The Leap
Patient Belligerence Scale

The Leap
Patient Belligerence Scale (used to assess a patient's belligerence as a vital sign)

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 possible. Elaborate gestures.

3  Unable to smoke unless actually on fire.
2  Asks for cigarette, but realizes he/she 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.

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

Total Score  
0-3  Can be discharged to jail or home without actually being examined.
4-6  Probably will require evaluation, although odds of dying relatively low.
6-9  Most likely has real injury or illness, but requires diligent re-evaluation so that patient can be downgraded as he improves or becomes increasingly annoying.


I discovered this Belligerence Scale and thought it was too funny not to put on my site.

1) This is not my work. I reposted it from Dr. Edwin Leap, and Emergency Medicine News. If you are Dr. Edwin Leap, someone from Emergency Medicine News, or object to my reposting of this material and wish me to remove this from my site, please contact me and I will comply.

2) Originally this was posted as "The Leap Non-severity Scale" I think it is funnier as "The Belligerence Scale". If you don't like it, feel free to ignore my title and continue to refer to it as the non-severity scale.

3) Dr. Leap's original article contained the following info and disclaimers that should be repeated:

Dr. Leap is a member of Blue Ridge Emergency Physicians and an emergency physician at Oconee Memorial Hospital in Seneca, SC, an op-ed columnist for the Greenville News, and a member of the board of directors of the South Carolina College of Emergency Physicians.

The Leap Non-Severity Scale is a groundbreaking algorithm developed through years of observation and several grueling minutes of computer time. It is based entirely on anecdote, and has no connection whatsoever with evidence-based anything. Therefore, it was not evaluated through double-blinded trials, it was not placebo-controlled, and it most certainly was not reviewed by any committee of caring, sensitive physicians to determine its ethical bearings. Use it in good health.

Based on Fluidity css adapted by Dan Delcollo