Assessing degree of organ dysfunction - Clinical

Cardiac

• Exercise tolerance (distance walked without stopping due to pain or dyspnoea)
• Degree of ankle/leg swelling
• Blood pressure
• Respiratory rate
• Oxygen saturation
• Gallop rhythm
• Lung crepitations
• Need for supplemental oxygen
• Ability to speak comfortably

Vascular

• Exercise tolerance (distance walked without stopping due to pain)
• Volume and extent of peripheral pulses
• Capillary refill
• Skin/hair changes

Respiratory

• Exercise tolerance (distance walked without stopping due to dyspnoea)
• Need for supplemental oxygen
• Bronchodilator usage (if airways disease)
• Respiratory rate
• Oxygen saturation
• Ability to speak comfortably
• Degree of air entry

GIT

• Dry mucous membranes
• BP, PR, cap refill, urine output (shock)
• Weight loss
• Pallor (anaemia)
• Hair and nail strength
• Ascites and oedema (severe protein malnutrition)

Hepato-biliary

• Jaundice
• Bruising
• Ascites
• Encephalopathy
• Hepatic flap

Haematology / Immunology

• BP, PR, capillary refill, urine output (shock)
• Pallor (anaemia)
• Bruising

Renal

• Urine output
• Urinary
• Bladder emptying (hesitancy, flow, dribbling)

PNS

• Degree of sensory change
• Degree of power loss
• Autonomic dysfunction (postural hypotension, loss of sphincter function)

CNS

• Consciousness
• Orientation
• Attention
• Memory
• Speech

Special senses

• Vision - visual acuity, visual fields
• Hearing - Tuning fork tests
• Smell - cloves

NB often severity can be gauged by the number of medications a person is on