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-00137: Silas Dunmore

62M · MRN45069000 · Hospital Medicine · admitted Sat Nov 07, 2026 12:09 PM · in hospital · attending Dr. Wes Merriweather · resident Dr. Noor Halvorsen · 174 cm, 136.9 kg

Documented diagnoses (current)

Principal: “community-acquired pneumonia” · J18.9 Pneumonia, unspecified organism
“chronic kidney disease” · N18.9 Chronic kidney disease, unspecified
“acute respiratory failure with hypoxia” · J96.01 Acute respiratory failure with hypoxia
“acute blood loss anemia” · D62 Acute posthemorrhagic anemia
“type 2 diabetes” · E11.9 Type 2 diabetes mellitus without complications
“GERD” · K21.9 Gastro-esophageal reflux disease without esophagitis

Illustrative grouping now: MS-DRG 193 Simple pneumonia and pleurisy with MCC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 194.

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=1.051, 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=1.051, t.ratio_s3=3.0, creat_peak=2.28, 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=1.051, 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 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=9.39, 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=3.4, 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

Criteria met

Specificity gap

Documented “chronic kidney disease” (N18.9); 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=240, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=38.7, egfr_late=33.6	38.7
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=38.7, t.g2=60, egfr_late=33.6	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=38.7, 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=38.7, egfr_late=33.6, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=38.7, t.g2=60	false
outcome: g3a	`category == 'G3a'`	category=G3b	false
outcome: g3b	`category == 'G3b'`	category=G3b	true

Heart failure

Insufficient data

No gap

Insufficient data: the criteria could not be applied.

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=False	0
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=0, 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=0	false

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

Insufficient data

No gap

Insufficient data: the criteria could not be applied.

Trace

Rule trace (rule malnutrition v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: a_sev_intake	`intake_pct <= t.a_sev_intake_pct and intake_days >= t.a_sev_intake_days`	intake_pct=unknown, t.a_sev_intake_pct=50, intake_days=unknown, t.a_sev_intake_days=5	unknown
derived: a_mod_intake	`intake_pct < t.a_mod_intake_pct and intake_days > t.a_mod_intake_days`	intake_pct=unknown, t.a_mod_intake_pct=75, intake_days=unknown, t.a_mod_intake_days=7	unknown
derived: a_sev_wt	`(wt_loss_days <= 7 and wt_loss_pct > 2) or (wt_loss_days <= 31 and wt_loss_pct > 5) or (wt_loss_days <= 92 and wt_loss_pct > 7.5)`	wt_loss_days=unknown, wt_loss_pct=unknown	unknown
derived: a_mod_wt	`(wt_loss_days <= 7 and wt_loss_pct >= 1) or (wt_loss_days <= 31 and wt_loss_pct >= 5) or (wt_loss_days <= 92 and wt_loss_pct >= 7.5)`	wt_loss_days=unknown, wt_loss_pct=unknown	unknown
derived: c_sev_intake	`intake_pct <= t.c_intake_pct and intake_days >= t.c_intake_days`	intake_pct=unknown, t.c_intake_pct=75, intake_days=unknown, t.c_intake_days=30	unknown
derived: c_mod_intake	`intake_pct < t.c_intake_pct and intake_days >= t.c_intake_days`	intake_pct=unknown, t.c_intake_pct=75, intake_days=unknown, t.c_intake_days=30	unknown
derived: c_sev_wt	`(wt_loss_days <= 31 and wt_loss_pct > 5) or (wt_loss_days <= 92 and wt_loss_pct > 7.5) or (wt_loss_days <= 183 and wt_loss_pct > 10) or (wt_loss_days <= 366 and wt_loss_pct > 20)`	wt_loss_days=unknown, wt_loss_pct=unknown	unknown
derived: c_mod_wt	`(wt_loss_days <= 31 and wt_loss_pct >= 5) or (wt_loss_days <= 92 and wt_loss_pct >= 7.5) or (wt_loss_days <= 183 and wt_loss_pct >= 10) or (wt_loss_days <= 366 and wt_loss_pct >= 20)`	wt_loss_days=unknown, wt_loss_pct=unknown	unknown
derived: n_assessed	`known(intake_pct, wt_loss_pct, fat_loss, muscle_loss, fluid, grip_reduced)`	intake_pct=unknown, wt_loss_pct=unknown, fat_loss=unknown, muscle_loss=unknown, fluid=unknown, grip_reduced=unknown	0
derived: n_severe	`case(nutr_context == 'acute', count(a_sev_intake, a_sev_wt, fat_loss >= 2, muscle_loss >= 2, fluid >= 2, grip_reduced), nutr_context == 'chronic', count(c_sev_intake, c_sev_wt, fat_loss >= 3, muscle_loss >= 3, fluid >= 3, grip_reduced), null)`	nutr_context=unknown, a_sev_intake=unknown, a_sev_wt=unknown, fat_loss=unknown, muscle_loss=unknown, fluid=unknown, grip_reduced=unknown, c_sev_intake=unknown, c_sev_wt=unknown	unknown
derived: n_moderate	`case(nutr_context == 'acute', count(a_sev_intake or a_mod_intake, a_sev_wt or a_mod_wt, fat_loss >= 1, muscle_loss >= 1, fluid >= 1, grip_reduced), nutr_context == 'chronic', count(c_sev_intake or c_mod_intake, c_sev_wt or c_mod_wt, fat_loss >= 1, muscle_loss >= 1, fluid >= 1, grip_reduced), null)`	nutr_context=unknown, a_sev_intake=unknown, a_mod_intake=unknown, a_sev_wt=unknown, a_mod_wt=unknown, fat_loss=unknown, muscle_loss=unknown, fluid=unknown, grip_reduced=unknown, c_sev_intake=unknown, c_mod_intake=unknown, c_sev_wt=unknown, c_mod_wt=unknown	unknown
outcome: severe	`n_severe >= 2`	n_severe=unknown	unknown
outcome: moderate	`n_moderate >= 2`	n_moderate=unknown	unknown
outcome: one_characteristic	`n_moderate == 1`	n_moderate=unknown	unknown
outcome: not_met	`n_moderate == 0 and n_assessed >= 2`	n_moderate=unknown, n_assessed=0	false

