GENERAL APPROACH
- Illness requiring ICU admission
- Reason for ongoing admission
- Things that need to happen to allow discharge
INTRODUCTION
CUBICLE
- personal items
- weaning or rehabilitation plan
INFUSIONS
- minimal IV therapy
- feeding established
- treatments required for slowly resolving problems (ongoing IV antibiotics for endocarditis)
VENTILATOR
- mode
- level of oxygenation: high FiO2, PEEP
- pressure support
- weaning strategy
- tracheostomy
MONITOR
- lack of invasive monitoring suggest respiratory wean man problem.
EQUIPMENT
- type of bed: prevention of pressure areas
- DVT prophylaxis strategies
- limb splints to prevent joint contractures: pressure areas
QUESTION SPECIFIC EXAMINATION
- hands/arms -> head -> chest -> abdo -> legs/feet -> back
-> general:
-> cardiovascular:
-> respiratory:
-> abdominal:
- neurological: conscious
- signs of slow improvement: being dressed in own items, dentures, wearing spectacles, interest in entertainment for stimulation.
- depression: flat affect
- pressure areas
- DVT
- scars/wounds: vascular access or traumatic injuries
- eye care
- personal hygiene
- mouth care
- grooming
- nutrition
- bowel function
- psychoactives: antidepressants, anxiolytics, hypnotics, antipsychotics.
RELEVANT INVESTIGATIONS
OPENING STATEMENT
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- Global statement
- Reason for admission
- Obvious complications
- How to progress from here
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