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-00104: Gideon Whitlock

88F · MRN62687831 · Cardiology · admitted Sun Nov 08, 2026 07:24 PM · in hospital · attending Dr. Jalen Carrow · 152 cm, 58.4 kg

Documented diagnoses (current)

Principal: “acute on chronic diastolic heart failure” · I50.33 Acute on chronic diastolic (congestive) heart failure
“hypoxia” · R09.02 Hypoxemia

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 293.

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=1.038, t.ratio_s1=1.5, creat_rise_48h=0.02, 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=1.038, t.ratio_s3=3.0, creat_peak=0.54, 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=1.038, 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=0.02, 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=13.34, 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=0.1, 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=0.1, t.drop_min=1.0, prbc_units=0	false
outcome: not_anaemic	`present(hgb_nadir) and not anaemic`	hgb_nadir=13.34, 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)
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=288, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=89.7, egfr_late=89.3	89.7
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=89.7, t.g2=60, egfr_late=89.3	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=89.7, 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=89.7, egfr_late=89.3, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=89.7, t.g2=60	true

Heart failure

Criteria met

No gap

Supported as documented (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=1208.0, 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=61.0, 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=61.0, 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=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 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=136.0, 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=136.0, t.low=135, na_low_count=0, t.repeat=2, na_treated=False	false
outcome: untreated	`na_min < t.low`	na_min=136.0, t.low=135	false
outcome: not_met	`na_min >= t.low`	na_min=136.0, 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=88, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=25.3, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=25.3, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=25.3, t.c1=30	false
outcome: not_met	`bmi < t.c1`	bmi=25.3, 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

Clinical judgement required

Clinical judgement required: Hypoxaemia without a charted sign of respiratory distress.

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=85.0, 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=85.0, 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=23.0, t.rr_distress=28, wob_increased=unknown, adv_resp_support=False	false
outcome: chronic_baseline	`home_o2 and hypoxemia`	home_o2=False, hypoxemia=True	false
outcome: met	`hypoxemia and distress`	hypoxemia=True, distress=False	false
outcome: hypoxemia_only	`hypoxemia`	hypoxemia=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=36.6, t.t_lo=36	false
derived: sirs_hr	`coalesce(hr_max_48h > t.hr, false)`	hr_max_48h=86.0, 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=23.0, 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=10.55, t.wbc_hi=12, wbc_min_48h=5.88, 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=179.0	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=0.91	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=74.0	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=0.52	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=0.52	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=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 (34)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-003528	Sat Dec 20, 2025 09:15 AM	creatinine	0.51 mg/dL
LAB-003529	Mon Oct 05, 2026 10:05 AM	creatinine	0.52 mg/dL
LAB-003530	Sun Nov 08, 2026 08:24 PM	creatinine	0.51 mg/dL
LAB-003536	Sun Nov 08, 2026 08:24 PM	bnp	1208.0 pg/mL
LAB-003537	Sun Nov 08, 2026 08:24 PM	sodium	139.0 mmol/L
LAB-003543	Sun Nov 08, 2026 08:24 PM	hemoglobin	13.37 g/dL
LAB-003549	Sun Nov 08, 2026 08:24 PM	wbc	7.47 x10^3/uL
LAB-003550	Sun Nov 08, 2026 08:24 PM	platelets	304.0 x10^3/uL
LAB-003561	Sun Nov 08, 2026 08:24 PM	bilirubin	0.91 mg/dL
LAB-003531	Mon Nov 09, 2026 05:00 AM	creatinine	0.52 mg/dL
LAB-003538	Mon Nov 09, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-003544	Mon Nov 09, 2026 05:00 AM	hemoglobin	13.48 g/dL
LAB-003551	Mon Nov 09, 2026 05:00 AM	wbc	10.55 x10^3/uL
LAB-003552	Mon Nov 09, 2026 05:00 AM	platelets	213.0 x10^3/uL
LAB-003532	Tue Nov 10, 2026 05:00 AM	creatinine	0.52 mg/dL
LAB-003539	Tue Nov 10, 2026 05:00 AM	sodium	138.0 mmol/L
LAB-003545	Tue Nov 10, 2026 05:00 AM	hemoglobin	13.34 g/dL
LAB-003553	Tue Nov 10, 2026 05:00 AM	wbc	5.88 x10^3/uL
LAB-003554	Tue Nov 10, 2026 05:00 AM	platelets	179.0 x10^3/uL
LAB-003533	Wed Nov 11, 2026 05:00 AM	creatinine	0.53 mg/dL
LAB-003540	Wed Nov 11, 2026 05:00 AM	sodium	138.0 mmol/L
LAB-003546	Wed Nov 11, 2026 05:00 AM	hemoglobin	13.49 g/dL
LAB-003555	Wed Nov 11, 2026 05:00 AM	wbc	5.8 x10^3/uL
LAB-003556	Wed Nov 11, 2026 05:00 AM	platelets	302.0 x10^3/uL
LAB-003534	Thu Nov 12, 2026 05:00 AM	creatinine	0.54 mg/dL
LAB-003541	Thu Nov 12, 2026 05:00 AM	sodium	136.0 mmol/L
LAB-003547	Thu Nov 12, 2026 05:00 AM	hemoglobin	13.64 g/dL
LAB-003557	Thu Nov 12, 2026 05:00 AM	wbc	9.66 x10^3/uL
LAB-003558	Thu Nov 12, 2026 05:00 AM	platelets	306.0 x10^3/uL
LAB-003535	Fri Nov 13, 2026 05:00 AM	creatinine	0.51 mg/dL
LAB-003542	Fri Nov 13, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-003548	Fri Nov 13, 2026 05:00 AM	hemoglobin	13.63 g/dL
LAB-003559	Fri Nov 13, 2026 05:00 AM	wbc	9.94 x10^3/uL
LAB-003560	Fri Nov 13, 2026 05:00 AM	platelets	171.0 x10^3/uL

Vitals (104)

Vitals
Row	When	Kind	Value	Detail
VIT-010137	Sun Nov 08, 2026 07:44 PM	spo2	85.0	room air
VIT-010138	Sun Nov 08, 2026 07:44 PM	rr	23.0
VIT-010181	Sun Nov 08, 2026 07:44 PM	temp_c	37.4
VIT-010182	Sun Nov 08, 2026 07:44 PM	hr	80.0
VIT-010183	Sun Nov 08, 2026 07:44 PM	map	74.0
VIT-010184	Sun Nov 08, 2026 07:44 PM	gcs	15.0
VIT-010139	Mon Nov 09, 2026 03:44 AM	spo2	92.0	nasal cannula
VIT-010140	Mon Nov 09, 2026 03:44 AM	rr	19.0
VIT-010141	Mon Nov 09, 2026 03:44 AM	o2_lpm	2.0	nasal cannula
VIT-010185	Mon Nov 09, 2026 03:44 AM	temp_c	37.1
VIT-010186	Mon Nov 09, 2026 03:44 AM	hr	73.0
VIT-010187	Mon Nov 09, 2026 03:44 AM	map	84.0
VIT-010188	Mon Nov 09, 2026 03:44 AM	gcs	15.0
VIT-010142	Mon Nov 09, 2026 11:44 AM	spo2	94.0	nasal cannula
VIT-010143	Mon Nov 09, 2026 11:44 AM	rr	22.0
VIT-010144	Mon Nov 09, 2026 11:44 AM	o2_lpm	2.0	nasal cannula
VIT-010189	Mon Nov 09, 2026 11:44 AM	temp_c	36.8
VIT-010190	Mon Nov 09, 2026 11:44 AM	hr	78.0
VIT-010191	Mon Nov 09, 2026 11:44 AM	map	85.0
VIT-010192	Mon Nov 09, 2026 11:44 AM	gcs	15.0
VIT-010145	Mon Nov 09, 2026 07:44 PM	spo2	95.0	nasal cannula
VIT-010146	Mon Nov 09, 2026 07:44 PM	rr	21.0
VIT-010147	Mon Nov 09, 2026 07:44 PM	o2_lpm	2.0	nasal cannula
VIT-010193	Mon Nov 09, 2026 07:44 PM	temp_c	37.4
VIT-010194	Mon Nov 09, 2026 07:44 PM	hr	72.0
VIT-010195	Mon Nov 09, 2026 07:44 PM	map	87.0
VIT-010196	Mon Nov 09, 2026 07:44 PM	gcs	15.0
VIT-010148	Tue Nov 10, 2026 03:44 AM	spo2	96.0	nasal cannula
VIT-010149	Tue Nov 10, 2026 03:44 AM	rr	18.0
VIT-010150	Tue Nov 10, 2026 03:44 AM	o2_lpm	2.0	nasal cannula
VIT-010197	Tue Nov 10, 2026 03:44 AM	temp_c	36.7
VIT-010198	Tue Nov 10, 2026 03:44 AM	hr	71.0
VIT-010199	Tue Nov 10, 2026 03:44 AM	map	75.0
VIT-010200	Tue Nov 10, 2026 03:44 AM	gcs	15.0
VIT-010151	Tue Nov 10, 2026 11:44 AM	spo2	96.0	nasal cannula
VIT-010152	Tue Nov 10, 2026 11:44 AM	rr	18.0
VIT-010153	Tue Nov 10, 2026 11:44 AM	o2_lpm	2.0	nasal cannula
VIT-010201	Tue Nov 10, 2026 11:44 AM	temp_c	36.6
VIT-010202	Tue Nov 10, 2026 11:44 AM	hr	86.0
VIT-010203	Tue Nov 10, 2026 11:44 AM	map	91.0
VIT-010204	Tue Nov 10, 2026 11:44 AM	gcs	15.0
VIT-010154	Tue Nov 10, 2026 07:44 PM	spo2	92.0	nasal cannula
VIT-010155	Tue Nov 10, 2026 07:44 PM	rr	22.0
VIT-010156	Tue Nov 10, 2026 07:44 PM	o2_lpm	2.0	nasal cannula
VIT-010205	Tue Nov 10, 2026 07:44 PM	temp_c	37.1
VIT-010206	Tue Nov 10, 2026 07:44 PM	hr	92.0
VIT-010207	Tue Nov 10, 2026 07:44 PM	map	84.0
VIT-010208	Tue Nov 10, 2026 07:44 PM	gcs	15.0
VIT-010157	Wed Nov 11, 2026 03:44 AM	spo2	95.0	nasal cannula
VIT-010158	Wed Nov 11, 2026 03:44 AM	rr	19.0
VIT-010159	Wed Nov 11, 2026 03:44 AM	o2_lpm	2.0	nasal cannula
