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TABLE OF RISK
 

 
Use highest level of risk based on ONE element from ANY of the categories below
Risk Level Presenting Problems Diagnostic Procedures Management Options Selected
Minimal Risk

  Requires ONE of these elements in ANY of the three categories listed
·  One self-limited or minor problem, e.g., cold, insect bite, tinea corporis
  • Laboratory tests
  • Chest X-rays
  • EKG/EEG
  • Urinalysis
  • Ultrasound/Echocardiogram
  • KOH prep
  • Rest
  • Gargles
  • Elastic bandages
  • Superficial dressings
Risk Level Presenting Problems Diagnostic Procedures Management Options Selected
Low Risk

Requires ONE of these elements in ANY of the three categories listed
  • Two or more self-limited or minor problems
  • One stable chronic illness, e.g., well controlled HTN , DM2, cataract
  • Acute uncomplicated injury or illness, e.g., cystitis, allergic rhinitis, sprain
  • Physiologic tests not under stress, e.g., PFTs
  • Non-cardiovascular imaging studies with contrast, e.g., barium enema
  • Superficial needle biopsy
  • ABG
  • Skin biopsies
  • Over the counter drugs
  • Minor surgery, with no identified risk factors
  • Physical therapy
  • Occupational therapy
  • IV fluids, without additives
Risk Level Presenting Problems Diagnostic Procedures Management Options Selected
Moderate Risk

Requires ONE of these elements in ANY of the three categories listed

  • Two stable chronic illnesses
  • One chronic illness with mild exacerbation or progression
  • Undiagnosed new problem with uncertain prognosis (e.g., lump in breast)
  • Acute complicated injury, e.g., head injury, with brief loss of consciousness
  • Physiologic tests under stress, e.g., cardiac stress test, fetal contraction stress test
  • Diagnostic endoscopies, with no identified risk factors
  • Deep needle, or incisional biopsies
  • Cardiovascular imaging studies, with contrast, with no identified risk factors, e.g., arteriogram, cardiac catheterization
  • Obtain fluid from body cavity, e.g., LP/thoracentesis
  • Minor surgery, with identified risk factors
  • Elective major surgery (open, percutaneous, or endoscopic), with no identified risk factors
  • Prescription drug management
  • Therapeutic nuclear medicine
  • IV fluids, with additives
  • Closed treatment of fracture or dislocation, without manipulation
Risk Level Presenting Problems Diagnostic Procedures Management Options Selected
High Risk

Requires ONE of these elements in ANY of the three categories listed
  • One or more chronic illness, with severe exacerbation or progression
  • Acute or chronic illness or injury, which poses a threat to life or bodily function, e.g., multiple trauma, acute MI, pulmonary embolism, severe respiratory distress, progressive severe rheumatoid arthritis, psychiatric illness, with potential threat to self or others, peritonitis, ARF
  • An abrupt change in neurological status, e.g., seizure, TIA, weakness, sensory loss
  • Cardiovascular imaging, with contrast, with identified risk factors
  • Cardiac EP studies
  • Diagnostic endoscopies, with identified risk factors
  • Discography
  • Elective major surgery (open, percutaneous, endoscopic), with identified risk factors
  • Emergency major surgery (open, percutaneous, endoscopic)
  • Parenteral controlled substances
  • Drug therapy requiring intensive monitoring for toxicity
  • Decision not to resuscitate, or to de-escalate care because of poor prognosis
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