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-00176: Florian Yardley

49F · MRN74233539 · Cardiology · admitted Sat Nov 07, 2026 07:36 PM · in hospital · attending Dr. Wes Merriweather · resident Dr. Elena Nakashima · 154 cm, 51.4 kg

Documented diagnoses (current)

“CKD stage 3b” · N18.32 Chronic kidney disease, stage 3b
Principal: “heart failure” · I50.9 Heart failure, unspecified
“acute blood loss anemia” · D62 Acute posthemorrhagic anemia
“hyperlipidemia” · E78.5 Hyperlipidemia, unspecified
“GERD” · K21.9 Gastro-esophageal reflux disease without esophagitis
“hypertension” · I10 Essential (primary) hypertension

Illustrative grouping now: MS-DRG 292 Heart failure and shock with CC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 292.

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=1.057, t.ratio_s1=1.5, creat_rise_48h=0.07, 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=1.057, t.ratio_s3=3.0, creat_peak=1.86, 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=1.057, 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=0.07, 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=F, hgb_nadir=8.74, 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=3.9, 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

No gap

Supported as documented (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=339, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=34.1, egfr_late=35.0	35.0
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=34.1, t.g2=60, egfr_late=35.0	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=35.0, 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=34.1, egfr_late=35.0, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=35.0, t.g2=60	false
outcome: g3a	`category == 'G3a'`	category=G3b	false
outcome: g3b	`category == 'G3b'`	category=G3b	true

Heart failure

Clinical judgement required

Clinical judgement required: 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=40.0, t.bnp=100, ntprobnp_max=unknown, t.ntprobnp=300	false
derived: acute_count	`count(iv_loop_diuretic, np_elevated, new_o2)`	iv_loop_diuretic=True, np_elevated=False, new_o2=False	1
derived: hf_type	`case(lvef <= t.ref, 'systolic', lvef >= t.pres, 'diastolic', 'midrange')`	lvef=59.0, 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=59.0, 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=1, hf_history=True	unknown
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=unknown	false
outcome: sys_acute	`hf_type == 'systolic' and acuity == 'acute'`	hf_type=diastolic, acuity=unknown	false
outcome: sys_chronic	`hf_type == 'systolic' and acuity == 'chronic'`	hf_type=diastolic, acuity=unknown	false
outcome: dia_aoc	`hf_type == 'diastolic' and acuity == 'acute on chronic'`	hf_type=diastolic, acuity=unknown	unknown
outcome: dia_acute	`hf_type == 'diastolic' and acuity == 'acute'`	hf_type=diastolic, acuity=unknown	unknown
outcome: dia_chronic	`hf_type == 'diastolic' and acuity == 'chronic'`	hf_type=diastolic, 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=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 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=21.7, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=21.7, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=21.7, t.c1=30	false
outcome: not_met	`bmi < t.c1`	bmi=21.7, t.c1=30	true

Pressure injury

Insufficient data

No gap

Insufficient data: the criteria could not be applied.

Trace

Rule trace (rule pressure_injury v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: sacral	`wound_site == 'sacral'`	wound_site=unknown	unknown
outcome: no_wound_note	`not present(wound_stage)`	wound_stage=unknown	true

Acute respiratory failure

Criteria not met

No gap

Not documented and not supported.

