Critical Care - FAST HUGS BID Flashcards
FAST HUGS BID
feeding
analgesia
sedation
thromboprophylaxis
head of bead (VAP prophylaxis)
ulcer prophylaxis
glycemic control
spontaneous breathing trial
bowel regimen
indwelling catheters
de-escalation of antibiotics
Feeding - Considerations
early enteral feeding preferred
parenteral may be necessary if gut not working or enteral foods not tolerated
Analgesia - Assessment Tools
critical care pain observation tool
behavioral pain scale
Analgesia - Considerations
type of pain (nociceptive or neuropathic)
duration of pain (boluses or long-acting agents?)
Analgesia - Common Drugs
fentanyl
hydromorphone
morphine
oxycodone
Sedation - Assessment Tool
RASS
SAS
Sedation - Preferred Agents
propofol
dexmedetomidine
Thromboembolism Prophylaxis - Considerations
should be given to all ICU patients
if high bleed risk - initiate mechanical prophylaxis with / without pharmacological
Thromboembolism Prophylaxis - Agents
LMWH 40 mg SQ QD or 30 mg SQ BID
if renal dysfunction - UFH 5000 units SQ Q8H
Head of Bed - Importance
specific to patients receiving mechanical ventilation
Head of Bed - Ventilator-Associated Pneumonia Prophylaxis
elevating the head & thorax at 30-45 degree angle
chlorhexidine topically to oral cavity TID
Ulcer Prophylaxis - Importance
prevention of stress-related mucosal damage
mortality 50-70%
Ulcer Prophylaxis - GI Bleeding Risk Factors
major:
mechanical ventilation > 48 hrs
INR > 1.5, PTT > 2x ULN, or platelets < 50,000
minor:
drugs that increase risk of bleeding
shock / sepsis / hypotension
hepatic or renal failure
burns > 35%
organ transplant
head or spinal trauma
history of GI bleeding
Ulcer Prophylaxis - Indications
one major risk factor or two minor risk factors
Ulcer Prophylaxis - Agents
pantoprazole 40 mg QD
famotidine 20 mg BID
