Mnemonic Monday: "Don't Mess With the Pancreas!"- Mnemonics for Ranson Criteria in Pancreatitis

By Molly Lewis

For patients diagnosed with acute pancreatitis, the Ranson criteria can be used to predict which patients will have poor outcomes. The criteria look at a patient’s lab values, etc., when they are admitted and then again 48 hours later.

Each criterion gives the patient 1 point:

score risk of mortality
0-2  2%
3-4 15% if score ? 3, = severe disease

  •   = admit to ICU!
5-6 40%
>6 100%

 

Whether or not your attending actually uses these criteria to make clinical decisions, they will be sure to quiz you on them! So, use one of the mnemonics below to help you remember them all and look brilliant!

 

Option 1:

 

Ranson   criteria for pancreatitis: at admission
“GA LAW” (think:   “Georgia Law”- “Don’t mess with the pancreas, and don’t mess with   the Georgia law!”) 

  •   Glucose >200
  •   AST >250
  •   LDH >350
  •   Age >55 y.o.
  •   WBC >16000

 

To   remember the numbers, I remember that this 1st set of criteria, when the   patient is admitted, includes factors that are all elevated/high. Then, I   memorize the #’s in this order: “20, 25, 35, 55, 16”, and match   them with the “GA LAW” criteria.

Ranson   criteria for pancreatitis: initial 48 hours
C & HOBBS (Calvin and Hobbes): 

  •   Calcium < 8
  •   Hct drop > 10%
  •   Oxygen (room air PaO2)   < 60 mmHg
  •   Base deficit > 4
  •   BUN incr > 5
  •   Sequestration of fluid   > 6L

 

To   remember the numbers, I remember that this 2nd set of criteria, 48 hours   after the patient has been admitted, include some factors that are   elevated/high, and some that are low (vs the 1st set, which are all high).   Then, I memorize the #’s in this order: “8, 10, 6, 4, 5, 6”, and match   them with the “C & HOBBS” criteria. Also, to keep the B’s   straight, I remember: “4 letters w/ the # 4” for base deficit (4   letters in “base”) being increased by 4.

 

Option 2:

(courtesy of Luke Murray, another firstaidteam.com post author. Thanks, Luke!)

 

Ranson Criteria – “Just ABC (sort of)”

when the patient if first admitted:

  • Age > 55
  • AST > 250
  • WBC > 16,000
  • GluCose > 200
  • LDH > 350

At 48 hrs

  • PaO2 < 60mmHg
  • BUN increased > 5
  • Base Deficit > 4
  • Ca < 8
  • HCT decrease > 10%
  • fluid sequestration > 6L

 

So, choose whichever of the above mnemonics fits your fancy, or invent your own! But, be sure to memorize the Ranson criteria before your 3rd year rotations; they are super high yield! I’ve been asked about them in my surgery, internal medicine, family medicine, and pediatrics clerkships!

 

Bibliography

Option 1 mnemonic: modified by me from Surgical Recall, 6th Edition- by Lorne H. Blackbourne

Ranson criteria data:

Brunicardi FC, Andersen DK, Billiar TR. Chapter 32: pancreas. In: Schwartz’s principles of surgery. 8th ed. New York, NY: McGraw-Hill; 2005.

Ranson criteria:

Ranson JH, Rifkind KM, Turner JW. Prognostic signs and nonoperative peritoneal lavage in acute pancreatitis. Surg Gynecol Obstet. 1976;143:209-219.

 

Discussion

4 thoughts on “Mnemonic Monday: "Don't Mess With the Pancreas!"- Mnemonics for Ranson Criteria in Pancreatitis”

  1. Mneumonic for the causes microcytic anemias….

    Since they are the “smaller” RBCs (MCV <80fL), they are the "TAILS"

    T-Thalassemias
    A-Anemia of Chronic Disease
    I-Iron deficiency
    L-Lead poisoning
    S-Sideroblastic anemia

  2. i am 47 and spent a week in the hospital for this what do i need to do or worry about now that i’ve been diagnosed with this ailment.. I was a M1A1 TANK GUNNER DURING DESERT STORM SINCE I’VE BEEN BACK TO THE AREA 3Xs in different capacities ben shot up with antrax ate nerve pills not tested on humans also had 2 stays in icu for kidney failure is this from the same thing and i have hep c not throw sex or drug use

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