SYSTEMIC | ||||
---|---|---|---|---|
Grade 1 (Mild) | Grade 2 (Moderate) | Grade 3* (Severe) | Grade 4* (Life-threatening) | |
Fever: oral1 | 38 – 38.5°C | 38.6 – 39.5°C | 39.6 – 40.5°C | >40.5°C |
Headache1 | Mild; no Rx required | Transient, moderate; Rx required | Severe; responds to initial narcotic Rx | Intractable; required repeated narcotic Rx |
Allergic reaction1 | Pruritus without rash | Localized urticaria | Generalized urticaria; angioedema | Anaphylaxis |
GASTROINTESTINAL | ||||
Nausea1 | Mild discomfort; maintains reasonable intake | Moderate discomfort; intake decreased significantly; some activity limited | Severe discomfort; no significant intake; activities limited | Minimal fluid intake |
Vomiting2 | 1 episode in 24 hours | 2 – 5 episodes in 24 hours | > 6 episodes in 24 hours or needing IV fluids | Physiologic consequences requiring hospitalization or parenteral nutrition |
Diarrhea2 | Mild or transient; 3–4 loose stools/day or mild diarrhea lasting < 1 week | Moderate or persistent; 5–7 loose stools/day or diarrhea lasting > 1 week. | >7 loose stools/day or bloody diarrhea; or orthostatic hypotension or electrolyte imbalance or >2 LIV fluids required | Hypotensive shock or physiologic consequences requiring hospitalization |
Oral discomfort2 | Mild discomfort; no difficulty swallowing | Some limits on eating/drinking | Eating/talking very limited; unable to swallow solid food | Unable to drink fluids; requires IV fluids |
CARDIOVASCULAR | ||||
Cardiac rhythm2 | ---- | Asymptomatic, transient signs, no Rx required | Recurrent/persistent symptomatic Rx required | Unstable dysrythmia; hospitalization and Rx required |
Hypertension1 | Transient increase > 20 mmHg; no Rx | Recurrent, chronic > 20 mmHg, Rx required | Requires acute Rx; no hospitalization | Requires hospitalization |
Hypotension1 | Transient orthostatic hypotension, no Rx | Symptoms corrected with oral fluids | Requires IV fluids; no hospitalization required | Requires hospitalization |
MUSCULOSKELETAL | ||||
Arthralgia2(joint pain) | Mild pain not interfering with function | Moderate pain, analgesics and/or pain interfering with function but not with ADL | Severe pain; pain and/or analgesics interfering with ADL | Disabling pain |
Myalgia2 | Myalgia with no limitation of activity | Muscle tenderness (at other than injection 2site) or with moderate impairment of activity | Severe muscle tenderness with marked impairment of activity | Frank myonecrosis |
RESPIRATORY | ||||
Cough3 | Mild, relieved by non-prescription medication only | Symptomatic requiring narcotic prescription medication | Symptomatic and significantly interfering with sleep or ADL | NA |
Dyspnea3 | Dyspnea on exertion, but can walk one flight of stairs without stopping | Dyspnea on exertion, but unable to walk 1 flight of stairs or 1 city block (0.1 Km) without stopping | Dyspnea interfering with ADL | Dyspnea at rest requiring oxygen therapy; intubation/ventilator indicated |