Table 1 WHO near miss criteria adapted to the L.cal context of ACSH (reproduced from Nelissen et a L. with modification) [20]
WHO Near– miss criteria | Modified Near– miss criteria |
|---|---|
Clinical Criteria | |
Acute cyanosis | Acute cyanosis |
Gasping | Gasping |
Respiratory rate > 40 or < 6/min | Respiratory rate > 40 or < 6/min |
Shock | Shock |
Oliguria non responsive to fluids or diuretics | Oliguria non responsive to fluids or diuretics |
Failure to form clots | Failure to form clots |
Loss of consciousness lasting > 12 h | Loss of consciousness lasting > 12 h |
Cardiac arrest | Cardiac arrest |
Stroke | Stroke |
Uncontrollable fit/total paralysis | Uncontrollable abnormal body movement |
Jaundice in the presence of pre-eclampsia | Jaundice in the presence of pre-eclampsia |
Laboratory based Criteria | |
Oxygen saturation < 90% for ≥ 60 min | Oxygen saturation < 90% for ≥ 60 min |
PaO2/FiO2 < 200 mmHg |  |
Creatinine ≥ 300 µmol/l or ≥ 3.5 mg/dL | Creatinine ≥ 300 µmol/l or ≥ 3.5 mg/dL |
Bilirubin > 100 µmol/l or > 6.0 mg/dL | Bilirubin > 100 µmol/l or > 6.0 mg/dL |
pH < 7.1 |  |
Lactate > 5 mEq/Ml |  |
Acute thrombocytopenia (< 50,000 platelets/ml) | Acute thrombocytopenia (< 50,000 platelets/ml) |
Loss of consciousness and ketoacids in urine | Â |
Management based criteria | |
| Â | Admission to intensive care unit |
Continuous vasoactive drugs | Â |
Hysterectomy following infection or hemorrhage | Hysterectomy following infection or hemorrhage |
Transfusion of >/= 5 units of blood | Transfusion of >/= 1 units of blood |
Intubation and ventilation for ≥ 60 min not related to anaesthesia | Intubation and ventilation for ≥ 60 min not related to anaesthesia |
Dialysis for acute renal failure | Dialysis for acute renal failure |
Cardio-pulmonary resuscitation | Cardio-pulmonary resuscitation |
Severe maternal complications | |
| Â | Eclampsia |
| Â | Sepsis or severe systemic infection |
| Â | Uterine rupture |