what — PTstuff

Reason for Visit

Shown as a tag in the results header.

Working Diagnosis

Optional; appears as a tag in the results header.

Presentation

Follow-Up Questions

Screening Results to Review

Consults

Diagnostics

Likely Diagnoses

Mobility Red Flags (hold)

Mobility Yellow Flags (caution)

Level of Care Criteria — General vs Step-Down vs ICU

Use these example criteria to align with local policies. They’re written for team discussion — adapt thresholds to your facility’s protocols.

General Ward (Med-Surg)

Hemodynamically stable without vasopressors; no active titration of IV antihypertensives.
Oxygen need low and stable (e.g., room air or low-flow nasal cannula to maintain patient’s baseline goals).
Airway protected; no escalating work of breathing.
Mentation at or near baseline; delirium manageable with standard precautions.
No recurrent chest pain or new ischemic ECG changes; telemetry if indicated but no rapid interventions expected.
Electrolyte or glucose issues mild and correctable without continuous infusions.
Single-agent IV antibiotics/fluids acceptable; no septic shock.
Nursing/monitoring needs routine (e.g., vitals q4h) with low risk of sudden deterioration.
Therapy: able to participate with standard precautions; mobility progresses on the unit.

Step-Down / Intermediate Care (IMC)

Higher monitoring intensity needed (e.g., titratable IV meds such as insulin or antiarrhythmic drips without pressors).
Non-invasive ventilation or high-flow oxygen stable with frequent assessments; no immediate intubation anticipated.
Frequent neuro checks (e.g., hourly to every 2 hours) for evolving deficits but no airway compromise.
Arrhythmia requiring close telemetry and potential medication titration; external pacing pads considered but not active transvenous pacing.
Sepsis under treatment with improving perfusion after fluids/antibiotics; no vasopressors.
Complex post-op or multi-system issues needing q1–2h nursing assessments.
Therapy: brief, symptom-limited sessions; mobility with close monitoring and ready access to nursing support.

Intensive Care Unit (ICU)

Any vasopressor or inotrope support; persistent hypotension or shock.
Invasive airway, mechanical ventilation, or rapidly escalating respiratory support with airway risk.
Unstable arrhythmia requiring continuous IV antiarrhythmic titration, transvenous pacing, or cardioversion readiness.
Acute neurologic compromise with airway risk, status epilepticus, or GCS around 12 or lower / rapidly fluctuating.
CRRT or acute dialysis initiation; severe acid-base or electrolyte derangements needing continuous titration.
Septic shock or refractory hypoxemia; high risk for sudden deterioration requiring minute-to-minute management.
Multiple active drips requiring titration (e.g., sedation, vasopressors) or invasive monitoring (arterial line, PA catheter as per facility).
Therapy: early mobility only when medically cleared and adequately staffed; prioritize hemodynamic and airway stability.

Tips for PT documentation when suggesting level of care:

Lead with the highest-acuity problem (hemodynamics, airway, neuro) and its current trend.
Quantify oxygen/device needs and response to activity (e.g., desaturation nadirs, recovery time, cues required).
State monitoring and nursing intensity observed during mobility (e.g., 1:1 assist, continuous pulse-ox, need for line/airway management).
Link therapy tolerance to environment needs (general vs step-down vs ICU) and safety supervision requirements.
End with a clear recommendation for anticipated level of care and the immediate triggers to escalate.

Note: This educational tool supports PT clinical reasoning. Confirm plan and disposition with the interdisciplinary team and payer rules; defer to local policies for final level-of-care placement.