Poisoning Severity Score in Acute Poisoning

symptoms

vomiting

diarrhea

abdominal pain

oral ulcers

prolonged vomiting

prolonged diarrhea

severe abdominal pain

ileus

dysphagia

severe dysphagia

massive hemorrhage

perforation

endoscopy

erythema

edema

transmucosal ulcerations

extensive and circumferential ulcerations

perforation

burn

first degree

oral irritation

first degree over large area

focal 2° or 3°

extensive 2° or 3°

symptoms

mild irritation

mild cough

prolonged cough

respiratory function

breathlessness, mild dyspnea

dyspnea

hypoxemia requiring oxygen

respiratory insufficiency

bronchospasm

mild

moderate

severe

other

stridor

glottal edema

pulmonary edema

ARDS

airway obstruction

pneumonia

pneumonitis

pneumothorax

chest X-ray

abnormal with no or minor symptoms

abnormal with moderate symptoms

abnormal with severe symptoms

sinus bradycardia (beats/minute)

80 - 90 neonates

60 - 80 infants

40 - 50 adults

< 80 neonates

< 60 infants

< 40 adults

sinus tachycardia (beats/minute)

160-200 neonates

160-190 infants or children

140-180 adults

> 200 neonates

> 190 infants or children

> 180 adults

arrhythmias

isolate extrasystole

frequent extrasystoles

atrial flutter or fibrillation

1° or 2° AV block

prolonged QRS

prolonged QTc repolarization

life threatening ventricular arrhythmias

3° AV block

asystole

hypotension

mild and transient

moderate

shock

hypertension

mild and transient

moderate

hypertensive crisis

perfusion

ischemia

infarction

function

drowsy

ataxia

vertigo

unconscious but responds to pain

coma with inappropriate or no response to pain

respiratory

apnea, bradypnea

respiratory depression

activity

restless

confusion

agitation

hallucinations

delirium

extreme agitation

seizures

infrequent, local

frequent,  generalized

status epilepticus

opisthotonus

extrapyramidal symptoms

mild

pronounced

cholinergic or anticholinergic symptoms

mild

pronounced

peripheral nerves

paresthesias

localized paralysis

generalized paralysis

paralysis vital function

vision

mild disturbances

moderate

blind

auditory function

mild disturbances

moderate

deaf

skin

irritation

first degree burn

second degree < 10% BSA

second degree 10-50% BSA in adult

second degree 10-30% in child

third degree <= 2% BSA

second degree > 50% in adult

second degree > 30% in child

third degree > 2% BSA

eyes

irritation

redness

lacrimation

mild palpebral edema

intense irritation

cornea

corneal abrasion

minor ulcer

ulceration

perforation

permanent damage

reaction to bites and stings

mild

itching

moderate

local necrosis

extreme

extensive necrosis

swelling from bites and stings

local

whole limb

whole limb and significant adjacent areas

critical location (airway)

proteinuria

minimal

massive

hematuria

minimal

massive

serum creatinine

(see below)

200- 500 µmol/L (2.26 - 5.66 mg/dL)

> 500 µmol/L

(> 5.55 mg/dL)

function

oliguria

polyuria

anuria

AST

2 - 5 times upper limit of normal

5 - 50 times

> 50 times

ALT

2 - 5 times upper limit of normal

5 - 50 times

> 50 times

other

clinical failure; biochemical failure (elevated ammonia, coagulopathy)

acid base disorder

mild

moderate

severe

pH

7.25 - 7.32

7.50 - 7.59

7.15 - 7.24

7.60 - 7.69

< 7.15

> 7.7

bicarbonate in mEq/L

15 - 20 mEq/L

30 - 40

10 - 14

> 40

< 10

fluid and electrolyte abnormality

mild

moderate

severe

potassium

3.0 - 4.0 mEq/L

5.2 - 5.9

2.5 - 2.9

6.0 - 6.9

< 2.5

> 7.0

hypoglycemia

mild (50- 70 mg/dL in adult)

moderate (30 - 50 mg/dL in adult)

severe (< 30 mg/dL in adult)

hyperthermia

brief

longer

dangerous

hypothermia

dangerous

hemolysis

mild

moderate

massive

methemo-globinemia

mild (10-30%)

30 - 50%

> 50%

coagulopathy

present without bleeding

present with bleeding

cytopenias

anemia

leukopenia

thrombocytopenia (TCP)

severe anemia

severe leukopenia

severe TCP

muscle pain

mild

moderate

intense

muscle symptoms

tenderness

rigidity

cramping

fasciculations

extreme rigidity

extreme cramping

extensive fasciculations

compartment syndrome

muscle damage

rhabdomyolysis

rhabdomyolysis with complications

CK

250 - 1,500 IU/L

1,500 - 10,000 IU/L

> 10,000 IU/L