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=94.0, 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=94.0, 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=20.0, 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=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=19.0, t.rr=20, paco2_min_48h=unknown, t.paco2=32	false
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=10.23, t.wbc_hi=12, wbc_min_48h=6.44, 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=False, sirs_wbc=False	0
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=250.0	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=0.52	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=76.0	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=1.83	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=1.76	1
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=1, sofa_renal_baseline=1	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=0, 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-006029	Tue Sep 23, 2025 09:15 AM	creatinine	1.8 mg/dL
LAB-006030	Fri Aug 28, 2026 10:05 AM	creatinine	1.76 mg/dL
LAB-006031	Sat Nov 07, 2026 08:36 PM	creatinine	1.76 mg/dL
LAB-006038	Sat Nov 07, 2026 08:36 PM	bnp	40.0 pg/mL
LAB-006039	Sat Nov 07, 2026 08:36 PM	sodium	136.0 mmol/L
LAB-006046	Sat Nov 07, 2026 08:36 PM	hemoglobin	12.61 g/dL
LAB-006053	Sat Nov 07, 2026 08:36 PM	wbc	6.44 x10^3/uL
LAB-006054	Sat Nov 07, 2026 08:36 PM	platelets	250.0 x10^3/uL
LAB-006067	Sat Nov 07, 2026 08:36 PM	bilirubin	0.52 mg/dL
LAB-006032	Sun Nov 08, 2026 05:00 AM	creatinine	1.8 mg/dL
LAB-006040	Sun Nov 08, 2026 05:00 AM	sodium	139.0 mmol/L
LAB-006047	Sun Nov 08, 2026 05:00 AM	hemoglobin	10.29 g/dL
LAB-006055	Sun Nov 08, 2026 05:00 AM	wbc	7.73 x10^3/uL
LAB-006056	Sun Nov 08, 2026 05:00 AM	platelets	258.0 x10^3/uL
LAB-006033	Mon Nov 09, 2026 05:00 AM	creatinine	1.83 mg/dL
LAB-006041	Mon Nov 09, 2026 05:00 AM	sodium	137.0 mmol/L
LAB-006048	Mon Nov 09, 2026 05:00 AM	hemoglobin	8.74 g/dL
LAB-006057	Mon Nov 09, 2026 05:00 AM	wbc	10.23 x10^3/uL
LAB-006058	Mon Nov 09, 2026 05:00 AM	platelets	305.0 x10^3/uL
LAB-006034	Tue Nov 10, 2026 05:00 AM	creatinine	1.86 mg/dL
LAB-006042	Tue Nov 10, 2026 05:00 AM	sodium	138.0 mmol/L
LAB-006049	Tue Nov 10, 2026 05:00 AM	hemoglobin	9.54 g/dL
LAB-006059	Tue Nov 10, 2026 05:00 AM	wbc	8.44 x10^3/uL
LAB-006060	Tue Nov 10, 2026 05:00 AM	platelets	168.0 x10^3/uL
LAB-006035	Wed Nov 11, 2026 05:00 AM	creatinine	1.82 mg/dL
LAB-006043	Wed Nov 11, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-006050	Wed Nov 11, 2026 05:00 AM	hemoglobin	9.84 g/dL
LAB-006061	Wed Nov 11, 2026 05:00 AM	wbc	5.5 x10^3/uL
LAB-006062	Wed Nov 11, 2026 05:00 AM	platelets	248.0 x10^3/uL
LAB-006036	Thu Nov 12, 2026 05:00 AM	creatinine	1.85 mg/dL
LAB-006044	Thu Nov 12, 2026 05:00 AM	sodium	142.0 mmol/L
LAB-006051	Thu Nov 12, 2026 05:00 AM	hemoglobin	9.94 g/dL
LAB-006063	Thu Nov 12, 2026 05:00 AM	wbc	7.05 x10^3/uL
LAB-006064	Thu Nov 12, 2026 05:00 AM	platelets	293.0 x10^3/uL
LAB-006037	Fri Nov 13, 2026 05:00 AM	creatinine	1.75 mg/dL
LAB-006045	Fri Nov 13, 2026 05:00 AM	sodium	139.0 mmol/L
LAB-006052	Fri Nov 13, 2026 05:00 AM	hemoglobin	9.94 g/dL
LAB-006065	Fri Nov 13, 2026 05:00 AM	wbc	8.38 x10^3/uL
LAB-006066	Fri Nov 13, 2026 05:00 AM	platelets	215.0 x10^3/uL

Vitals (108)

