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-00101: Celeste Marlow

63F · MRN13440226 · Hospital Medicine · admitted Wed Nov 11, 2026 08:39 AM · in hospital · attending Dr. Cyrus Ellingham · 160 cm, 99.0 kg

Documented diagnoses (current)

Principal: “community-acquired pneumonia” · J18.9 Pneumonia, unspecified organism
“class 2 obesity” · E66.812 Obesity, class 2
“CKD stage 3” · N18.30 Chronic kidney disease, stage 3 unspecified
“hypoxia” · R09.02 Hypoxemia
“hypertension” · I10 Essential (primary) hypertension
“type 2 diabetes” · E11.9 Type 2 diabetes mellitus without complications

Illustrative grouping now: MS-DRG 195 Simple pneumonia and pleurisy without CC/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=1.048, t.ratio_s1=1.5, creat_rise_48h=0.08, 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=1.048, t.ratio_s3=3.0, creat_peak=1.52, 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=1.048, 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=0.08, 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=F, hgb_nadir=13.58, 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=0.0, 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=0.0, t.drop_min=1.0, prbc_units=0	false
outcome: not_anaemic	`present(hgb_nadir) and not anaemic`	hgb_nadir=13.58, anaemic=False	true

Chronic kidney disease

Criteria met

Specificity gap

Documented “CKD stage 3” (N18.30); criteria support the more specific Chronic kidney disease stage 3b (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=338, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=39.2, egfr_late=40.5	40.5
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=39.2, t.g2=60, egfr_late=40.5	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=40.5, 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=39.2, egfr_late=40.5, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=40.5, t.g2=60	false
outcome: g3a	`category == 'G3a'`	category=G3b	false
outcome: g3b	`category == 'G3b'`	category=G3b	true

Heart failure

Clinical judgement required

No gap

Not documented; only one acute indicator; acuity needs clinical judgement.

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=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=True	1
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=1, 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=1	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

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

No gap

Supported as documented (E66.812).

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=63, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=38.7, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=38.7, t.c2=35	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 “hypoxia” (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=82.0, pao2_min_ra=52.0, pf_min=248	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=82.0, t.spo2_ra=88, pao2_min_ra=52.0, t.pao2=60, pf_min=248, t.pf=300	true
derived: distress	`coalesce(rr_max >= t.rr_distress, false) or coalesce(wob_increased, false) or adv_resp_support`	rr_max=34.0, 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 met

No gap

Criteria support Sepsis (Sepsis-3); not documented (this rule does not prompt for an undocumented diagnosis).

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=37.2, t.t_hi=38, temp_min_48h=36.6, 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=34.0, 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=10.61, t.wbc_hi=12, wbc_min_48h=5.6, 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=248, adv_resp_support=False	2
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=184.0	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=0.65	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=1.52	1
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=1.45	1
derived: sofa_delta	`sofa_resp + sofa_coag + sofa_liver + sofa_cardio + sofa_cns + sofa_renal - sofa_renal_baseline`	sofa_resp=2, sofa_coag=0, sofa_liver=0, sofa_cardio=0, sofa_cns=0, sofa_renal=1, sofa_renal_baseline=1	2
derived: sepsis3	`infection_documented and sofa_delta >= t.sofa_delta`	infection_documented=True, sofa_delta=2, t.sofa_delta=2	true
derived: sepsis2	`infection_documented and sirs_count >= t.sirs_min`	infection_documented=True, 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=True, 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=True, sepsis2=False	false
outcome: sepsis3_only	`sepsis3`	sepsis3=True	true

