Emergency Medicine · Pulmonology · Infectious Disease
ACEP ED COVID-19 Management Tool calculator
Enter the published formula inputs below to calculate and interpret this score.
Clinical inputs
Allowed range: 18–120 years
Adults are 18 years or older. Age is recorded and is not part of the Step 1 class.
Allowed range: 50–100 %
Sea-level room air. Under 94% is severe only when the resting baseline is normal. At 94% or higher, lower respiratory disease can be moderate.
Allowed range: 4–80 /min
Over 30 breaths per minute is severe. A rate of 30 stays below that rule.
Allowed range: 20–700 mm Hg
Under 300 mm Hg is severe when an arterial blood gas was obtained. A ratio of 300 stays below that rule.
Result
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Clinical inputs
- Age (years)Accepted range: 18 to 120
- Any listed mild symptom
- Shortness of breath
- Dyspnea
- Abnormal chest imaging
- Lower respiratory disease on examination
- Lower respiratory disease on imaging
- Oxygen saturation on room air (%)Accepted range: 50 to 100
- Resting baseline saturation is normal
- Respiratory rate (/min)Accepted range: 4 to 80
- Arterial blood gas was obtained
- PaO2/FiO2 (mm Hg)Accepted range: 20 to 700
- Lung infiltrates over 50%
- Respiratory failure
- Septic shock
- Multiorgan dysfunction or failure
Primary source
American College of Emergency Physicians. Emergency Department COVID-19 Management Tool, Fall 2023. Step 1 assigns NIH severity. Mild: any of fever, cough, sore throat, malaise, headache, muscle pain, nausea, vomiting, diarrhea, or loss of taste or smell, and none of shortness of breath, dyspnea, or abnormal chest imaging. Moderate: lower respiratory disease on clinical assessment or imaging, and SpO2 at least 94% on room air at sea level when the resting baseline SpO2 is normal. Severe, any one: SpO2 under 94% on room air at sea level when the resting baseline SpO2 is normal; PaO2/FiO2 under 300 mm Hg when an arterial blood gas was obtained; respiratory rate over 30 breaths/min; lung infiltrates over 50%. Critical, any one: respiratory failure, septic shock, or multiorgan dysfunction or failure. A critical finding outranks severe, severe outranks moderate, and moderate outranks mild. SpO2 94% stays on the moderate side of the severe SpO2 rule. Respiratory rate 30 stays below the severe respiratory-rate rule. PaO2/FiO2 300 stays below the severe gas-exchange rule. The PaO2/FiO2 rule is used only when an arterial blood gas was obtained. (2023)
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