Risk Classification of Pneumonia
Introduction
Pneumonia is defined as the inflammation of lung tissue caused by an infectious agent that results in acute respiratory signs and symptoms. It can either be acquired outside (community-acquired) or within the hospital (hospital-acquired)
Who shall be considered as having community-acquired Pneumonia?
For ages 3 months to 5 years are tachypnea and/or chest indrawing For ages 5 to 12 years are fever, tachypnea, and crackles
Who shall be considered as having community-acquired Pneumonia?
Beyond 12 years of ages are the presence of the following features: y Fever, tachypnea, and tachycardia y At least one abnormal chest findings of
diminished breathing sounds, ronchi, crackles or wheezes
Tachypnea is still the best predictor of pneumonia
Who will require admission?
A patient who is at moderate to high risk to develop pneumonia-related mortality should be admitted A patient who is minimal to low risk can be managed on an outpatient basis
Risk Classification of Pneumonia
Variables PCAP A Minimal risk None Yes Possible None Able >11 mos PCAP B Low risk Present Yes Possible Mild Able >11 mos PCAP C Moderate risk Present No Not possible Moderate Unable 50/min >40/min >30/min
>60/min >50/min >35/min
>70/min >50/min >35/min
Risk Classification of Pneumonia
Variables PCAP A Minimal risk PCAP B Low risk PCAP C Moderate risk PCAP D High risk Signs of respiratory failure a. Retraction b. Head bobbing c. Cyanosis d. Grunting e. Apnea f. Sensorium None None None None None Awake None None None None None Awake Intercostal/Subcostal Present Present None None Irritable Supraclavicular/Interco stal/Subcostal Present Present Present Present Lethargic/Stuporous/ Comatose
Complication (effusion, pneumothorax) Action Plan
None
None
Present
Present
OPD follow up at end of treatment
OPD follow up after 3 days
Admit to regular ward
Admit to ICU Refer to specialist
The
Pneumonia is defined as the inflammation of lung tissue caused by an infectious agent that results in acute respiratory signs and symptoms. It can either be acquired outside (community-acquired) or within the hospital (hospital-acquired)
Who shall be considered as having community-acquired Pneumonia?
For ages 3 months to 5 years are tachypnea and/or chest indrawing For ages 5 to 12 years are fever, tachypnea, and crackles
Who shall be considered as having community-acquired Pneumonia?
Beyond 12 years of ages are the presence of the following features: y Fever, tachypnea, and tachycardia y At least one abnormal chest findings of
diminished breathing sounds, ronchi, crackles or wheezes
Tachypnea is still the best predictor of pneumonia
Who will require admission?
A patient who is at moderate to high risk to develop pneumonia-related mortality should be admitted A patient who is minimal to low risk can be managed on an outpatient basis
Risk Classification of Pneumonia
Variables PCAP A Minimal risk None Yes Possible None Able >11 mos PCAP B Low risk Present Yes Possible Mild Able >11 mos PCAP C Moderate risk Present No Not possible Moderate Unable 50/min >40/min >30/min
>60/min >50/min >35/min
>70/min >50/min >35/min
Risk Classification of Pneumonia
Variables PCAP A Minimal risk PCAP B Low risk PCAP C Moderate risk PCAP D High risk Signs of respiratory failure a. Retraction b. Head bobbing c. Cyanosis d. Grunting e. Apnea f. Sensorium None None None None None Awake None None None None None Awake Intercostal/Subcostal Present Present None None Irritable Supraclavicular/Interco stal/Subcostal Present Present Present Present Lethargic/Stuporous/ Comatose
Complication (effusion, pneumothorax) Action Plan
None
None
Present
Present
OPD follow up at end of treatment
OPD follow up after 3 days
Admit to regular ward
Admit to ICU Refer to specialist
The