METHOD FOR ESTIMATING PATIENT STATE SEVERITY DEGREE IN THE CASES OF ACUTE POISONING WITH ACETIC ACID Russian patent published in 2006 - IPC A61B5/205 A61B5/145 

FIELD: medicine.

SUBSTANCE: method involves estimating nineteen functional laboratory indices of six systems. The central nerve system is estimated using Gasgo scale: 0 for 15 points; 1 for 14 points, 2 for 9-13 points, 3 for the number of points less than 9. The cardiovascular system is estimated using skin surface condition data. 0 points are assigned in physiologic micro circulation state with rosy skin of usual moisture, pale spot lasts less than 1 s. The pale spot test duration grows to 1-2 s, 1 points are assigned. Skin surface being pale, wet and warm, the pale spot test duration growing longer to 3 s, 2 points are assigned. Mottled skin being observed with pale spot test duration being greater than 3 s pointing to marked microcirculation bed injury, 3 points are to be assigned. Heart beat rate is estimated as follows. 0 points are assigned if the heart beat rate is within physiologic oscillations. 1 point is given, if tachycardia is found with the number of strokes per 1 min being less than 110. Marked tachycardia being found with 111-130 strokes per 1 min, 2 points are assigned. Marked tachycardia with the number of strokes per 1 min being greater than 130 or marked bradycardia is found with the number of strokes per 1 min being less than 60, 3 points are assigned. Systolic blood pressure is estimated as follows. 0 points are assigned if the systolic blood pressure is within the limits of physiologic oscillations. Systolic blood pressure rise or drop within the limits of 20 mm of mercury column being observed, 1 point is given. Systolic blood pressure rising by more than 20 mm of mercury column, 2 points are given. Systolic blood pressure dropping by more than 20 mm of mercury column, 3 points are given. Respiratory system characteristics are estimated from respiratory movements frequency. 0 points are given if the frequency is within the limits of physiologic norm. 1 point is given, if 20-29 respirations per 1 min is the case. 30-35 respirations per 1 min being the case, 2 points are given. Marked tachypnea with the frequency exceeding 35 respirations per 1 min being the case, 3 points are given. Oxigenation changes (PaO₂/FiO₂) being higher than 300 mm of mercury column, 0 points are assigned. The PaO₂/FiO₂ being equal to 299-250 mm of mercury column, 1 point is assigned; 249-200 mm of mercury column - 2 points. PaO₂/FiO₂ being dropped below 200 mm of mercury column, 3 points are assigned. Acid-base balance changes are estimated in arterial and venous blood. The value of pH being equal to 7.35-7.44, 0 points are assigned; 7.34-7.32 - 1 point; 7.31-7.22 - 2 points; <7.21 - 3 points. P_aCO₂ (mm of mercury column): 35.0-45.0 - 0 points; 34-30 or 46-50 - 1 point; 29-19 or 51-60 - 2 points; ≤19 or ≥60 - 3 points; BE (mmole/l) ±2.3 - 0 points; -2.3-5.0 - 1 point; -5.1-10 - 2 points; > -10 - 3 points. pH in venous blood (conditional units): 7.32-7.42 - 0 points; 7.31-7.29 - 1 point; 7.28-7.19 - 2 points; <7.19 - 3 points. PvCO₂ (mm of mercury column), 40.0-50.0 - 0 points; 39.0-35.0 or 51.0-55.0 - 1 point; 34.0-20.0 or 56-65 - 2 points; <20 or >65 - 3 points; BE (mmole/l) ±2.3 - 0 points; -2.3-5.0 - 1 point; -5.1-10 - 2 points; > -10 - 3 points. Availability of prerequisites to respiratory tract burn is estimated as vomiting during the first poisoning minutes is estimated with 2 points; respiratory tract burn symptoms like cough, husky throat, respiratory stridor and aphonia - 3 points. Changes in laboratory indices: free hemoglobin concentration in blood plasma:0 mg/l - 0 points; 5 g/l - 1 point; 5-10 g/l - 2 points; >10 g/l - 3 points; leukocytic intoxication index in venous blood 0.5-1.4 conditional units - 0 points; 1.5-4.9 conditional units - 1 point; 5.0-8.5 conditional units - 2 points; >8.5 conditional units - 3 points. Excretory detoxification system is estimated by taking hour-by-hour diuresis and hematuria and hemoglobinuria signs into account. Diuresis being at least50 ml/h - 0 points; diuresis being equal to 50 ml/h, microhematuria and proteinuria signs being available - 1 point is assigned; diuresis being equal to 50-30 ml/h, urine color being red, brown, hemoglobinuria, proteinuria, formed elements being available, 2 points are to be assigned; diuresis being <30 ml/h, urine color being cherry red, tar-like, hemoglobinuria, proteinuria, formed elements being available, 3 points are to be assigned. The gastrointestinal tract is estimated as follows. Active peristalsis, gas discharge and stool being available - 0 points; feeble peristalsis, gas discharge and stool not available - 2 points; no peristalsis - 3 points. The total number of points is calculated and acute poisoning severity degree with acetic acid is determined. Light poisoning receives to 19 points; medium severity degree - 20-38 points and heavy poisoning degree receives 39 points and more.

EFFECT: high reliability of estimate.

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