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-00131: Quinn Yardley

49M · MRN29630531 · Cardiology · admitted Mon Oct 26, 2026 09:17 PM · discharged Sun Nov 01, 2026 11:20 AM · attending Dr. Jalen Carrow · resident Dr. Keira Upfield · 168 cm, 78.9 kg

Documented diagnoses (current)

Principal: “heart failure” · I50.9 Heart failure, unspecified
“acute hypoxic respiratory failure” · J96.01 Acute respiratory failure with hypoxia
“acute blood loss anemia” · D62 Acute posthemorrhagic anemia
“hypertension” · I10 Essential (primary) hypertension
“type 2 diabetes” · E11.9 Type 2 diabetes mellitus without complications

Illustrative grouping now: MS-DRG 291 Heart failure and shock with 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 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=1.058, 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=1.058, t.ratio_s3=3.0, creat_peak=1.1, 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=1.058, 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 met

No gap

Supported as documented (D62).

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=10.05, 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=3.6, t.drop_major=2.0, prbc_units=2, t.prbc_major=2	true
outcome: met	`bleeding_documented and anaemic and acute_fall`	bleeding_documented=True, anaemic=True, acute_fall=True	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=250, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=90.1, egfr_late=88.0	90.1
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=90.1, t.g2=60, egfr_late=88.0	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=90.1, 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=90.1, egfr_late=88.0, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=90.1, t.g2=60	true

Heart failure

Criteria met

Specificity gap

Documented “heart failure” (I50.9); criteria support the more specific Acute on chronic systolic (HFrEF) heart failure (I50.23).

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=1712.0, 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=27.0, t.ref=40, t.pres=50	systolic
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=27.0, 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=systolic	false
outcome: sys_aoc	`hf_type == 'systolic' and acuity == 'acute on chronic'`	hf_type=systolic, 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=124.0, 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=124.0, 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 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=49, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=28.0, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=28.0, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=28.0, t.c1=30	false
outcome: not_met	`bmi < t.c1`	bmi=28.0, t.c1=30	true

Pressure injury

Insufficient data

No gap

Insufficient data: the criteria could not be applied.