Vitals
Row	When	Kind	Value	Detail
VIT-017367	Sat Nov 07, 2026 07:56 PM	spo2	96.0	room air
VIT-017368	Sat Nov 07, 2026 07:56 PM	rr	16.0
VIT-017403	Sat Nov 07, 2026 07:56 PM	temp_c	36.7
VIT-017404	Sat Nov 07, 2026 07:56 PM	hr	87.0
VIT-017405	Sat Nov 07, 2026 07:56 PM	map	90.0
VIT-017406	Sat Nov 07, 2026 07:56 PM	gcs	15.0
VIT-017369	Sun Nov 08, 2026 03:56 AM	spo2	95.0	room air
VIT-017370	Sun Nov 08, 2026 03:56 AM	rr	19.0
VIT-017407	Sun Nov 08, 2026 03:56 AM	temp_c	36.6
VIT-017408	Sun Nov 08, 2026 03:56 AM	hr	78.0
VIT-017409	Sun Nov 08, 2026 03:56 AM	map	91.0
VIT-017410	Sun Nov 08, 2026 03:56 AM	gcs	15.0
VIT-017371	Sun Nov 08, 2026 11:56 AM	spo2	99.0	room air
VIT-017372	Sun Nov 08, 2026 11:56 AM	rr	15.0
VIT-017411	Sun Nov 08, 2026 11:56 AM	temp_c	36.7
VIT-017412	Sun Nov 08, 2026 11:56 AM	hr	74.0
VIT-017413	Sun Nov 08, 2026 11:56 AM	map	85.0
VIT-017414	Sun Nov 08, 2026 11:56 AM	gcs	15.0
VIT-017373	Sun Nov 08, 2026 07:56 PM	spo2	94.0	room air
VIT-017374	Sun Nov 08, 2026 07:56 PM	rr	17.0
VIT-017415	Sun Nov 08, 2026 07:56 PM	temp_c	37.3
VIT-017416	Sun Nov 08, 2026 07:56 PM	hr	68.0
VIT-017417	Sun Nov 08, 2026 07:56 PM	map	76.0
VIT-017418	Sun Nov 08, 2026 07:56 PM	gcs	15.0
VIT-017375	Mon Nov 09, 2026 03:56 AM	spo2	98.0	room air
VIT-017376	Mon Nov 09, 2026 03:56 AM	rr	16.0
VIT-017419	Mon Nov 09, 2026 03:56 AM	temp_c	37.0
VIT-017420	Mon Nov 09, 2026 03:56 AM	hr	88.0
VIT-017421	Mon Nov 09, 2026 03:56 AM	map	82.0
VIT-017422	Mon Nov 09, 2026 03:56 AM	gcs	15.0
VIT-017377	Mon Nov 09, 2026 11:56 AM	spo2	94.0	room air
VIT-017378	Mon Nov 09, 2026 11:56 AM	rr	16.0
VIT-017423	Mon Nov 09, 2026 11:56 AM	temp_c	36.7
VIT-017424	Mon Nov 09, 2026 11:56 AM	hr	73.0
VIT-017425	Mon Nov 09, 2026 11:56 AM	map	92.0
VIT-017426	Mon Nov 09, 2026 11:56 AM	gcs	15.0
VIT-017379	Mon Nov 09, 2026 07:56 PM	spo2	99.0	room air
VIT-017380	Mon Nov 09, 2026 07:56 PM	rr	14.0
VIT-017427	Mon Nov 09, 2026 07:56 PM	temp_c	37.3
VIT-017428	Mon Nov 09, 2026 07:56 PM	hr	87.0
VIT-017429	Mon Nov 09, 2026 07:56 PM	map	75.0
VIT-017430	Mon Nov 09, 2026 07:56 PM	gcs	15.0
VIT-017381	Tue Nov 10, 2026 03:56 AM	spo2	96.0	room air
VIT-017382	Tue Nov 10, 2026 03:56 AM	rr	19.0
VIT-017431	Tue Nov 10, 2026 03:56 AM	temp_c	36.5
VIT-017432	Tue Nov 10, 2026 03:56 AM	hr	68.0
VIT-017433	Tue Nov 10, 2026 03:56 AM	map	86.0
VIT-017434	Tue Nov 10, 2026 03:56 AM	gcs	15.0
VIT-017383	Tue Nov 10, 2026 11:56 AM	spo2	97.0	room air
VIT-017384	Tue Nov 10, 2026 11:56 AM	rr	15.0
VIT-017435	Tue Nov 10, 2026 11:56 AM	temp_c	37.3
VIT-017436	Tue Nov 10, 2026 11:56 AM	hr	84.0
VIT-017437	Tue Nov 10, 2026 11:56 AM	map	77.0
VIT-017438	Tue Nov 10, 2026 11:56 AM	gcs	15.0
VIT-017385	Tue Nov 10, 2026 07:56 PM	spo2	94.0	room air
VIT-017386	Tue Nov 10, 2026 07:56 PM	rr	17.0
VIT-017439	Tue Nov 10, 2026 07:56 PM	temp_c	36.6
VIT-017440	Tue Nov 10, 2026 07:56 PM	hr	84.0
VIT-017441	Tue Nov 10, 2026 07:56 PM	map	82.0
VIT-017442	Tue Nov 10, 2026 07:56 PM	gcs	15.0
VIT-017387	Wed Nov 11, 2026 03:56 AM	spo2	99.0	room air
VIT-017388	Wed Nov 11, 2026 03:56 AM	rr	14.0
VIT-017443	Wed Nov 11, 2026 03:56 AM	temp_c	37.6
VIT-017444	Wed Nov 11, 2026 03:56 AM	hr	72.0
VIT-017445	Wed Nov 11, 2026 03:56 AM	map	85.0
VIT-017446	Wed Nov 11, 2026 03:56 AM	gcs	15.0
VIT-017389	Wed Nov 11, 2026 11:56 AM	spo2	97.0	room air
VIT-017390	Wed Nov 11, 2026 11:56 AM	rr	18.0
VIT-017447	Wed Nov 11, 2026 11:56 AM	temp_c	36.9
VIT-017448	Wed Nov 11, 2026 11:56 AM	hr	86.0
VIT-017449	Wed Nov 11, 2026 11:56 AM	map	88.0
VIT-017450	Wed Nov 11, 2026 11:56 AM	gcs	15.0
VIT-017391	Wed Nov 11, 2026 07:56 PM	spo2	97.0	room air
VIT-017392	Wed Nov 11, 2026 07:56 PM	rr	17.0
VIT-017451	Wed Nov 11, 2026 07:56 PM	temp_c	36.7
VIT-017452	Wed Nov 11, 2026 07:56 PM	hr	81.0
VIT-017453	Wed Nov 11, 2026 07:56 PM	map	91.0
VIT-017454	Wed Nov 11, 2026 07:56 PM	gcs	15.0
VIT-017393	Thu Nov 12, 2026 03:56 AM	spo2	96.0	room air
VIT-017394	Thu Nov 12, 2026 03:56 AM	rr	18.0
VIT-017455	Thu Nov 12, 2026 03:56 AM	temp_c	37.6
VIT-017456	Thu Nov 12, 2026 03:56 AM	hr	73.0
VIT-017457	Thu Nov 12, 2026 03:56 AM	map	81.0
VIT-017458	Thu Nov 12, 2026 03:56 AM	gcs	15.0
VIT-017395	Thu Nov 12, 2026 11:56 AM	spo2	95.0	room air
VIT-017396	Thu Nov 12, 2026 11:56 AM	rr	16.0
VIT-017459	Thu Nov 12, 2026 11:56 AM	temp_c	37.5
VIT-017460	Thu Nov 12, 2026 11:56 AM	hr	70.0
VIT-017461	Thu Nov 12, 2026 11:56 AM	map	79.0
VIT-017462	Thu Nov 12, 2026 11:56 AM	gcs	15.0
VIT-017397	Thu Nov 12, 2026 07:56 PM	spo2	98.0	room air
VIT-017398	Thu Nov 12, 2026 07:56 PM	rr	20.0
VIT-017463	Thu Nov 12, 2026 07:56 PM	temp_c	37.5
VIT-017464	Thu Nov 12, 2026 07:56 PM	hr	74.0
VIT-017465	Thu Nov 12, 2026 07:56 PM	map	90.0
VIT-017466	Thu Nov 12, 2026 07:56 PM	gcs	15.0
VIT-017399	Fri Nov 13, 2026 03:56 AM	spo2	98.0	room air
VIT-017400	Fri Nov 13, 2026 03:56 AM	rr	19.0
VIT-017467	Fri Nov 13, 2026 03:56 AM	temp_c	37.6
VIT-017468	Fri Nov 13, 2026 03:56 AM	hr	72.0
VIT-017469	Fri Nov 13, 2026 03:56 AM	map	87.0
VIT-017470	Fri Nov 13, 2026 03:56 AM	gcs	15.0
VIT-017401	Fri Nov 13, 2026 11:56 AM	spo2	98.0	room air
VIT-017402	Fri Nov 13, 2026 11:56 AM	rr	18.0
VIT-017471	Fri Nov 13, 2026 11:56 AM	temp_c	37.0
VIT-017472	Fri Nov 13, 2026 11:56 AM	hr	85.0
VIT-017473	Fri Nov 13, 2026 11:56 AM	map	76.0
VIT-017474	Fri Nov 13, 2026 11:56 AM	gcs	15.0

