Screening and diagnosis

Classification and risk stratification

Perioperative care

Quality improvement

Patient education

Nonpharmacologic interventions

Therapeutic procedures

Respiratory support

Follow-up and surveillance

Specific circumstances

Preventative measures

Medical management

Surgical interventions

Inpatient care

Diagnostic procedures

Diagnostic investigations

Insufficient evidence to make a recommendation.

Strongly favor this test or intervention.

The American Society of Anesthesiologists score (ASA score) is a preoperative assessment tool used to evaluate a patient's overall health status prior to undergoing anesthesia for surgery. It is applicable to all patients who are scheduled for surgery, regardless of their age or type of surgery. 

The ASA score is used to predict perioperative risks and potential complications, helping clinicians to plan appropriate anesthetic management and postoperative care. It ranges from ASA I (a healthy patient) to ASA VI (a declared brain-dead patient whose organs are being removed for donor purposes). 

There are no specific exclusion criteria for the ASA score, but it should be noted that it is a subjective assessment and may vary between clinicians. It does not take into account the type or complexity of the surgery, and it is not designed to predict long-term prognosis or survival.

American Society of Anesthesiologists score (ASA score)

# Description:
The American Society of Anesthesiologists score (ASA score) is a preoperative assessment tool used to evaluate a patient's overall health status prior to undergoing anesthesia for surgery. It is applicable to all patients who are scheduled for surgery, regardless of their age or type of surgery. 

The ASA score is used to predict perioperative risks and potential complications, helping clinicians to plan appropriate anesthetic management and postoperative care. It ranges from ASA I (a healthy patient) to ASA VI (a declared brain-dead patient whose organs are being removed for donor purposes). 

There are no specific exclusion criteria for the ASA score, but it should be noted that it is a subjective assessment and may vary between clinicians. It does not take into account the type or complexity of the surgery, and it is not designed to predict long-term prognosis or survival.
---
# Inputs:
## Description
A. Absence of systemic disease
B. Mild systemic disease without functional limitations
C. Moderate systemic disease with functional limitations
D. Severe systemic disease that is a constant threat to life
E. A moribund patient who is not expected to survive without the operation
F. Brain-dead patient whose organs are being removed for donor purposes

## Emergency surgery
G. No
H. Yes
---
# Scoring:
- If A and G, then ASA 1
- If A and H, then ASA 1E
- If B and G, then ASA 2
- If B and H, then ASA 2E
- If C and G, then ASA 3
- If C and H, then ASA 3E
- If D and G, then ASA 4
- If D and H, then ASA 4E
- If E and G, then ASA 5
- If E and H, then ASA 5E
- If F and G, then ASA 6
- If F and H, then ASA 6E
- If true, then Please make a selection)

The 4 A's Test, also known as the 4AT, is a clinical calculator used for delirium screening in patients. It is applicable to a wide range of patient populations, particularly those in acute hospital settings, intensive care units, and long-term care facilities. The 4AT is designed to quickly and accurately identify patients who may be suffering from delirium, a common and serious cognitive disorder. The test assesses four areas: alertness, AMT4 (a brief memory test), attention, and acute change or fluctuating course. The 4AT is particularly useful because it does not require any special training to administer and can be completed in under 2 minutes. There are no specific exclusion criteria for its use, making it a versatile tool for healthcare professionals.

4 'A's Test (4AT) for delirium screening

# Description:
The 4 A's Test, also known as the 4AT, is a clinical calculator used for delirium screening in patients. It is applicable to a wide range of patient populations, particularly those in acute hospital settings, intensive care units, and long-term care facilities. The 4AT is designed to quickly and accurately identify patients who may be suffering from delirium, a common and serious cognitive disorder. The test assesses four areas: alertness, AMT4 (a brief memory test), attention, and acute change or fluctuating course. The 4AT is particularly useful because it does not require any special training to administer and can be completed in under 2 minutes. There are no specific exclusion criteria for its use, making it a versatile tool for healthcare professionals.
---
# Inputs:
## Alertness
A. Normal (+0)
B. Mild sleepiness for < 10 seconds after waking, then normal (+0)
C. Clearly abnormal (+4)

## AMT 4 (ask to state age, date of birth, name of the hospital or place, current year)
D. No mistakes (+0)
E. 1 mistake (+1)
F. >= 2 mistakes or untestable (+2)

## Attention (ask to list months in reverse order, starting from December)
G. List >= 7 months (+0)
H. Starts but lists < 7 months or refuses to start (+1)
I. Untestable or cannot start because unwell (+2)

## Acute change or fluctuating course (within the last 2 weeks and still persisting in the last 24 hours)
K. No (+0)
L. Yes (+4)
---
# Scoring:
- If score == 0, then Delirium or severe cognitive impairment unlikely
- If score == 1, then Possible cognitive impairment
- If score == 2, then Possible cognitive impairment
- If score == 3, then Possible cognitive impairment
- If score >= 4, then Possible delirium and/or cognitive impairment)

The Richmond Agitation-Sedation Scale (RASS) is a clinical tool used primarily in intensive care units (ICUs) to assess the level of sedation and agitation in patients. It is particularly useful in monitoring the sedation status of mechanically ventilated patients, helping to guide sedation therapy and ensure optimal patient comfort without over-sedation. The RASS score ranges from -5 (indicating unarousable sedation) to +4 (indicating combative agitation). It is not applicable to patients who are not in an ICU setting or those who are not at risk of over- or under-sedation.

