Patient Name:

Hospital Number: Date: Time:

Critical Care Department

‫أقسام العنايه المركزه‬ ICU General Admission Orders
CNS
Sedation:
Midazolam bolus mg IV stat or q min
Midazolam infusion @ mg/hour
Propofol infusion @ mg/hour
Analgesia:
Fentanyl infusion @ /hour
Morphine mg/hour or infusion @ /hour
Others:
Paralyzing Agents
Daily Sedation Interruption at 6:00 AM
Target Sedation Scale
Respiratory
MV Mode VT PEEP
PS/PC FIO2 Flow/I/E Ratio
Maintain O2 Sat > %
Target pH
Target PCO2
Special Protocol
CVS
Targets:
MAP HR CVP
Call MD if MAP, HR & CVP outside these parameters
IV Bolus 250mls if CVP < and/or MAP <
Call MD if no response to MAP and / or CVP
Inotropes / Pressors:
Dopamine mcg/kg/min to max. dose mcg/kg/min
Adrenaline mcg/kg/min to max. dose mcg/kg/min
Noradrenaline mcg/kg/min to max. dose mcg/kg/min

IVFluids
IV Fluids @ ml/hour
Additives @ mEq/L
GIT/Diet
Enteral Formula: @ ml/hour
TPN Protocol
Prokinetics:
Metochlopromide mg IV / PO q h X48h
Erythromycin mg IV / PO q h X48h

KSMC-CCD-F-003-08
 Renal–FluidBalance
Fluid Balance Aim in 24 Hours
Call MD If Urine Output is less than 0.5 ml/kg for 2 hours
Dialysis/ CRRT
ID
Septic Screen if Temp > 38.5 including blood cultures
Review Vascular Access Sites
If Septic – see Sepsis Protocol
Metabolic
Tight Insulin Protocol
Steroids Protocol
DiagnosticInvestigations
Electrolytes Kidney Function Test
CBC Cardiac Enzyme
Coagulation Profile LFT
Chest X-ray EKG
Other Tests:

Prophylaxis
DVT
Pneumatic Pump
Anticoagulation Protocol
Enoxiparin 30 mg SC QD 40 mg SC QD
Tenzoparin
UF Heparin Protocol
Stress Ulcer Prophylaxis
Ranitidine 150 mg PO QD

Consultations/Referrals

Medications
1.
2.
3.
4.
5.

Skin/Position&Activity
Head-up 30 degrees
Mobilization

Resident Physician : Registrar/Specialist: Nurse:

Signature: Signature: Signature:

Job No. Job No. Job No.

KSMC-CCD-F-003-08