Obesity

Criteria met

Specificity gap

Criteria support Obesity, class 3 (E66.813); no corresponding diagnosis is documented.

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=62, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=45.2, t.c3=40	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 not met

Clinical validation gap

Documented “acute respiratory failure with hypoxia” (J96.01) but the criteria are not met: No hypoxaemia on room air (lowest SpO2 93%), oxygen no more than 0 L/min, no advanced support.

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=93.0, 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=93.0, t.spo2_ra=88, pao2_min_ra=unknown, t.pao2=60, pf_min=unknown, t.pf=300	false
derived: distress	`coalesce(rr_max >= t.rr_distress, false) or coalesce(wob_increased, false) or adv_resp_support`	rr_max=21.0, t.rr_distress=28, wob_increased=unknown, adv_resp_support=False	false
outcome: chronic_baseline	`home_o2 and hypoxemia`	home_o2=False, hypoxemia=False	false
outcome: met	`hypoxemia and distress`	hypoxemia=False, distress=False	false
outcome: hypoxemia_only	`hypoxemia`	hypoxemia=False	false
outcome: not_met	`measured and not hypoxemia and o2_max_lpm <= t.o2_low and not adv_resp_support`	measured=True, hypoxemia=False, o2_max_lpm=0.0, t.o2_low=2, adv_resp_support=False	true

Sepsis

Criteria not met

No gap

Not documented and not supported.

Trace

Rule trace (rule sepsis v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: sirs_temp	`coalesce(temp_max_48h > t.t_hi, false) or coalesce(temp_min_48h < t.t_lo, false)`	temp_max_48h=37.3, 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=79.0, 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=21.0, 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=9.14, t.wbc_hi=12, wbc_min_48h=7.77, 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=210.0	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=0.6	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=81.0	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=2.28	2
derived: sofa_renal_baseline	`coalesce(case(creat_baseline >= 5, 4, creat_baseline >= 3.5, 3, creat_baseline >= 2, 2, creat_baseline >= 1.2, 1, 0), 0)`	creat_baseline=2.17	2
derived: sofa_delta	`sofa_resp + sofa_coag + sofa_liver + sofa_cardio + sofa_cns + sofa_renal - sofa_renal_baseline`	sofa_resp=0, sofa_coag=0, sofa_liver=0, sofa_cardio=0, sofa_cns=0, sofa_renal=2, sofa_renal_baseline=2	0
derived: sepsis3	`infection_documented and sofa_delta >= t.sofa_delta`	infection_documented=True, sofa_delta=0, t.sofa_delta=2	false
derived: sepsis2	`infection_documented and sirs_count >= t.sirs_min`	infection_documented=True, sirs_count=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=True	false
outcome: septic_shock	`shock`	shock=False	false
outcome: both	`sepsis3 and sepsis2`	sepsis3=False, sepsis2=False	false
outcome: sepsis3_only	`sepsis3`	sepsis3=False	false
outcome: definitions_disagree	`sepsis2`	sepsis2=False	false
outcome: neither	`true`	—	true

