutrition_context: acute · cited p. 1, line 4 · confidence 0.95

Show source for nutrition_context

NUTRITION ASSESSMENT (Registered Dietitian) Patient: Blake Emberly MRN: MRN63590030 Context: acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle was …

Source document DOC-000240: Nutrition assessment (synthetic)

NUTRITION ASSESSMENT (Registered Dietitian)
Patient: Blake Emberly   MRN: MRN63590030

Context: acute illness
Intake: eating 100% of meals.
Weight history: weight stable over the past 3 months.
Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation.
Assessment: well nourished; no malnutrition identified.

Progress note · DOC-000242 · Dr. Priya Thorne (resident) · Mon Nov 02, 2026 06:27 PM

Source document DOC-000242: Progress note (synthetic)

PROGRESS NOTE (Resident)
Patient: Blake Emberly   MRN: MRN63590030   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Congestive heart failure: continue current management.
2. Hypoxemia: supplemental oxygen, wean as tolerated.
3. Anemia: trend hemoglobin.

Resident: Dr. Priya Thorne   Attending cosign: completed

Discharge summary · DOC-000243 · Dr. Cyrus Ellingham (attending) · Tue Nov 03, 2026 10:30 AM

Source document DOC-000243: Discharge summary (synthetic)

DISCHARGE SUMMARY
Patient: Blake Emberly   MRN: MRN63590030
Admitted 2026-10-31; discharged 2026-11-03.

Discharge diagnoses:
- congestive heart failure
- hypoxemia
- anemia
- GERD
- hypertension

Disposition: home with follow-up.