Standardized text blocks (accessible using SmartText and SmartPhrases) help simplify and standardize documentation tasks for persons with COVID-19 illness. The blocks are incorporated into templates for COVID-19 Progress notes, as well as Summary notes (admit, intake, discharge, handover, transfer). They can also be inserted into personalized SmartPhrases.
Most COVID-19 text blocks are "interactive". Although formatted in prose to make them easier to read, any text appearing in a dark blue font can be selected to activate popup data-entry tools for entering or editing structured data behind the prose.
The COVID-19 Markers text block lists key laboratory tests and risk prediction scores used to assess how COVID-19 infection is affecting a patient's body and prospects. Clinical prediction scores commonly used to gauge the degree of COVID-19 illness are also listed, with most making use of the previously listed laboratory tests.
Laboratory Tests [Normal range]: COVID-19 alarm range
CRP (C-Reactive Protein) [< 8 mg/L]: > 100
Neutrophils [1.8-7.5 10*9/L]: > 10,000 or < 4000
Lymphocytes (absolute count) [1-4.5 10**9/L]: < 0.8
D-Dimer [<0.50 mg/L]: >10
INR [0.8-1.2]: >1.5
Platelets [140-400 10*9/L]: < 100
Creatinine [40-100 umol/L]: > 150
Lactate [0.5-2.2 mmol/L]: > 2.5
HbA1c [4.3-5.9%]: > 8
Bilirubin [<20 umol/L]: > 25
LDH (lactate dehydrogenase) [100-225 U/L]: > 245
Ferritin [30-500 ug/L]: > 3000
Troponin [<10 mg/L]: > 50
Many risk scores have been promoted for guiding decisions about COVID-19 care. The most common are shown in this block. These scores are "interactive" in that links are embedded so that the score values and interpretations can be updated with the aid of an evidence-based calculator. Click on the score title to open a relevant score flowsheet. This will, in turn, have a link to the relevant calculator. Use the calculator to obtain the score and interpretation. Enter the score in the text field provided. Enter the interpretation in the comment link provided. Then accept/save the popup flowsheet. When the source text (e.g., Sidebar) is refreshed, the scores will automatically update.
SOFA - Sequential Organ Failure Assessment
4C Hospital Mortality - inpatient mortality prognostication
CURB-65 - inpatient morbidity prognostication
This risk score estimates the likelihood of a patient experiencing a bleeding event during an inpatient encounter; useful when making decisions about whether hospitalized COVID-19 patients receive prophylactic or therapeutic anticoagulation.