How to Survive the Surgical ICU
Spacer  ICU Template Note Introduction to ICUHome
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Intensive Care Unit Template Note
Date: Time: Service: HD #: POD #:
Antibiotics #: Drips #: Lines #:   Medicines:
Events Overnight:
Subjective:
VS:  Tmax | 00:00 | Tcurrent | HR | BP | CVP
Pulmonary Artery Catheter:   PAP | PWP | CO | CI | SV | MV02
Ventilator:  Mode | FI02 | TV | Patient Rate / Set Rate | Peep | PS | PAP
02 Saturation:  %
ABG (00:00):   ph | p02 | pC02 | Hco3 | Base Excess
In Total:
    Crystalloid
    Colloid
    Blood
    Feeds (enteral/ parenteral)
    Per oral
Out Total:
    Urine (color)
    Blood Loss
    Emesis/ Stool
    Nasogastric/ Drains
Net:
Labs:   Chemistry 10 | cbc | liver function tests
Microbiology:   Serum | Sputnum | Urine | Stool | Ascites | Drain | Cultures
Imaging:  Daily Chest Radiograph, Computed Tomography, MRI, Abdominal Radiograph, Ultrasound Echocardiograph (TEE, TTE)
Physical Exam:
Assessment and Plan
Neurologic Status
Cardiovascular Status
Respiratory Status
Gastrointestinal
Genitourinary
Infectious Disease(ID)
Hematology
Endocrine
Electrolytes
Skin Care
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by the webmaster@cybermed.ucsd.edu
Copyright © 2004, University of California San Diego, School of Medicine