Medications, orders, echo, history (4)

MED-000698 11-07 22:36 furosemide 40 mg IV
ORD-000153 11-08 09:00 transfusion_prbc: transfuse PRBC
ECH-000081 2026-11-08 echo LVEF 59.0%
HX-000062 history: heart failure with preserved ejection fraction

Notes

History and physical · DOC-000590 · Dr. Elena Nakashima (resident) · Sat Nov 07, 2026 10:36 PM

Cited facts from this note (1)

bleeding_source: black tarry stools · cited p. 1, line 5 · confidence 0.85

Show source for bleeding_source

… ervice: Cardiology Attending: Dr. Wes Merriweather History of present illness: 49-year-old woman admitted with heart failure. Hospital course complicated by black tarry stools. Past medical history: heart failure with preserved ejection fraction, hyperlipidemia, GERD, hypertension. Review of systems otherwise negative. Exam: Lungs: c …

Source document DOC-000590: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Florian Yardley   MRN: MRN74233539   Admitted: 2026-11-07 19:36
Service: Cardiology   Attending: Dr. Wes Merriweather

History of present illness: 49-year-old woman admitted with heart failure. Hospital course complicated by black tarry stools.
Past medical history: heart failure with preserved ejection fraction, hyperlipidemia, GERD, hypertension.
Review of systems otherwise negative.
Exam: Lungs: clear to auscultation bilaterally.
Assessment and plan:
1. CKD stage 3b: renally dose medications.
2. Heart failure: diuresis and daily weights; monitor electrolytes.

Progress note · DOC-000591 · Dr. Elena Nakashima (resident) · Fri Nov 13, 2026 01:55 PM · awaiting cosign

Source document DOC-000591: Progress note (synthetic)

PROGRESS NOTE (Resident)
Patient: Florian Yardley   MRN: MRN74233539   Hospital day 6

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

Resident: Dr. Elena Nakashima   Attending cosign: pending