Trace

Rule trace (rule pressure_injury v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
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=87.0, 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=87.0, 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=37.5, t.t_hi=38, temp_min_48h=36.8, t.t_lo=36	false
derived: sirs_hr	`coalesce(hr_max_48h > t.hr, false)`	hr_max_48h=88.0, t.hr=90	false
derived: sirs_rr	`coalesce(rr_max_48h > t.rr, false) or coalesce(paco2_min_48h < t.paco2, false)`	rr_max_48h=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=10.69, t.wbc_hi=12, wbc_min_48h=9.41, 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=186.0	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=0.53	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=1.07	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=1.04	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 (39)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-004464	Mon Oct 27, 2025 09:15 AM	creatinine	1.02 mg/dL
LAB-004465	Sat Jul 04, 2026 10:05 AM	creatinine	1.04 mg/dL
LAB-004466	Mon Oct 26, 2026 10:17 PM	creatinine	1.07 mg/dL
LAB-004473	Mon Oct 26, 2026 10:17 PM	bnp	1712.0 pg/mL
LAB-004474	Mon Oct 26, 2026 10:17 PM	sodium	126.0 mmol/L
LAB-004481	Mon Oct 26, 2026 10:17 PM	hemoglobin	13.63 g/dL
LAB-004488	Mon Oct 26, 2026 10:17 PM	wbc	10.69 x10^3/uL
LAB-004489	Mon Oct 26, 2026 10:17 PM	platelets	300.0 x10^3/uL
LAB-004502	Mon Oct 26, 2026 10:17 PM	bilirubin	0.53 mg/dL
LAB-004467	Tue Oct 27, 2026 05:00 AM	creatinine	1.06 mg/dL
LAB-004475	Tue Oct 27, 2026 05:00 AM	sodium	124.0 mmol/L
LAB-004482	Tue Oct 27, 2026 05:00 AM	hemoglobin	11.48 g/dL
LAB-004490	Tue Oct 27, 2026 05:00 AM	wbc	10.07 x10^3/uL
LAB-004491	Tue Oct 27, 2026 05:00 AM	platelets	242.0 x10^3/uL
LAB-004468	Wed Oct 28, 2026 05:00 AM	creatinine	1.02 mg/dL
LAB-004476	Wed Oct 28, 2026 05:00 AM	sodium	125.0 mmol/L
LAB-004483	Wed Oct 28, 2026 05:00 AM	hemoglobin	10.05 g/dL
LAB-004492	Wed Oct 28, 2026 05:00 AM	wbc	9.41 x10^3/uL
LAB-004493	Wed Oct 28, 2026 05:00 AM	platelets	186.0 x10^3/uL
LAB-004469	Thu Oct 29, 2026 05:00 AM	creatinine	1.05 mg/dL
LAB-004477	Thu Oct 29, 2026 05:00 AM	sodium	128.0 mmol/L
LAB-004484	Thu Oct 29, 2026 05:00 AM	hemoglobin	10.85 g/dL
LAB-004494	Thu Oct 29, 2026 05:00 AM	wbc	8.53 x10^3/uL
LAB-004495	Thu Oct 29, 2026 05:00 AM	platelets	214.0 x10^3/uL
LAB-004470	Fri Oct 30, 2026 05:00 AM	creatinine	1.04 mg/dL
LAB-004478	Fri Oct 30, 2026 05:00 AM	sodium	130.0 mmol/L
LAB-004485	Fri Oct 30, 2026 05:00 AM	hemoglobin	11.15 g/dL
LAB-004496	Fri Oct 30, 2026 05:00 AM	wbc	7.76 x10^3/uL
LAB-004497	Fri Oct 30, 2026 05:00 AM	platelets	190.0 x10^3/uL
LAB-004471	Sat Oct 31, 2026 05:00 AM	creatinine	1.06 mg/dL
LAB-004479	Sat Oct 31, 2026 05:00 AM	sodium	134.0 mmol/L
LAB-004486	Sat Oct 31, 2026 05:00 AM	hemoglobin	11.25 g/dL
LAB-004498	Sat Oct 31, 2026 05:00 AM	wbc	6.26 x10^3/uL
LAB-004499	Sat Oct 31, 2026 05:00 AM	platelets	180.0 x10^3/uL
LAB-004472	Sun Nov 01, 2026 05:00 AM	creatinine	1.1 mg/dL
LAB-004480	Sun Nov 01, 2026 05:00 AM	sodium	136.0 mmol/L
LAB-004487	Sun Nov 01, 2026 05:00 AM	hemoglobin	11.25 g/dL
LAB-004500	Sun Nov 01, 2026 05:00 AM	wbc	7.46 x10^3/uL
LAB-004501	Sun Nov 01, 2026 05:00 AM	platelets	211.0 x10^3/uL

Vitals (118)