Structured data

Labs (38)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-004665	Thu Dec 04, 2025 09:15 AM	creatinine	1.93 mg/dL
LAB-004666	Sun Aug 02, 2026 10:05 AM	creatinine	2.17 mg/dL
LAB-004667	Sat Nov 07, 2026 01:09 PM	creatinine	2.2 mg/dL
LAB-004674	Sat Nov 07, 2026 01:09 PM	sodium	140.0 mmol/L
LAB-004681	Sat Nov 07, 2026 01:09 PM	hemoglobin	12.82 g/dL
LAB-004688	Sat Nov 07, 2026 01:09 PM	wbc	8.93 x10^3/uL
LAB-004689	Sat Nov 07, 2026 01:09 PM	platelets	233.0 x10^3/uL
LAB-004702	Sat Nov 07, 2026 01:09 PM	bilirubin	0.6 mg/dL
LAB-004668	Sun Nov 08, 2026 05:00 AM	creatinine	2.28 mg/dL
LAB-004675	Sun Nov 08, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-004682	Sun Nov 08, 2026 05:00 AM	hemoglobin	10.76 g/dL
LAB-004690	Sun Nov 08, 2026 05:00 AM	wbc	9.14 x10^3/uL
LAB-004691	Sun Nov 08, 2026 05:00 AM	platelets	221.0 x10^3/uL
LAB-004669	Mon Nov 09, 2026 05:00 AM	creatinine	2.2 mg/dL
LAB-004676	Mon Nov 09, 2026 05:00 AM	sodium	139.0 mmol/L
LAB-004683	Mon Nov 09, 2026 05:00 AM	hemoglobin	9.39 g/dL
LAB-004692	Mon Nov 09, 2026 05:00 AM	wbc	7.77 x10^3/uL
LAB-004693	Mon Nov 09, 2026 05:00 AM	platelets	210.0 x10^3/uL
LAB-004670	Tue Nov 10, 2026 05:00 AM	creatinine	2.23 mg/dL
LAB-004677	Tue Nov 10, 2026 05:00 AM	sodium	141.0 mmol/L
LAB-004684	Tue Nov 10, 2026 05:00 AM	hemoglobin	10.19 g/dL
LAB-004694	Tue Nov 10, 2026 05:00 AM	wbc	7.24 x10^3/uL
LAB-004695	Tue Nov 10, 2026 05:00 AM	platelets	275.0 x10^3/uL
LAB-004671	Wed Nov 11, 2026 05:00 AM	creatinine	2.27 mg/dL
LAB-004678	Wed Nov 11, 2026 05:00 AM	sodium	136.0 mmol/L
LAB-004685	Wed Nov 11, 2026 05:00 AM	hemoglobin	10.49 g/dL
LAB-004696	Wed Nov 11, 2026 05:00 AM	wbc	7.87 x10^3/uL
LAB-004697	Wed Nov 11, 2026 05:00 AM	platelets	255.0 x10^3/uL
LAB-004672	Thu Nov 12, 2026 05:00 AM	creatinine	2.15 mg/dL
LAB-004679	Thu Nov 12, 2026 05:00 AM	sodium	139.0 mmol/L
LAB-004686	Thu Nov 12, 2026 05:00 AM	hemoglobin	10.59 g/dL
LAB-004698	Thu Nov 12, 2026 05:00 AM	wbc	6.28 x10^3/uL
LAB-004699	Thu Nov 12, 2026 05:00 AM	platelets	259.0 x10^3/uL
LAB-004673	Fri Nov 13, 2026 05:00 AM	creatinine	2.18 mg/dL
LAB-004680	Fri Nov 13, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-004687	Fri Nov 13, 2026 05:00 AM	hemoglobin	10.59 g/dL
LAB-004700	Fri Nov 13, 2026 05:00 AM	wbc	7.11 x10^3/uL
LAB-004701	Fri Nov 13, 2026 05:00 AM	platelets	220.0 x10^3/uL