Richmond Agitation-Sedation Scale (RASS)

# Description:
The Richmond Agitation-Sedation Scale (RASS) is a clinical tool used primarily in intensive care units (ICUs) to assess the level of sedation and agitation in patients. It is particularly useful in monitoring the sedation status of mechanically ventilated patients, helping to guide sedation therapy and ensure optimal patient comfort without over-sedation. The RASS score ranges from -5 (indicating unarousable sedation) to +4 (indicating combative agitation). It is not applicable to patients who are not in an ICU setting or those who are not at risk of over- or under-sedation.
---
# Inputs:
## Patient description
A. Combative: overtly combative or violent; immediate danger to staff
B. Very agitated: pulls on or removes tube(s) or catheter(s) or has aggressive behavior
toward staff
C. Agitated: frequent non-purposeful movement or patient-ventilator dyssynchrony
D. Restless: anxious or apprehensive, but movements not aggressive or vigorous
E. Alert and calm
F. Drowsy: not fully alert, but has sustained (> 10 seconds) awakening, with eye contact, to voice
G. Light sedation: briefly (< 10 seconds) awakens with eye contact to voice
H. Moderate sedation: any movement (but no eye contact) to voice
I. Deep sedation: no response to voice, but any movement to physical stimulation
J. Unarousable sedation: no response to voice or physical stimulation
---
# Scoring:
- If A, then RASS +4
- If B, then RASS +3
- If C, then RASS +2
- If D, then RASS +1
- If E, then RASS 0
- If F, then RASS -1
- If G, then RASS -2
- If H, then RASS -3
- If I, then RASS -4
- If J, then RASS -5
- If true, then Please make a selection)

The Charlson Comorbidity Index (CCI) is a clinical calculator used to predict the ten-year mortality for a patient who may have a range of comorbid conditions. Each condition is assigned a score of 1, 2, 3, or 6, depending on the risk of dying associated with each one. Conditions include heart disease, AIDS, and cancer among others. The scores are summed to provide a total score to predict mortality. 

This calculator is applicable to a wide range of patients, particularly those with multiple comorbid conditions. It is often used in research settings to control for the confounding effect of comorbidities. 

The CCI is not recommended for use in patients without any comorbid conditions, as the score would be zero and not provide any additional prognostic information. It also may not be as accurate in populations with conditions not included in the original index, or in those with very high levels of comorbidity.

Charlson Comorbidity Index (CCI)

# Description:
The Charlson Comorbidity Index (CCI) is a clinical calculator used to predict the ten-year mortality for a patient who may have a range of comorbid conditions. Each condition is assigned a score of 1, 2, 3, or 6, depending on the risk of dying associated with each one. Conditions include heart disease, AIDS, and cancer among others. The scores are summed to provide a total score to predict mortality. 

This calculator is applicable to a wide range of patients, particularly those with multiple comorbid conditions. It is often used in research settings to control for the confounding effect of comorbidities. 

The CCI is not recommended for use in patients without any comorbid conditions, as the score would be zero and not provide any additional prognostic information. It also may not be as accurate in populations with conditions not included in the original index, or in those with very high levels of comorbidity.
---
# Inputs:
## Age
A. < 50 years (+0)
B. 50-59 years (+1)
C. 60-69 years (+2)
D. 70-79 years (+3)
E. >= 80 years (+4)

## Myocardial infarction
F. Yes (+1)
G. No (+0)

## Congestive heart failure
H. Yes (+1)
I. No (+0)

## Peripheral vascular disease
J. Yes (+1)
K. No (+0)

## Cerebrovascular disease
L. Yes (+1)
M. No (+0)

## Dementia
N. Yes (+1)
O. No (+0)

## Chronic pulmonary disease
P. Yes (+1)
Q. No (+0)

## Connective tissue disease
R. Yes (+1)
S. No (+0)

## Ulcer disease
T. Yes (+1)
U. No (+0)

## Liver disease
V. None (+0)
W. Mild (chronic hepatitis/cirrhosis without portal hypertension) (+1)
X. Moderate to severe (cirrhosis and portal hypertension with or without variceal bleeding) (+3)

## Diabetes mellitus
Y. None (+0)
Z. Uncomplicated (+1)
AA. End-organ damage (+2)

## Hemiplegia
AB. Yes (+2)
AC. No (+0)

## Moderate to severe chronic kidney disease 
AD. Yes (+2)
AE. No (+0)

## Solid tumor
AF. None (+0)
AG. Localized (+2)
AH. Metastatic (+6)

## Leukemia
AI. Yes (+2)
AJ. No (+0)

## Lymphoma
AK. Yes (+2)
AL. No (+0)

## AIDS
AM. Yes (+6)
AN. No (+0)
---
# Scoring:
- If score == 0, then Estimated 10-year survival is 98%
- If score == 1, then Estimated 10-year survival is 96%
- If score == 2, then Estimated 10-year survival is 90%
- If score == 3, then Estimated 10-year survival is 77%
- If score == 4, then Estimated 10-year survival is 53%
- If score == 5, then Estimated 10-year survival is 21%
- If score >= 6, then Estimated 10-year survival is < 21%)