1. Before You See the Patient 

 Overnight Events

• ☐ Any instability? (hypotension, hypoxia, arrhythmia)

• ☐ Pressor changes: type + dose trend

• ☐ Ventilator changes & ABGs

• ☐ Sedation/analgesia changes

• ☐ New fever? Cultures?

• ☐ New imaging? Procedures?

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2. Vitals & Trends

• ☐ MAP range (last 12–24 hrs)

• ☐ HR, rhythm changes

• ☐ Tmax

• ☐ SpO₂/FiO₂ trends

• ☐ Respiratory rate

• ☐ UOP per hour & 24-hr I/Os

• ☐ Net fluid balance (last 24 hrs + since admission)

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3. Ventilator Review (if intubated)

• ☐ Mode: AC/VC, AC/PC, PSV

• ☐ FiO₂

• ☐ PEEP

• ☐ Tidal volume (confirm lung-protective: 6 mL/kg IBW)

• ☐ Peak pressure

• ☐ Plateau pressure

• ☐ Driving pressure

• ☐ ABG: pH / pCO₂ / pO₂ / HCO₃

• ☐ Compliance changes?

• ☐ SBT eligibility today?

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4. Lines, Tubes, Drips

• ☐ Central line: day #, needed?

• ☐ Arterial line: still necessary?

• ☐ Foley: needed?

• ☐ Chest tube, drains

• ☐ Drips currently running:

  • Pressors (norepi/vaso)

  • Sedation (propofol, dex)

  • Analgesia (fentanyl)

  • Insulin

  • Antiarrhythmics (amio, lidocaine)

  • Heparin

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5. Medications

• ☐ Antibiotics + days of therapy

• ☐ DVT prophylaxis

• ☐ Stress ulcer prophylaxis

• ☐ Nutrition: NPO / tube feeds / TPN

• ☐ Steroids? Immunosuppression?

6. Labs (Morning Labs + Trend Review)

Check last 24–48 hours:

CBC

• ☐ WBC trend

• ☐ Hgb (transfusion threshold?)

• ☐ Platelets

BMP / CMP

• ☐ Na, K, Cl

• ☐ Cr, BUN

• ☐ Glucose

• ☐ Anion gap

• ☐ LFTs

Critical ICU electrolytes

• ☐ K > 4

• ☐ Mg > 2

• ☐ Phos > 3

Other Important Labs

• ☐ Lactate

• ☐ Coags

• ☐ CK, troponin (if indicated)

Microbiology

• ☐ Blood cultures

• ☐ Sputum cultures

• ☐ Urine cultures

• ☐ MRSA swab

• ☐ Pending sensitivities

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7. Imaging

• ☐ Daily CXR (if applicable)

• ☐ CT results pending?

• ☐ Echo results?

• ☐ Ultrasound (RUSH, lung, abdomen)

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8. Organ-System Brief Assessment (for Rounds)

Neuro

• ☐ RASS/GCS

• ☐ Sedation weaning?

• ☐ Delirium screening

Pulm

• ☐ Oxygenation

• ☐ Vent strategy

• ☐ SBT/SAT today?

CV

• ☐ Shock type + plan

• ☐ Pressor requirements

• ☐ MAP goal

Renal

• ☐ AKI? UOP?

• ☐ CRRT needed? Volume status?

ID

• ☐ Source control

• ☐ Abx day #

• ☐ Culture results

GI

• ☐ Nutrition plan

• ☐ Bowel regimen

Endo

• ☐ Glucose control (gtt vs SQ)

Heme

• ☐ Transfusion thresholds

• ☐ Coags

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9. Daily Must-Do

• ☐ SAT (sedation awakening)

• ☐ SBT (spontaneous breathing trial)

• ☐ DVT prophylaxis

• ☐ GI prophylaxis

• ☐ Evaluate need for lines/tubes

• ☐ Plan for de-escalation (pressors, vent, abx)

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10. Family & Goals of Care

• ☐ Family updated?

• ☐ Code status confirmed?

• ☐ Prognosis discussion needed?