Structured data

Labs (20)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-003450	Sun Nov 02, 2025 09:15 AM	creatinine	1.49 mg/dL
LAB-003451	Wed Oct 07, 2026 10:05 AM	creatinine	1.45 mg/dL
LAB-003455	Wed Nov 11, 2026 09:04 AM	pao2	52.0 mmHg
LAB-003456	Wed Nov 11, 2026 09:04 AM	fio2	21.0 %
LAB-003452	Wed Nov 11, 2026 09:39 AM	creatinine	1.44 mg/dL
LAB-003457	Wed Nov 11, 2026 09:39 AM	sodium	140.0 mmol/L
LAB-003460	Wed Nov 11, 2026 09:39 AM	hemoglobin	13.58 g/dL
LAB-003463	Wed Nov 11, 2026 09:39 AM	wbc	9.34 x10^3/uL
LAB-003464	Wed Nov 11, 2026 09:39 AM	platelets	282.0 x10^3/uL
LAB-003469	Wed Nov 11, 2026 09:39 AM	bilirubin	0.65 mg/dL
LAB-003453	Thu Nov 12, 2026 05:00 AM	creatinine	1.52 mg/dL
LAB-003458	Thu Nov 12, 2026 05:00 AM	sodium	142.0 mmol/L
LAB-003461	Thu Nov 12, 2026 05:00 AM	hemoglobin	13.9 g/dL
LAB-003465	Thu Nov 12, 2026 05:00 AM	wbc	10.61 x10^3/uL
LAB-003466	Thu Nov 12, 2026 05:00 AM	platelets	188.0 x10^3/uL
LAB-003454	Fri Nov 13, 2026 05:00 AM	creatinine	1.51 mg/dL
LAB-003459	Fri Nov 13, 2026 05:00 AM	sodium	138.0 mmol/L
LAB-003462	Fri Nov 13, 2026 05:00 AM	hemoglobin	13.97 g/dL
LAB-003467	Fri Nov 13, 2026 05:00 AM	wbc	5.6 x10^3/uL
LAB-003468	Fri Nov 13, 2026 05:00 AM	platelets	184.0 x10^3/uL

Vitals (49)

Vitals
Row	When	Kind	Value	Detail
VIT-009919	Wed Nov 11, 2026 08:59 AM	spo2	82.0	room air
VIT-009920	Wed Nov 11, 2026 08:59 AM	rr	34.0
VIT-009940	Wed Nov 11, 2026 08:59 AM	temp_c	36.6
VIT-009941	Wed Nov 11, 2026 08:59 AM	hr	73.0
VIT-009942	Wed Nov 11, 2026 08:59 AM	map	81.0
VIT-009943	Wed Nov 11, 2026 08:59 AM	gcs	15.0
VIT-009921	Wed Nov 11, 2026 09:09 AM	o2_lpm	5.0	nasal cannula
VIT-009922	Wed Nov 11, 2026 04:59 PM	spo2	92.0	nasal cannula
VIT-009923	Wed Nov 11, 2026 04:59 PM	rr	24.0
VIT-009924	Wed Nov 11, 2026 04:59 PM	o2_lpm	2.0	nasal cannula
VIT-009944	Wed Nov 11, 2026 04:59 PM	temp_c	36.6
VIT-009945	Wed Nov 11, 2026 04:59 PM	hr	83.0
VIT-009946	Wed Nov 11, 2026 04:59 PM	map	90.0
VIT-009947	Wed Nov 11, 2026 04:59 PM	gcs	15.0
VIT-009925	Thu Nov 12, 2026 12:59 AM	spo2	92.0	nasal cannula
VIT-009926	Thu Nov 12, 2026 12:59 AM	rr	24.0
VIT-009927	Thu Nov 12, 2026 12:59 AM	o2_lpm	3.0	nasal cannula
VIT-009948	Thu Nov 12, 2026 12:59 AM	temp_c	37.2
VIT-009949	Thu Nov 12, 2026 12:59 AM	hr	87.0
VIT-009950	Thu Nov 12, 2026 12:59 AM	map	87.0
VIT-009951	Thu Nov 12, 2026 12:59 AM	gcs	15.0
VIT-009928	Thu Nov 12, 2026 08:59 AM	spo2	91.0	nasal cannula
VIT-009929	Thu Nov 12, 2026 08:59 AM	rr	22.0
VIT-009930	Thu Nov 12, 2026 08:59 AM	o2_lpm	4.0	nasal cannula
VIT-009952	Thu Nov 12, 2026 08:59 AM	temp_c	36.9
VIT-009953	Thu Nov 12, 2026 08:59 AM	hr	76.0
VIT-009954	Thu Nov 12, 2026 08:59 AM	map	88.0
VIT-009955	Thu Nov 12, 2026 08:59 AM	gcs	15.0
VIT-009931	Thu Nov 12, 2026 04:59 PM	spo2	93.0	nasal cannula
VIT-009932	Thu Nov 12, 2026 04:59 PM	rr	20.0
VIT-009933	Thu Nov 12, 2026 04:59 PM	o2_lpm	2.0	nasal cannula
VIT-009956	Thu Nov 12, 2026 04:59 PM	temp_c	36.9
VIT-009957	Thu Nov 12, 2026 04:59 PM	hr	87.0
VIT-009958	Thu Nov 12, 2026 04:59 PM	map	77.0
VIT-009959	Thu Nov 12, 2026 04:59 PM	gcs	15.0
VIT-009934	Fri Nov 13, 2026 12:59 AM	spo2	94.0	nasal cannula
VIT-009935	Fri Nov 13, 2026 12:59 AM	rr	25.0
VIT-009936	Fri Nov 13, 2026 12:59 AM	o2_lpm	4.0	nasal cannula
VIT-009960	Fri Nov 13, 2026 12:59 AM	temp_c	36.6
VIT-009961	Fri Nov 13, 2026 12:59 AM	hr	72.0
VIT-009962	Fri Nov 13, 2026 12:59 AM	map	75.0
VIT-009963	Fri Nov 13, 2026 12:59 AM	gcs	15.0
VIT-009937	Fri Nov 13, 2026 08:59 AM	spo2	94.0	nasal cannula
VIT-009938	Fri Nov 13, 2026 08:59 AM	rr	23.0
VIT-009939	Fri Nov 13, 2026 08:59 AM	o2_lpm	4.0	nasal cannula
VIT-009964	Fri Nov 13, 2026 08:59 AM	temp_c	36.8
VIT-009965	Fri Nov 13, 2026 08:59 AM	hr	74.0
VIT-009966	Fri Nov 13, 2026 08:59 AM	map	82.0
VIT-009967	Fri Nov 13, 2026 08:59 AM	gcs	15.0

