Admitting in the ICU - Checklist
VITALS: If bad, stop and go see the patient immediately; you can always review the chart at bedside!
LABS: Baseline + new (you can start making a problem list here, ie hyponatremia, AKI, etc.)
IMAGING: Always compare new to prior & make sure you look at the imaging yourself!
TTE: Helps to know if the pt has pre-existing heart failure, esp in work-up/management of shock
MICRO: Make sure cultures ordered if indicated, also helpful to know priors (don't miss MDR bugs)
MEDS: Quick review can help you figure out the Pt's PMH; consider withdrawal or overdose of home meds!
Floor transfer? - Could anything they've been given be contributing to current decompensation?
NOTES: The last clinic note, discharge summary, and ED triage notes are usually good places to look quickly
BUT, be careful not to spend too much on them prior to seeing the patient
REMEMBER, something has acutely changed, and they're sick!
Make your own objective assessment of the Pt's current clinical status & ensure they're stabilized
THEN feel free to dive deep into notes and speak with family for more history
Initial Work-up:
• For most ICU pts a CBC and CMP is a good place to start.
• Most will also get an EKG and CXR.
• And an initial bedside echo is never a bad idea - make sure to report your findings in your H&P!
Other Things to Consider (depending on the clinical scenario):
• Lactate, Troponin, TSH, CPK, HIV, EtOH, Urine Pregnancy Test, UTox
Dr. Meredith Greer @EmmGeezee
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