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Stable Vital Signs: Unstable Vital Signs: Any of the clinical feature of moderate
RR <30 breaths/ min. RR > 30 breaths/ min. risk CAP plus any of the following:
PR <125 beats/min. PR > 125 beats/ min.
SBP > 90 mmHg Temp > 40`C or < 35`C Shock or signs of hypo perfusion
DBP> 60 mmHg
None or stable co-morbid Unstable co morbid condition ____hypotension
conditions such as the ff: ____altered mental state
No evidence of aspiration ____uncontrolled DM ____urine output <30mL/hr.
____active malignancies ____hypoxia (PaO2<60mmHg) or
Chest X-ray: ____progressing neurologic dse. ____acute hypercapnia
Localized infiltrates ____congestive heart failure (CHF) (PaCO2>50mmHg)
No evidence of pleural effusion ___ unstable coronary artery dse.
Not progressive within 24 hrs. ____renal failure on dialysis Chest X-ray:
____uncomp/decomp.COPD
As in moderate risk CAP
Evidence of extra pulmonary
sepsis (hepatic, hematologic,
gastrointestinal, endocrine)
Suspected Aspiration
Chest X-ray:
Multilobar infiltrates
Pleural effusion or abscess
Progression of findings to >50%
in 24 hrs.
These patients are suitable for These patients need to be These patients warrant admission
outpatient care (Grade A)6 hospitalized for parenteral therapy in the intensive care unit (Grade A)6
(Grade A)6
ER Nurse on Duty: Resident on Duty: Attending Physician: