ICU Checklist for Rounding

1. Is DVT prophylaxis in place?

a. Dosing appropriate for clinical status?
2. Is the patient a candidate for stress ulcer prophylaxis?
a. Famotidine is 1st line, unless on PPI prior to admit for GI indication or
persistent hypotension requiring pressors
3. Does the patient need corneal protection with lacrilube q4hr?
4. Are opioids, sedatives, vasoactive, paralytic and furosemide drips prescribed
for titration to specific parameters within maximum and maximum rates
specified?
a. Propofol check TG @ > 72 hours
5. Antibiotics
a. Indication? Susceptibility and MIC values?
b. What day of therapy are we on?
c. What is planned duration?
d. Can we de-escalate?
6. Do medications need adjustment for renal or hepatic failure? What
adjustments need to be made while on CRRT or IHD?
7. Are there IV medications which can be given orally or via feeding tube?
8. Has a bowel regimen been prescribed for those on scheduled opioids? Is it
working?
9. For patients on corticosteroids
a. Indication?
b. Can we begin weaning or discontinue?
10. Evaluate medications used prior to admission
a. Are all pertinent medications continued?
b. Is there a risk of withdrawal from any medications if not continued?
11. Glycemic control
a. Glucose within range?
b. If not, is a more intensive SS, long acting or insulin drip warranted?
12. Nutrition/Fluids
a. Is the patient being adequately fed? What is indicated - Enteral tube
feeds,TPN, Clinimix?
b. What is the fluid status?
c. Do we need to minimize fluid intake?
13. For prn medications, are the indications specified?
14. Anticoagulation
a. Indication
b. Duration for indication
c. Monitoring
d. Conversion to warfarin?
15. Pain management/Sedation/Delirium
a. Appropriate agent for clinical status
b. Specific monitoring for agent prescribed
c. Can we start titrating?
d. Would daily awakening from sedation be appropriate at this time?
e. Can we convert to po if more longer duration of therapy is necessary