ICU Pre-Rounding Bundle Checklist

VITALS: trends!

 • Important to know if the pt is getting better or worse 9 don't forget context!

 • Write down your vitals all together, but know they are in the context of drips (BP/HR) and the vent (RR/SpO2)

 • If your VS changes, it's important to know if the drips or vent have changed.

VENT: mode + settings + what the patient is doing (breathing over? dyssynchronous? how?)

 • AC/VC (VTE/RR/PEEP/FiO2; know actual RR, and P plateau)

 • AC/PC (PC/PEEP/RR/FiO2; know actual RR, exhaled volumes: VTE)

 • On SBT? If so, know PS, PEEP, Pt's own RR, FiO2, VTE and RSBI, and if they failed, know why!

DRIPS: trends! (how long on/off, increased/decreased, response)

 • Sedation: know RASS + goal (+/- CAM-ICU)

 • Pressor: know BPs, HR, UOP (see below)

I+Os: trends! 24hr total + NET + for hospitalization

 • INS: what's their main source of ins? (drips, abx, transfusions, feeds - PO or parenteral - ie PPN/TPN?)

 • OUTS: UOP (total and hourly, note if it is rapidly dropping off), CRRT (total and hourly net negative),

 • iHD (how much out in a session?), BMs (know last BM/how many per 24 hrs. and bowel regimen)

ABX: day #? total course length? new/updated culture data?

STEROIDS: day #? total course length? taper?

PPX: GI, DVT, ABX (ppx for chronically immunosuppressed - transplant, HIV, etc.)?

EXAM / LABS / IMAGING: trends! + changes/new findings

LINES / TUBES: know gauges, types, and locations



Dr. Meredith Greer @EmmGeezee



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