Описание
R-I-S-C Prism App – The clinical “MEASURE”© [Multi-system Emergency And Severity Urgent Risk Evaluation] calculator
The emergent patient evaluation includes the initial examination of the vital clinical parameters – e.g. Airway, Breathing & Circulation
We could also summarize the initial important clinical parameters (that we must immediately evaluate) with the checklist “R-I-S-C” – i.e. the Responsiveness (consciousness/GCS), Imminent / acute upper airway obstruction, Increased or decreased temperature, Saturation/breathing status (i.e. the respiratory rate & oxygenation) & Circulation/hemodynamics status (i.e. the heart rate & blood pressure) [these also correspond with the Airway, Breathing, Circulation & Disability (“A-B-C-D”s) of the advanced cardiovascular life support (ACLS), the advanced trauma life support (ATLS) & the pediatric advanced life support (PALS) training].
The Emergency severity “R-I-S-C” score (that is calculated with the commonly collected vital-signs) would give us a more objective & composite initial estimate of the combined various multi-organ system parameters’ clinical stability & also the illness severity [i.e. the clinical “MEASURE”© – Multi-system Emergency And Severity Urgent Risk Evaluation]. We could also compute such a score quickly & intuitively with just the basic bedside point-of-care tests & exams.
Along with the R-I-S-C score, we also have a color-coded risk triangle display, and when the score is very elevated there is also a caution sign & an audio alarm tone. Also, when the “GCS ≤8” option is selected, the Airway option is automatically marked at least “At risk”, underscoring that airway precautions/protection is most likely necessary.
The more elevated the score, the more emergent & critical the illness severity and we could use this in the initial triage process. We could also use this R-I-S-C score subsequently as a sequential guide to monitor the immediate course of the illness (e.g. whether increasing or improving etc.).
Disclaimer – This App is intended for medical professionals. It is strongly suggested that the general public also consult a physician and obtain the required advice [or in case of emergency, call 911 (or any other local medical emergency phone number)]. Although utmost care was taken in optimizing the scoring system, none of the personnel involved in the development of the same take any responsibility about its performance and it is recommended that healthcare providers also consider the complete clinical context along with their experience & provide the appropriate medical care necessary
We have more details on emergent clinical topics at these websites -
American Heart Association – ACLS
https://www.ahajournals.org/doi/10.1161/CIR.0000000000000918
American College of Surgeons – ATLS
https://www.facs.org/~/media/files/education/core%20curriculum/shock.ashx
Society of Critical Care Medicine and European Society of Intensive Care Medicine
https://www.sccm.org/Research/Quality/Sepsis-Definitions
American Heart Association
https://www.ahajournals.org/doi/full/10.1161/JAHA.119.011991
American College of Cardiology
http://www.onlinejacc.org/content/71/19/e127
American Thoracic Society
https://www.thoracic.org/professionals/clinical-resources/critical-care/clinical-education/mechanical-ventilation/respiratory-failure-mechanical-ventilation.pdf
European Respiratory Society
https://erj.ersjournals.com/content/22/47_suppl/3s
American Society of Anesthesiologists
https://pubs.asahq.org/anesthesiology/article/118/2/251/13535/Practice-Guidelines-for-Management-of-the?_ga=2.127778501.911922357.1605694824-1527949363.1584602639
Association of Anaesthetists
https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.14779
GCS
https://www.glasgowcomascale.org/
American Association of Neurological Surgeons
https://thejns.org/view/journals/j-neurosurg/aop/article-10.3171-2020.6.JNS20992/article-10.3171-2020.6.JNS20992.xml