Vitals (114)

Vitals
Row	When	Kind	Value	Detail
VIT-013398	Sat Nov 07, 2026 12:29 PM	spo2	95.0	room air
VIT-013399	Sat Nov 07, 2026 12:29 PM	rr	21.0
VIT-013436	Sat Nov 07, 2026 12:29 PM	temp_c	37.0
VIT-013437	Sat Nov 07, 2026 12:29 PM	hr	76.0
VIT-013438	Sat Nov 07, 2026 12:29 PM	map	81.0
VIT-013439	Sat Nov 07, 2026 12:29 PM	gcs	15.0
VIT-013400	Sat Nov 07, 2026 08:29 PM	spo2	93.0	room air
VIT-013401	Sat Nov 07, 2026 08:29 PM	rr	21.0
VIT-013440	Sat Nov 07, 2026 08:29 PM	temp_c	36.6
VIT-013441	Sat Nov 07, 2026 08:29 PM	hr	77.0
VIT-013442	Sat Nov 07, 2026 08:29 PM	map	92.0
VIT-013443	Sat Nov 07, 2026 08:29 PM	gcs	15.0
VIT-013402	Sun Nov 08, 2026 04:29 AM	spo2	96.0	room air
VIT-013403	Sun Nov 08, 2026 04:29 AM	rr	16.0
VIT-013444	Sun Nov 08, 2026 04:29 AM	temp_c	36.9
VIT-013445	Sun Nov 08, 2026 04:29 AM	hr	79.0
VIT-013446	Sun Nov 08, 2026 04:29 AM	map	81.0
VIT-013447	Sun Nov 08, 2026 04:29 AM	gcs	15.0
VIT-013404	Sun Nov 08, 2026 12:29 PM	spo2	93.0	room air
VIT-013405	Sun Nov 08, 2026 12:29 PM	rr	19.0
VIT-013448	Sun Nov 08, 2026 12:29 PM	temp_c	37.3
VIT-013449	Sun Nov 08, 2026 12:29 PM	hr	77.0
VIT-013450	Sun Nov 08, 2026 12:29 PM	map	84.0
VIT-013451	Sun Nov 08, 2026 12:29 PM	gcs	15.0
VIT-013406	Sun Nov 08, 2026 08:29 PM	spo2	95.0	room air
VIT-013407	Sun Nov 08, 2026 08:29 PM	rr	21.0
VIT-013452	Sun Nov 08, 2026 08:29 PM	temp_c	37.2
VIT-013453	Sun Nov 08, 2026 08:29 PM	hr	78.0
VIT-013454	Sun Nov 08, 2026 08:29 PM	map	87.0
VIT-013455	Sun Nov 08, 2026 08:29 PM	gcs	15.0
VIT-013408	Mon Nov 09, 2026 04:29 AM	spo2	93.0	room air
VIT-013409	Mon Nov 09, 2026 04:29 AM	rr	20.0
VIT-013456	Mon Nov 09, 2026 04:29 AM	temp_c	37.1
VIT-013457	Mon Nov 09, 2026 04:29 AM	hr	77.0
VIT-013458	Mon Nov 09, 2026 04:29 AM	map	85.0
VIT-013459	Mon Nov 09, 2026 04:29 AM	gcs	15.0
VIT-013410	Mon Nov 09, 2026 12:29 PM	spo2	95.0	room air
VIT-013411	Mon Nov 09, 2026 12:29 PM	rr	16.0
VIT-013460	Mon Nov 09, 2026 12:29 PM	temp_c	37.6
VIT-013461	Mon Nov 09, 2026 12:29 PM	hr	69.0
VIT-013462	Mon Nov 09, 2026 12:29 PM	map	74.0
VIT-013463	Mon Nov 09, 2026 12:29 PM	gcs	15.0
VIT-013412	Mon Nov 09, 2026 08:29 PM	spo2	97.0	room air
VIT-013413	Mon Nov 09, 2026 08:29 PM	rr	20.0
VIT-013464	Mon Nov 09, 2026 08:29 PM	temp_c	37.0
VIT-013465	Mon Nov 09, 2026 08:29 PM	hr	77.0
VIT-013466	Mon Nov 09, 2026 08:29 PM	map	76.0
VIT-013467	Mon Nov 09, 2026 08:29 PM	gcs	15.0
VIT-013414	Tue Nov 10, 2026 04:29 AM	spo2	96.0	room air
VIT-013415	Tue Nov 10, 2026 04:29 AM	rr	20.0
VIT-013468	Tue Nov 10, 2026 04:29 AM	temp_c	37.1
VIT-013469	Tue Nov 10, 2026 04:29 AM	hr	79.0
VIT-013470	Tue Nov 10, 2026 04:29 AM	map	76.0
VIT-013471	Tue Nov 10, 2026 04:29 AM	gcs	15.0
VIT-013416	Tue Nov 10, 2026 12:29 PM	spo2	93.0	room air
VIT-013417	Tue Nov 10, 2026 12:29 PM	rr	16.0
