Page 628 - Clinical Application of Mechanical Ventilation

594 Chapter 18

TABLE 18-4 Sequential Organ Failure Assessment (SOFA) Score

Variable/Score 0 1 2 3 4

Criteria/Score 0 1 2 3 4

Respiratory .400 #400 #300 #200 #100
PaO /F O (mm Hg)
2
2
I
Coagulation .150 #150 #100 #50 #20
Platelets, 3 103/μL (.150) (#150) (#100) (#50) (#20)
(3 106/L)

Liver ,1.2 1.2–1.9 2.0–5.9 6.0–11.9 .12
Bilirubin, mg/dL (,20) (20–32) (33–100) (101–203) (.203)
(μmol/L)

Cardiovascular None MAP ,70 Dop # 5 or Dop .5, Dop . 15,
Hypotension mmHg dobuta- Epi # 0.1, Epi . 0.1, or
(infusion dosages mine any or Norepi Norepi
in μg/kg/min) dose # 0.1 .0.1

Central Nervous 15 13–14 10–12 6–9 ,6
System
Glasgow Coma
Score

Renal ,1.2 1.2–1.9 2.0–3.4 3.5–4.9 .5
Creatinine, mg/dL (,106) (106–168) (169–300) (301–433) or (. 434) or
(μmol/L) or urine urine out- urine out-
output (use worst put ,500 put ,200
value) mL/day mL/day

Dopamine [Dop], epinephrine [Epi], norepinephrine [Norepi]. SI units in brackets.
Reference http://www.mdcalc.com/sequential-organ-failure-assessment-sofa-score.
© Cengage Learning 2014

Strategic National Stockpile

The SNS program owns
and maintains approximately The Centers for Disease Control and Prevention (CDC) uses a strategic national
10,000 mechanical ventilators stockpile (SNS) program to store large quantities of medicine and medical sup-
for distribution to states af-
fected by mass casualty. plies in a centralized location for the public in case of a health emergency. The
SNS program owns and maintains approximately 10,000 mechanical ventilators
for distribution to states affected by mass casualty (AARC, 2006; news medical,
strategic national stockpile 2009). There are advantages and disadvantages of a stockpile program where all of
(SNS): a federal program that the medicines and medical supplies are stored at a centralized location managed by
stores large quantities of medicine
and medical supplies in a central- the federal government. Pros include the immediate delivery of a large number of
ized location for the public in case ventilators to hospitals experiencing an isolated disaster. Cons include the potential
of a health emergency.
lack of experience and troubleshooting skills by clinicians with the brand-specific

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