Vitals
Row	When	Kind	Value	Detail
VIT-012815	Mon Oct 26, 2026 09:37 PM	spo2	87.0	room air
VIT-012816	Mon Oct 26, 2026 09:37 PM	rr	21.0
VIT-012865	Mon Oct 26, 2026 09:37 PM	temp_c	37.5
VIT-012866	Mon Oct 26, 2026 09:37 PM	hr	70.0
VIT-012867	Mon Oct 26, 2026 09:37 PM	map	74.0
VIT-012868	Mon Oct 26, 2026 09:37 PM	gcs	15.0
VIT-012817	Tue Oct 27, 2026 05:37 AM	spo2	93.0	nasal cannula
VIT-012818	Tue Oct 27, 2026 05:37 AM	rr	21.0
VIT-012819	Tue Oct 27, 2026 05:37 AM	o2_lpm	2.0	nasal cannula
VIT-012869	Tue Oct 27, 2026 05:37 AM	temp_c	36.8
VIT-012870	Tue Oct 27, 2026 05:37 AM	hr	84.0
VIT-012871	Tue Oct 27, 2026 05:37 AM	map	83.0
VIT-012872	Tue Oct 27, 2026 05:37 AM	gcs	15.0
VIT-012820	Tue Oct 27, 2026 01:37 PM	spo2	96.0	nasal cannula
VIT-012821	Tue Oct 27, 2026 01:37 PM	rr	19.0
VIT-012822	Tue Oct 27, 2026 01:37 PM	o2_lpm	2.0	nasal cannula
VIT-012873	Tue Oct 27, 2026 01:37 PM	temp_c	36.8
VIT-012874	Tue Oct 27, 2026 01:37 PM	hr	81.0
VIT-012875	Tue Oct 27, 2026 01:37 PM	map	92.0
VIT-012876	Tue Oct 27, 2026 01:37 PM	gcs	15.0
VIT-012823	Tue Oct 27, 2026 09:37 PM	spo2	95.0	nasal cannula
VIT-012824	Tue Oct 27, 2026 09:37 PM	rr	23.0
VIT-012825	Tue Oct 27, 2026 09:37 PM	o2_lpm	2.0	nasal cannula
VIT-012877	Tue Oct 27, 2026 09:37 PM	temp_c	36.8
VIT-012878	Tue Oct 27, 2026 09:37 PM	hr	76.0
VIT-012879	Tue Oct 27, 2026 09:37 PM	map	90.0
VIT-012880	Tue Oct 27, 2026 09:37 PM	gcs	15.0
VIT-012826	Wed Oct 28, 2026 05:37 AM	spo2	96.0	nasal cannula
VIT-012827	Wed Oct 28, 2026 05:37 AM	rr	23.0
VIT-012828	Wed Oct 28, 2026 05:37 AM	o2_lpm	2.0	nasal cannula
VIT-012881	Wed Oct 28, 2026 05:37 AM	temp_c	37.3
VIT-012882	Wed Oct 28, 2026 05:37 AM	hr	83.0
VIT-012883	Wed Oct 28, 2026 05:37 AM	map	81.0
VIT-012884	Wed Oct 28, 2026 05:37 AM	gcs	15.0
VIT-012829	Wed Oct 28, 2026 01:37 PM	spo2	94.0	nasal cannula
VIT-012830	Wed Oct 28, 2026 01:37 PM	rr	22.0
VIT-012831	Wed Oct 28, 2026 01:37 PM	o2_lpm	2.0	nasal cannula
VIT-012885	Wed Oct 28, 2026 01:37 PM	temp_c	37.1
VIT-012886	Wed Oct 28, 2026 01:37 PM	hr	88.0
VIT-012887	Wed Oct 28, 2026 01:37 PM	map	87.0
VIT-012888	Wed Oct 28, 2026 01:37 PM	gcs	15.0
VIT-012832	Wed Oct 28, 2026 09:37 PM	spo2	92.0	nasal cannula
VIT-012833	Wed Oct 28, 2026 09:37 PM	rr	22.0
VIT-012834	Wed Oct 28, 2026 09:37 PM	o2_lpm	2.0	nasal cannula
VIT-012889	Wed Oct 28, 2026 09:37 PM	temp_c	37.1
VIT-012890	Wed Oct 28, 2026 09:37 PM	hr	78.0
VIT-012891	Wed Oct 28, 2026 09:37 PM	map	85.0
VIT-012892	Wed Oct 28, 2026 09:37 PM	gcs	15.0
VIT-012835	Thu Oct 29, 2026 05:37 AM	spo2	94.0	nasal cannula
VIT-012836	Thu Oct 29, 2026 05:37 AM	rr	23.0
VIT-012837	Thu Oct 29, 2026 05:37 AM	o2_lpm	2.0	nasal cannula
VIT-012893	Thu Oct 29, 2026 05:37 AM	temp_c	37.3
VIT-012894	Thu Oct 29, 2026 05:37 AM	hr	76.0
VIT-012895	Thu Oct 29, 2026 05:37 AM	map	89.0
VIT-012896	Thu Oct 29, 2026 05:37 AM	gcs	15.0
VIT-012838	Thu Oct 29, 2026 01:37 PM	spo2	96.0	nasal cannula
VIT-012839	Thu Oct 29, 2026 01:37 PM	rr	19.0
VIT-012840	Thu Oct 29, 2026 01:37 PM	o2_lpm	2.0	nasal cannula
VIT-012897	Thu Oct 29, 2026 01:37 PM	temp_c	37.0
VIT-012898	Thu Oct 29, 2026 01:37 PM	hr	77.0
VIT-012899	Thu Oct 29, 2026 01:37 PM	map	77.0
VIT-012900	Thu Oct 29, 2026 01:37 PM	gcs	15.0
VIT-012841	Thu Oct 29, 2026 09:37 PM	spo2	96.0	nasal cannula
VIT-012842	Thu Oct 29, 2026 09:37 PM	rr	22.0
VIT-012843	Thu Oct 29, 2026 09:37 PM	o2_lpm	2.0	nasal cannula
VIT-012901	Thu Oct 29, 2026 09:37 PM	temp_c	36.6
VIT-012902	Thu Oct 29, 2026 09:37 PM	hr	69.0
VIT-012903	Thu Oct 29, 2026 09:37 PM	map	78.0
VIT-012904	Thu Oct 29, 2026 09:37 PM	gcs	15.0
VIT-012844	Fri Oct 30, 2026 05:37 AM	spo2	96.0	nasal cannula
VIT-012845	Fri Oct 30, 2026 05:37 AM	rr	19.0
VIT-012846	Fri Oct 30, 2026 05:37 AM	o2_lpm	2.0	nasal cannula
VIT-012905	Fri Oct 30, 2026 05:37 AM	temp_c	37.1
VIT-012906	Fri Oct 30, 2026 05:37 AM	hr	78.0
VIT-012907	Fri Oct 30, 2026 05:37 AM	map	86.0
VIT-012908	Fri Oct 30, 2026 05:37 AM	gcs	15.0
VIT-012847	Fri Oct 30, 2026 01:37 PM	spo2	92.0	nasal cannula
VIT-012848	Fri Oct 30, 2026 01:37 PM	rr	20.0
VIT-012849	Fri Oct 30, 2026 01:37 PM	o2_lpm	2.0	nasal cannula
VIT-012909	Fri Oct 30, 2026 01:37 PM	temp_c	36.9
VIT-012910	Fri Oct 30, 2026 01:37 PM	hr	84.0
VIT-012911	Fri Oct 30, 2026 01:37 PM	map	92.0
VIT-012912	Fri Oct 30, 2026 01:37 PM	gcs	15.0
VIT-012850	Fri Oct 30, 2026 09:37 PM	spo2	96.0	nasal cannula
VIT-012851	Fri Oct 30, 2026 09:37 PM	rr	19.0
VIT-012852	Fri Oct 30, 2026 09:37 PM	o2_lpm	2.0	nasal cannula
VIT-012913	Fri Oct 30, 2026 09:37 PM	temp_c	36.7
VIT-012914	Fri Oct 30, 2026 09:37 PM	hr	81.0
VIT-012915	Fri Oct 30, 2026 09:37 PM	map	82.0
VIT-012916	Fri Oct 30, 2026 09:37 PM	gcs	15.0
VIT-012853	Sat Oct 31, 2026 05:37 AM	spo2	94.0	nasal cannula
VIT-012854	Sat Oct 31, 2026 05:37 AM	rr	20.0
VIT-012855	Sat Oct 31, 2026 05:37 AM	o2_lpm	2.0	nasal cannula
VIT-012917	Sat Oct 31, 2026 05:37 AM	temp_c	37.5
VIT-012918	Sat Oct 31, 2026 05:37 AM	hr	90.0
VIT-012919	Sat Oct 31, 2026 05:37 AM	map	90.0
VIT-012920	Sat Oct 31, 2026 05:37 AM	gcs	15.0
VIT-012856	Sat Oct 31, 2026 01:37 PM	spo2	95.0	nasal cannula
VIT-012857	Sat Oct 31, 2026 01:37 PM	rr	20.0
VIT-012858	Sat Oct 31, 2026 01:37 PM	o2_lpm	2.0	nasal cannula
VIT-012921	Sat Oct 31, 2026 01:37 PM	temp_c	37.4
VIT-012922	Sat Oct 31, 2026 01:37 PM	hr	73.0
VIT-012923	Sat Oct 31, 2026 01:37 PM	map	77.0
VIT-012924	Sat Oct 31, 2026 01:37 PM	gcs	15.0
VIT-012859	Sat Oct 31, 2026 09:37 PM	spo2	94.0	nasal cannula
VIT-012860	Sat Oct 31, 2026 09:37 PM	rr	23.0
VIT-012861	Sat Oct 31, 2026 09:37 PM	o2_lpm	2.0	nasal cannula
VIT-012925	Sat Oct 31, 2026 09:37 PM	temp_c	37.0
VIT-012926	Sat Oct 31, 2026 09:37 PM	hr	90.0
VIT-012927	Sat Oct 31, 2026 09:37 PM	map	91.0
VIT-012928	Sat Oct 31, 2026 09:37 PM	gcs	15.0
VIT-012862	Sun Nov 01, 2026 05:37 AM	spo2	93.0	nasal cannula
VIT-012863	Sun Nov 01, 2026 05:37 AM	rr	19.0
VIT-012864	Sun Nov 01, 2026 05:37 AM	o2_lpm	2.0	nasal cannula
VIT-012929	Sun Nov 01, 2026 05:37 AM	temp_c	37.4
VIT-012930	Sun Nov 01, 2026 05:37 AM	hr	85.0
VIT-012931	Sun Nov 01, 2026 05:37 AM	map	76.0
VIT-012932	Sun Nov 01, 2026 05:37 AM	gcs	15.0