VIT-013472	Tue Nov 10, 2026 12:29 PM	temp_c	37.4
VIT-013473	Tue Nov 10, 2026 12:29 PM	hr	86.0
VIT-013474	Tue Nov 10, 2026 12:29 PM	map	76.0
VIT-013475	Tue Nov 10, 2026 12:29 PM	gcs	15.0
VIT-013418	Tue Nov 10, 2026 08:29 PM	spo2	93.0	room air
VIT-013419	Tue Nov 10, 2026 08:29 PM	rr	20.0
VIT-013476	Tue Nov 10, 2026 08:29 PM	temp_c	37.6
VIT-013477	Tue Nov 10, 2026 08:29 PM	hr	92.0
VIT-013478	Tue Nov 10, 2026 08:29 PM	map	79.0
VIT-013479	Tue Nov 10, 2026 08:29 PM	gcs	15.0
VIT-013420	Wed Nov 11, 2026 04:29 AM	spo2	94.0	room air
VIT-013421	Wed Nov 11, 2026 04:29 AM	rr	18.0
VIT-013480	Wed Nov 11, 2026 04:29 AM	temp_c	36.5
VIT-013481	Wed Nov 11, 2026 04:29 AM	hr	82.0
VIT-013482	Wed Nov 11, 2026 04:29 AM	map	76.0
VIT-013483	Wed Nov 11, 2026 04:29 AM	gcs	15.0
VIT-013422	Wed Nov 11, 2026 12:29 PM	spo2	94.0	room air
VIT-013423	Wed Nov 11, 2026 12:29 PM	rr	16.0
VIT-013484	Wed Nov 11, 2026 12:29 PM	temp_c	36.5
VIT-013485	Wed Nov 11, 2026 12:29 PM	hr	78.0
VIT-013486	Wed Nov 11, 2026 12:29 PM	map	82.0
VIT-013487	Wed Nov 11, 2026 12:29 PM	gcs	15.0
VIT-013424	Wed Nov 11, 2026 08:29 PM	spo2	93.0	room air
VIT-013425	Wed Nov 11, 2026 08:29 PM	rr	21.0
VIT-013488	Wed Nov 11, 2026 08:29 PM	temp_c	37.3
VIT-013489	Wed Nov 11, 2026 08:29 PM	hr	91.0
VIT-013490	Wed Nov 11, 2026 08:29 PM	map	90.0
VIT-013491	Wed Nov 11, 2026 08:29 PM	gcs	15.0
VIT-013426	Thu Nov 12, 2026 04:29 AM	spo2	96.0	room air
VIT-013427	Thu Nov 12, 2026 04:29 AM	rr	20.0
VIT-013492	Thu Nov 12, 2026 04:29 AM	temp_c	37.2
VIT-013493	Thu Nov 12, 2026 04:29 AM	hr	69.0
VIT-013494	Thu Nov 12, 2026 04:29 AM	map	80.0
VIT-013495	Thu Nov 12, 2026 04:29 AM	gcs	15.0
VIT-013428	Thu Nov 12, 2026 12:29 PM	spo2	96.0	room air
VIT-013429	Thu Nov 12, 2026 12:29 PM	rr	16.0
VIT-013496	Thu Nov 12, 2026 12:29 PM	temp_c	36.8
VIT-013497	Thu Nov 12, 2026 12:29 PM	hr	68.0
VIT-013498	Thu Nov 12, 2026 12:29 PM	map	90.0
VIT-013499	Thu Nov 12, 2026 12:29 PM	gcs	15.0
VIT-013430	Thu Nov 12, 2026 08:29 PM	spo2	95.0	room air
VIT-013431	Thu Nov 12, 2026 08:29 PM	rr	21.0
VIT-013500	Thu Nov 12, 2026 08:29 PM	temp_c	36.7
VIT-013501	Thu Nov 12, 2026 08:29 PM	hr	68.0
VIT-013502	Thu Nov 12, 2026 08:29 PM	map	90.0
VIT-013503	Thu Nov 12, 2026 08:29 PM	gcs	15.0
VIT-013432	Fri Nov 13, 2026 04:29 AM	spo2	97.0	room air
VIT-013433	Fri Nov 13, 2026 04:29 AM	rr	17.0
VIT-013504	Fri Nov 13, 2026 04:29 AM	temp_c	36.8
VIT-013505	Fri Nov 13, 2026 04:29 AM	hr	89.0
VIT-013506	Fri Nov 13, 2026 04:29 AM	map	75.0
VIT-013507	Fri Nov 13, 2026 04:29 AM	gcs	15.0
VIT-013434	Fri Nov 13, 2026 12:29 PM	spo2	93.0	room air
VIT-013435	Fri Nov 13, 2026 12:29 PM	rr	17.0
VIT-013508	Fri Nov 13, 2026 12:29 PM	temp_c	36.7
VIT-013509	Fri Nov 13, 2026 12:29 PM	hr	81.0
VIT-013510	Fri Nov 13, 2026 12:29 PM	map	86.0
VIT-013511	Fri Nov 13, 2026 12:29 PM	gcs	15.0

