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DAILY PROGRESS NOTES (I.C.U.

) Diagnosis:
Date: Time:

D.O.A: T.O.A:

Name: _________________ Age/sex: ________ Wt:_____(kg) Vaccination Status:


Birth history: Active Issues:
Presenting Complaints:

A: Airway Self Self Ventilation Mechanical Mode:_____ FiO₂_____


Ventilation e O₂ @____ L/min Ventilation Rate: _____ I.E______

B: Breathing + Chest examination: R.R SpO₂


Gases

pH: pO2: pCO2: HCO3: BE:


C: Circulation + Cardiac exam: B.P H.R
Inotropes
Pulses: CRT:

Supports:
D: Disability & A/F: Pupils: GCS: /15
CNS
Power: Tone: Reflexes:

E: Electrolytes Na: K: Cl: Ca: Mg: P04:


F: Fluids (IOP) Input Type: Amount: Output
G: GIT Abdominal exam: BSR

H: Hematology Hb: TLC: PLT: Retics:


& Hepatic AST: ALT: ALP: STB:
I: Infection + CRP: Blood c/s: CSF: Urine:
Antibiotics

K: Kidneys Urea: Cr: GFR: Scan:


L: Lines IV lines: NG Tube: Foley’s:
M: Medicines

N: Nursing Temp:
care
O: Others
Plans: Round Orders: Doctor’s Sign & Stamp: