Therapeutic Intervention Scoring System (TISS)

chest physiotherapy

1

continuous ECG monitoring

1

decubitus care

1

dressing changes

1

frequent stat blood tests (more than 1 per shift) [1]

1

hourly vital signs

1

orthopedic traction

1

standard intake and output [2]

1

urinary catheter

1

hourly neurologic signs

2

central venous pressure (CVP)

2

multiple arterial blood gases, and/or stat tests (more than 3 per shift) [1]

3

accurate, precise input and output [2]

3

arterial catheter

3

pulmonary artery catheter

4

intracranial pressure monitoring

4

measurement of cardiac output

4

Interventions

Points

GI decompression

1

tracheostomy care

2

new tracheostomy (< 48 hours)

2

hemodialysis, stable patient [3]

2

hypothermia blanket [4]

3

chest tube

3

emergency thora-, para- or pericardiocentesis

3

nasotracheal or orotracheal intubation

3

emergency endoscopy or bronchoscopy

4

lavage of acute GI bleeding

4

emergency operative procedure (within 24 hours)

4

induced hypothermia [4]

4

peritoneal dialysis [3]

4

hemodialysis in unstable patient [3]

4

balloon tamponade of varices

4

Interventions

Points

IV antibiotics, 1 or 2 [5]

1

intermittent scheduled IV medications

1

chronic anticoagulation

1

1 peripheral IV catheter [6]

1

parenteral chemotherapy

2

replacement of excess fluid loss

2

> 2  IV lines [6]

2

active anticoagulation

3

IV antibiotics, more than 2 [5]

3

phlebotomy for fluid overload

3

acute treatment for metabolic acidosis or alkalosis

3

bolus IV medications

3

central intravenous hyperalimentation

3

multiple (3+) parenteral lines [6]

3

treatment of seizures or metabolic encephalopathy (within 48 hours of onset)

3

active diuresis for fluid overload or cerebral edema

3

frequent infusions of blood products (>= 20 mL/kg)

3

concentrated potassium infusion

3

pressure activated blood transfusion

4

continuous arterial infusions

4

platelet transfusion

4

supplemental oxygen [7]

1

spontaneous ventilation via tracheostomy tube [7]

2

pacemaker on standby [8]

3

cardioversion for arrhythmias

3

continuous antiarrhythmia infusions

3

vasoactive drug infusions

3

blind intra-tracheal suctioning (non-intubated)

3

acute digitalization (within 48 hours)

3

continuous positive airway pressure (CPAP) [7]

3

intermittent mandatory ventilation or assisted ventilation [7]

3

membrane oxygenation

4

intra-aortic balloon assist

4

G-suit

4

atrial and/or ventricular pacing [8]

4

cardiac resuscitation and/or countershock within past 48 hours

4

controlled ventilation with/without PEEP [7]

4

controlled ventilation with intermittent or continuous muscle paralysis/relaxants [7]

4

>= 50

75%

40-49

35%

30-39

20%

20-29

13%

10-19

6%