Are you evaluating a cancer patient who is admitted to the ICU?

Did the patient require CPR during the 24 hours prior to ICU admission?

Is there evidence of an intracranial mass effect?

Does the patient have a history of an allogenic bone marrow transplant?

Is there clinical evidence of cancer progression?

Respiratory rate (enter -1 if unknown)


Systolic blood pressure (enter -1 if unknown)

mm Hg

Glasgow Coma Score (enter from 3 to 15)

PaO2 (enter -1 if unknown)

FIO2 (enter from 0.21 to 1.0)

Platelet count (enter -1 if unknown)

Prothrombin time


Serum albumin

Total bilirubin


Number of days in hospital prior to ICU admission

Select an appropriate answer for each finding

Airway on admission to the ICU

Performance status


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