Medications, orders, echo, history (5)

MED-000537 11-07 13:09 piperacillin-tazobactam per protocol IV
MED-000538 11-08 05:00 piperacillin-tazobactam per protocol IV
MED-000539 11-09 05:00 piperacillin-tazobactam per protocol IV
ORD-000121 11-07 12:39 blood_culture: blood cultures x2
ORD-000122 11-08 09:00 transfusion_prbc: transfuse PRBC

Notes

History and physical · DOC-000464 · Dr. Noor Halvorsen (resident) · Sat Nov 07, 2026 03:09 PM

Cited facts from this note (2)

bleeding_source: bleeding from the surgical drain · cited p. 1, line 5 · confidence 0.85

Show source for bleeding_source

… d with community-acquired pneumonia. Chest x-ray shows right lower lobe pneumonia; blood cultures drawn and ceftriaxone started. Hospital course complicated by bleeding from the surgical drain. Past medical history: type 2 diabetes, GERD. Review of systems otherwise negative. Exam: Lungs: clear to auscultation bilaterally. Assessment and plan: 1. Com …
infection_source: right lower lobe pneumonia · cited p. 1, line 5 · confidence 0.85

Show source for infection_source

… Hospital Medicine Attending: Dr. Wes Merriweather History of present illness: 62-year-old man admitted with community-acquired pneumonia. Chest x-ray shows right lower lobe pneumonia; blood cultures drawn and ceftriaxone started. Hospital course complicated by bleeding from the surgical drain. Past medical history: type 2 diabetes, GERD. Re …

Source document DOC-000464: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Silas Dunmore   MRN: MRN45069000   Admitted: 2026-11-07 12:09
Service: Hospital Medicine   Attending: Dr. Wes Merriweather

History of present illness: 62-year-old man admitted with community-acquired pneumonia. Chest x-ray shows right lower lobe pneumonia; blood cultures drawn and ceftriaxone started. Hospital course complicated by bleeding from the surgical drain.
Past medical history: type 2 diabetes, GERD.
Review of systems otherwise negative.
Exam: Lungs: clear to auscultation bilaterally.
Assessment and plan:
1. Community-acquired pneumonia: antibiotics.
2. Chronic kidney disease: renally dose medications.

Progress note · DOC-000465 · Dr. Noor Halvorsen (resident) · Fri Nov 13, 2026 12:55 PM · awaiting cosign

Source document DOC-000465: Progress note (synthetic)

PROGRESS NOTE (Resident)
Patient: Silas Dunmore   MRN: MRN45069000   Hospital day 7

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

Resident: Dr. Noor Halvorsen   Attending cosign: pending