Medications, orders, echo, history (11)

MED-000509 10-26 08:00 furosemide 40 mg IV
MED-000510 10-26 20:00 furosemide 40 mg IV
MED-000511 10-27 08:00 furosemide 40 mg IV
MED-000512 10-27 20:00 furosemide 40 mg IV
MED-000513 10-28 08:00 furosemide 40 mg IV
MED-000514 10-28 20:00 furosemide 40 mg IV
MED-000515 10-27 01:17 sodium chloride 3% 100 mL IV
ORD-000113 10-27 00:17 fluid_restriction: fluid restriction 1.2 L/day
ORD-000114 10-27 09:00 transfusion_prbc: transfuse PRBC
ECH-000062 2026-10-27 echo LVEF 27.0%
HX-000048 history: heart failure with reduced ejection fraction

Notes

History and physical · DOC-000442 · Dr. Keira Upfield (resident) · Tue Oct 27, 2026 12:17 AM

Cited facts from this note (1)

bleeding_source: bright red blood per rectum · cited p. 1, line 5 · confidence 0.85

Show source for bleeding_source

… 1:17 Service: Cardiology Attending: Dr. Jalen Carrow History of present illness: 49-year-old man admitted with heart failure. Hospital course complicated by bright red blood per rectum. Past medical history: heart failure with reduced ejection fraction, hypertension, type 2 diabetes. Review of systems otherwise negative. Exam: Lungs: clear to …

Source document DOC-000442: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Quinn Yardley   MRN: MRN29630531   Admitted: 2026-10-26 21:17
Service: Cardiology   Attending: Dr. Jalen Carrow

History of present illness: 49-year-old man admitted with heart failure. Hospital course complicated by bright red blood per rectum.
Past medical history: heart failure with reduced ejection fraction, hypertension, type 2 diabetes.
Review of systems otherwise negative.
Exam: Lungs: clear to auscultation bilaterally.
Assessment and plan:
1. Heart failure: diuresis and daily weights; monitor electrolytes.

Progress note · DOC-000443 · Dr. Keira Upfield (resident) · Wed Oct 28, 2026 11:17 PM

Source document DOC-000443: Progress note (synthetic)

PROGRESS NOTE (Resident)
Patient: Quinn Yardley   MRN: MRN29630531   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Heart failure: continue current management.
2. Acute hypoxic respiratory failure: supplemental oxygen, wean as tolerated.
3. Acute blood loss anemia: trend hemoglobin, transfuse if needed.

Resident: Dr. Keira Upfield   Attending cosign: completed

Discharge summary · DOC-000444 · Dr. Jalen Carrow (attending) · Sun Nov 01, 2026 11:20 AM

Source document DOC-000444: Discharge summary (synthetic)

DISCHARGE SUMMARY
Patient: Quinn Yardley   MRN: MRN29630531
Admitted 2026-10-26; discharged 2026-11-01.

Discharge diagnoses:
- heart failure
- acute hypoxic respiratory failure
- acute blood loss anemia
- hypertension
- type 2 diabetes

Disposition: home with follow-up.