Burns et al reported the Burns Wean Assessment Program (BWAP) for evaluating a patient for weaning. The first part of the program is a general health assessment. The authors are from the University of Virginia.
Patient selection: ventilated patient being assessed for weaning
General assessment:
(1) hemodynamically stable
(2) free of factors that may increase or decrease the metabolic rate (fever, sepsis, seizures, thyroid disorder)
(3) hematocrit > 25%
(4) hydrated systematically with balanced intake and output
(5) nourished (serum albumin > 2.5 g/dL; maximized nutritional support)
(6) electrolytes (calcium, magnesium, phosphorus) within normal limits
(7) pain under control
(8) sleep and rest adequate
(9) appropriate level of anxiety or nervousness
(10) no bowel problems (diarrhea, constipation, ileus)
(11) improved general body strength and endurance
(12) findings on chest X-ray improving
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Response
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Poiints
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yes
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1
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no
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0
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not assessed
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0
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Exceptions:
(1) low albumin with anasarca or third spacing indicates hydration scored "No".
total subscore for general assessment =
= SUM(points for all 12 questions)
Interpretation:
• minimum subscore: 0
• maximum subscore: 12
