Patient selection: pediatric patient in the ICU
Severe bleeding - one or more of the following:
(1) causes >= 1 organ dysfunction by the PELOD-2 criteria within 24 hours
(2) causes hemodynamic instability
(3) causes a drop in hematocrit > 20% within 24 hours
(4) causes a drop in systolic blood pressure > 20% from baseline within 24 hours
(5) >= 5 mL per kg per hour for >= 1 hour
(6) intraspinal bleeding with loss of neurologic function below the lesion
(7) nontraumatic intra-articular bleeding with decreased range of motion
(8) intra-ocular bleeding with impaired vision
The implicated finding should not be caused by another condition.
Minimal bleeding - one or more of the following:
(1) streaks of blood in endotracheal tube or during suctioning only
(2) streaks of blood in nasogastric tube
(3) blood-tinged urine or <= 1+ RBC on urine dipstick
(4) subcutaneous bleeding (hematoma, petechiae, etc) < 5 cm in diameter
(5) bleeding < 1 mL per kg per hour, including dressing weight increase < 1 g per kg per hour if weighed
(6) bloody dressing changed every 6+ hours
Bleeding not severe and not minimal is moderate bleeding.
Progressive bleeding causes one of the following:
(1) increase in severity by one level
(2) increase in number of criteria within a severity level
