FW: Acute on chronic respiratory failure
Oddly enough many of our recent audits have been for RESP failure and clinical indicators-or lack there-of! We call them "anti" queries (when we have to ask for clinical indicators/criteria used to support a diagnosis) So, we just recently formalized criteria with our pulm staff for resp failure criteria.
Though obviously not all are needed, we have noted from the RAC audits "they" like to see an increase % in amount of oxygen, and especially documentation of "unable to complete sentences, struggling to breath" etc. (see below). Many times we don’t do an ABG, but you have that for support as well! Hope this helps!
Criteria for Respiratory Failure
• pH less than 7.35
• pO2 less than 60
• pCO2 greater than 50
• RR greater than 29
• Use of accessory muscles
• Unable to speak in full sentences
• Cyanosis
• Increased work of breathing
• Supplemental FiO2 greater than 60%
• SpO2 less than 91% on room air
• pO2 decrease or pCO2 increase by
10 mmHg from baseline
• Intubation is not required
Juli
Juli Bovard RN CCDS
Certified Clinical Documentation Specialist
Clinical Effectiveness/Clinical Quality
Rapid City Regional Hospital
755-8426 (work)
786-2677 (cell)
"No Limit to Better......"
Though obviously not all are needed, we have noted from the RAC audits "they" like to see an increase % in amount of oxygen, and especially documentation of "unable to complete sentences, struggling to breath" etc. (see below). Many times we don’t do an ABG, but you have that for support as well! Hope this helps!
Criteria for Respiratory Failure
• pH less than 7.35
• pO2 less than 60
• pCO2 greater than 50
• RR greater than 29
• Use of accessory muscles
• Unable to speak in full sentences
• Cyanosis
• Increased work of breathing
• Supplemental FiO2 greater than 60%
• SpO2 less than 91% on room air
• pO2 decrease or pCO2 increase by
10 mmHg from baseline
• Intubation is not required
Juli
Juli Bovard RN CCDS
Certified Clinical Documentation Specialist
Clinical Effectiveness/Clinical Quality
Rapid City Regional Hospital
755-8426 (work)
786-2677 (cell)
"No Limit to Better......"