VIT-010209	Wed Nov 11, 2026 03:44 AM	temp_c	37.0
VIT-010210	Wed Nov 11, 2026 03:44 AM	hr	71.0
VIT-010211	Wed Nov 11, 2026 03:44 AM	map	85.0
VIT-010212	Wed Nov 11, 2026 03:44 AM	gcs	15.0
VIT-010160	Wed Nov 11, 2026 11:44 AM	spo2	96.0	nasal cannula
VIT-010161	Wed Nov 11, 2026 11:44 AM	rr	23.0
VIT-010162	Wed Nov 11, 2026 11:44 AM	o2_lpm	2.0	nasal cannula
VIT-010213	Wed Nov 11, 2026 11:44 AM	temp_c	37.0
VIT-010214	Wed Nov 11, 2026 11:44 AM	hr	69.0
VIT-010215	Wed Nov 11, 2026 11:44 AM	map	81.0
VIT-010216	Wed Nov 11, 2026 11:44 AM	gcs	15.0
VIT-010163	Wed Nov 11, 2026 07:44 PM	spo2	94.0	nasal cannula
VIT-010164	Wed Nov 11, 2026 07:44 PM	rr	22.0
VIT-010165	Wed Nov 11, 2026 07:44 PM	o2_lpm	2.0	nasal cannula
VIT-010217	Wed Nov 11, 2026 07:44 PM	temp_c	37.3
VIT-010218	Wed Nov 11, 2026 07:44 PM	hr	91.0
VIT-010219	Wed Nov 11, 2026 07:44 PM	map	91.0
VIT-010220	Wed Nov 11, 2026 07:44 PM	gcs	15.0
VIT-010166	Thu Nov 12, 2026 03:44 AM	spo2	94.0	nasal cannula
VIT-010167	Thu Nov 12, 2026 03:44 AM	rr	19.0
VIT-010168	Thu Nov 12, 2026 03:44 AM	o2_lpm	2.0	nasal cannula
VIT-010221	Thu Nov 12, 2026 03:44 AM	temp_c	36.5
VIT-010222	Thu Nov 12, 2026 03:44 AM	hr	71.0
VIT-010223	Thu Nov 12, 2026 03:44 AM	map	83.0
VIT-010224	Thu Nov 12, 2026 03:44 AM	gcs	15.0
VIT-010169	Thu Nov 12, 2026 11:44 AM	spo2	92.0	nasal cannula
VIT-010170	Thu Nov 12, 2026 11:44 AM	rr	22.0
VIT-010171	Thu Nov 12, 2026 11:44 AM	o2_lpm	2.0	nasal cannula
VIT-010225	Thu Nov 12, 2026 11:44 AM	temp_c	36.7
VIT-010226	Thu Nov 12, 2026 11:44 AM	hr	90.0
VIT-010227	Thu Nov 12, 2026 11:44 AM	map	82.0
VIT-010228	Thu Nov 12, 2026 11:44 AM	gcs	15.0
VIT-010172	Thu Nov 12, 2026 07:44 PM	spo2	92.0	nasal cannula
VIT-010173	Thu Nov 12, 2026 07:44 PM	rr	20.0
VIT-010174	Thu Nov 12, 2026 07:44 PM	o2_lpm	2.0	nasal cannula
VIT-010229	Thu Nov 12, 2026 07:44 PM	temp_c	36.6
VIT-010230	Thu Nov 12, 2026 07:44 PM	hr	80.0
VIT-010231	Thu Nov 12, 2026 07:44 PM	map	92.0
VIT-010232	Thu Nov 12, 2026 07:44 PM	gcs	15.0
VIT-010175	Fri Nov 13, 2026 03:44 AM	spo2	93.0	nasal cannula
VIT-010176	Fri Nov 13, 2026 03:44 AM	rr	22.0
VIT-010177	Fri Nov 13, 2026 03:44 AM	o2_lpm	2.0	nasal cannula
VIT-010233	Fri Nov 13, 2026 03:44 AM	temp_c	36.7
VIT-010234	Fri Nov 13, 2026 03:44 AM	hr	77.0
VIT-010235	Fri Nov 13, 2026 03:44 AM	map	81.0
VIT-010236	Fri Nov 13, 2026 03:44 AM	gcs	15.0
VIT-010178	Fri Nov 13, 2026 11:44 AM	spo2	95.0	nasal cannula
VIT-010179	Fri Nov 13, 2026 11:44 AM	rr	23.0
VIT-010180	Fri Nov 13, 2026 11:44 AM	o2_lpm	2.0	nasal cannula
VIT-010237	Fri Nov 13, 2026 11:44 AM	temp_c	37.4
VIT-010238	Fri Nov 13, 2026 11:44 AM	hr	77.0
VIT-010239	Fri Nov 13, 2026 11:44 AM	map	92.0
VIT-010240	Fri Nov 13, 2026 11:44 AM	gcs	15.0