Medications, orders, echo, history (4)

MED-000394 11-11 09:39 cefepime per protocol IV
MED-000395 11-12 05:00 cefepime per protocol IV
MED-000396 11-13 05:00 piperacillin-tazobactam per protocol IV
ORD-000088 11-11 09:09 blood_culture: blood cultures x2

Notes

History and physical · DOC-000340 · Dr. Cyrus Ellingham (attending) · Wed Nov 11, 2026 11:39 AM

Cited facts from this note (1)

infection_source: multifocal pneumonia · cited p. 1, line 5 · confidence 0.85

Show source for infection_source

… Hospital Medicine Attending: Dr. Cyrus Ellingham History of present illness: 63-year-old woman admitted with community-acquired pneumonia. Chest x-ray shows multifocal pneumonia; blood cultures drawn and ceftriaxone started. Past medical history: hypertension, type 2 diabetes. Review of systems otherwise negative. Exam: Lungs: labored …

Source document DOC-000340: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Celeste Marlow   MRN: MRN13440226   Admitted: 2026-11-11 08:39
Service: Hospital Medicine   Attending: Dr. Cyrus Ellingham

History of present illness: 63-year-old woman admitted with community-acquired pneumonia. Chest x-ray shows multifocal pneumonia; blood cultures drawn and ceftriaxone started.
Past medical history: hypertension, type 2 diabetes.
Review of systems otherwise negative.
Exam: Lungs: labored respirations.
Assessment and plan:
1. Community-acquired pneumonia: antibiotics.
2. CKD stage 3: renally dose medications.

Progress note · DOC-000341 · Dr. Cyrus Ellingham (attending) · Fri Nov 13, 2026 11:55 AM

Source document DOC-000341: Progress note (synthetic)

PROGRESS NOTE (Attending)
Patient: Celeste Marlow   MRN: MRN13440226   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Community-acquired pneumonia: continue current management.
2. Class 2 obesity: counsel on weight.
3. Hypoxia: supplemental oxygen, wean as tolerated.

Attending: Dr. Cyrus Ellingham