My scoring system for critical illness:

The Leap Non-severity scale:

Profanity:

3  Unable to speak profanity or make profane gestures.

2  Slurs profanity, exposes genitalia or makes confusing lewd gestures.

1  Speaks profanity clearly, but with the same poor sentence structure he or she uses for English.  Recognizable, but not very interesting.

0  Profanity used like poetry, flowing and uninterrupted.  Suggests physical acts neither legal nor, in many instances, actually possible.  Elaborate gestures.

Smoking:

3  Unable to smoke unless actually on fire.

2  Asks for cigarette, but realizes he cannot hold cigarette or inhale smoke.

1  Smokes in room, with oxygen on high flow and friends smoking for company.

0  Wanders parking lot still partially attached to backboard, asking everyone for cigarette.

Violence:

3  So ill or impaired that behavior can be controlled without Droperidol.

2  Threatens doctor and staff with death, but can’t actually move due to pain or disability.

1  Points to each staff member individually and says “I know where you live and I’ll kill you” as police officers hold him down on bed.

0  Actually attacks staff member.

Scoring:

0 – 3:  Can be discharged to jail or home without actually being examined.

4 – 6:  Probably will require evaluation, although odds of dying still relatively low.

6 – 9:  Most likely has real injury or illness.  However, requires diligent re-evaluation using Leap Non-severity Scale (LNSS) so that patient can be down-graded as he or she improves or becomes increasingly annoying.