Medications, orders, echo, history (8)

MED-000403 11-08 08:00 furosemide 40 mg IV
MED-000404 11-08 20:00 furosemide 40 mg IV
MED-000405 11-09 08:00 furosemide 40 mg IV
MED-000406 11-09 20:00 furosemide 40 mg IV
MED-000407 11-10 08:00 furosemide 40 mg IV
MED-000408 11-10 20:00 furosemide 40 mg IV
ECH-000049 2026-11-09 echo LVEF 61.0%
HX-000039 history: heart failure with preserved ejection fraction

Notes

History and physical · DOC-000350 · Dr. Jalen Carrow (attending) · Sun Nov 08, 2026 10:24 PM

Source document DOC-000350: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Gideon Whitlock   MRN: MRN62687831   Admitted: 2026-11-08 19:24
Service: Cardiology   Attending: Dr. Jalen Carrow

History of present illness: 88-year-old woman admitted with acute on chronic diastolic heart failure. 
Past medical history: heart failure with preserved ejection fraction.
Review of systems otherwise negative.
Exam: Lungs: clear to auscultation bilaterally.
Assessment and plan:
1. Acute on chronic diastolic heart failure: diuresis and daily weights; monitor electrolytes.

Nutrition assessment · DOC-000349 · Dario Larkspur, RD (dietitian) · Mon Nov 09, 2026 11:24 PM

Cited facts from this note (5)

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

Show source for fat_loss

… MRN: MRN62687831 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: Gideon Whitlock MRN: MRN62687831 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: Gideon Whitlock MRN: MRN62687831 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-000349: Nutrition assessment (synthetic)

NUTRITION ASSESSMENT (Registered Dietitian)
Patient: Gideon Whitlock   MRN: MRN62687831

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-000351 · Dr. Jalen Carrow (attending) · Fri Nov 13, 2026 03:55 PM

Source document DOC-000351: Progress note (synthetic)

PROGRESS NOTE (Attending)
Patient: Gideon Whitlock   MRN: MRN62687831   Hospital day 5

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Acute on chronic diastolic heart failure: continue current management.
2. Hypoxia: supplemental oxygen, wean as tolerated.

Attending: Dr. Jalen Carrow