CHEARS

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As clinical pharmacists when we enter the ICU, it's a factor of fear and confusion in the initial days. We also undergo emotional trauma as the patient's life is always in a critical state. Due to lack of experience

working in an ICU set up,  there are chances to get screwed up by senior Doctors. So let's get started with the basics of ICU patient care.

GENERAL:

DOs and DON'Ts

• Don't be late for the ICU rounds.

• Don't act lazy during ICU rounds.

• Don't lie about the physical    examination of the patient that

You didn't do.

• Always be organized

• Schedule a pre- ICU round for     yourself so that you can answer     questions in actual rounds.

• Involve yourself in the ICU activities

• Show your efficiency

• Be thorough with the Case you are

In charge of.

• Take initiative for activities.

• Take ownership of your own     patients.

• Be polite with the Co-staffs.

DAILY CHECKLIST:

• Code status

• Sedation ( given in day time, when    stopping, etc.)

• GI prophylaxis ( most important     when intubated)

• DVT prophylaxis

• Fluid, Electrolytes, Nutrition

• Disposition

OTHER DAILY CHECKLIST:

• Monitor I/O on every patient with 24h    totals.

• Know their IV access including dates

central lines have been placed.

• Duration of Antibiotics use.

• Duration of steroid use for shock    patients.

For mechanically ventilated patients, always know the following:

• Date intubated

• Size of the tube

• Ventilator settings (mode, rate,     volume, pressure, PEEP,FiO2)

• Peak/ Plateau pressure

PROGRESS NOTES:

Check the progress notes written by the Doctor incharge. Organ based is generally the most thorough. For CCU, check cardiac studies :

•  CAD

•  CHF

•  EP

•  HTN

•  Lipids

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