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''This is the main page for Harbor-UCLA Trauma SICU''
''This is the main page for Harbor-UCLA Trauma SICU''


==Admin Updates==
=='''Admin Updates & Reminders'''==
*Please review and remember the '''Standardized Work for Morning Rounds'''
**[[media:Standardized_Work_3WICU_Morning_Rounds_v.5.pdf]]


==General Administrative==
*Please ensure continued and timely use of the '''OR to TSICU Handoff Tool'''
**[[media:OR_to_TSICU_RN_Handoff_Tool_.pdf]]


*Morning Rounds
*Ensure that '''Admit to ICU order is placed PRIOR to patient arrival in the SICU'''
**Roles and Responsibilities
**[[media:ER_to_SICU_Workflow_v2.pdf]]


===[[Media:SICU Intern Guide.pdf]]===


===Clinical Documentation===
===''Coming Soon:'' TSICU Orientation & Welcome Video-Dr. Dennis Kim===
*ICU Required Progress Note Details
*Common Conditions
*Hospital Acquired Pressure Injuries (HAPIs)
*FAST HUGS BID
*Code Status


===SICU Order Sets===
=='''[[TSICU:General Administrative]]'''==


===Schedule===
*'''[[TSICU: Phone Numbers]]'''


===Educational Conferences===
*'''[[TSICU:Consult Services]]'''


===Mandatory Call Criteria===
*'''[[Los Angeles ED phone directory]]'''


===Consult Services===
===[[TSICU: Weekly Schedule]]===


===Performance Improvement and Patient Safety===
===[[TSICU:Educational Conferences]]===
*Safety Intelligence (SI)


===Contact Information===
===[[TSICU:Clinical Documentation]]===


===[[TSICU:Order Sets]]===


==Patient Care Management==
===[[TSICU:Mandatory Call Criteria]]===
*[[media: TSICU_Mandatory_Call_Criteria_Final.pdf]]


===General===
===[[TSICU:Equipment & Supplies]]===


===Admission to the TSICU===
===[[TSICU:Miscellaneous]]===


===Transfers & Downgrades===
=='''[[TSICU:Patient Care Management]]'''==


===Tests & Orders===
===[[TSICU:Admissions]]===
'''*Every admission to the TSICU requires Trauma/SICU Attending approval'''


====Labs====
===[[TSICU:Transfers & Downgrades]]===


===Point of Care===
===[[TSICU:Ordering Labs, Tests, & Diagnostic Imaging]]===


===[[TSICU:Antibiotic Stewardship]]===
*[[media:2018 Harbor-UCLA Antibiogram.pdf]]


====Diagnostic Imaging====
===[[TSICU:Bedside Procedures]]===


*Chest X-rays
===Referral to One Legacy===
*[[Brain death]]
*[[media:Tissue_and_Organ_Donations.pdf]]


*Ultrasound
===Death Packet Checklist===


*CT scan
=='''[[TSICU:Educational Resources]]'''==


*MRI
=='''Core Clinical Conditions & Management'''==


====Bedside Echocardiogram====
==='''Assessment & Management of the Injured Patient'''===
*'''Roles & Responsibilities of the Trauma Team'''
**[[media:Trauma_roles_and_responsibilities_revised.pdf]]
*'''Trauma Team Activation and Response'''
**[[media:Trauma_team_activation_and_response.pdf]]
*'''Initial Assessment and Management of the Trauma Patient'''
**[[media:Initial_assessment_and_management_of_the_trauma_patient.pdf]]
*'''Blunt Head Trauma Evaluation'''
**[[media:Blunt_head_trauma_evaluation.pdf]]
*'''Traumatic Intracranial Hemorrhage Algorithm'''
**[[media:Traumatic_Intracranial_Hemorrhage.pdf]]
*'''Blunt Neck Trauma Evaluation'''
**[[media:Blunt_Neck_Trauma_.pdf]]
*'''Blunt Cerebrovascular Injury Evaluation and Management'''
**[[media:BCVI_Evaluation_and_Management.pdf]]
*'''Cervical Spine Evaluation and Injury Management'''
**[[media:C-Spine_Injury_Evaluation_and_Managment.pdf]]
*'''Penetrating Neck Trauma Evaluation and Management'''
**[[media:Penetrating_neck_trauma_evaluation_and_management.pdf]]
*'''Blunt Chest Trauma Evaluation and Management'''
**[[media:Blunt_Chest_Trauma_.pdf]]
*'''Rib Fractures and Flail Chest'''
**[[media:Rib_Fractures_&_Flail_Chest.pdf]]
*'''Pneumothorax or Hemothorax'''
**[[media:Pneumothorax_and_Hemothorax.pdf]]
*'''Pneumomediastinum Evaluation and Management'''
**[[media:Pneumomediastinum.pdf]]
*'''Blunt Cardiac Injury'''
**[[media:Blunt_Cardiac_Injury.pdf]]
*'''Penetrating Precordial Trauma'''
**[[media:Penetrating_Precordial_Trauma.pdf]]
*'''Blunt Aortic Injury'''
**[[media:Blunt_Aortic_Injury.pdf]]
*'''Blunt Abdominal Trauma'''
**[[media:Blunt_Abdominal_Trauma.pdf]]
*'''Solid Organ Injury Management (Kidney, Spleen, Liver)'''
**[[media:Solid_Organ_Injury.pdf]]
*'''Genitourinary Trauma (Kidney, Ureter, Bladder)'''
**[[media:GU_Trauma.pdf]]
*'''Penetrating Abdominal/Flank/Back injury evaluation and management'''
**[[media:Penetrating_Abdo_Flank_Back.pdf]]
*'''Pelvic Fractures'''
**[[media:Pelvic_fracture_Harbor_Trauma.pdf]]
*'''Blunt Peripheral Vascular Trauma'''
**[[media:Blunt_peripheral_vascular.pdf]]
*'''Penetrating Peripheral Vascular Trauma'''
**[[media:Penetrating_peripheral_vascular_trauma.pdf]]
*'''Evaluation of the Thoracolumbar Spine after Blunt Trauma management'''
**[[media:Blunt_Thoracolumbar_spine_.pdf]]
*'''Traumatic Injury Potentially Requiring Catheter Based/Endovascular Intervention'''
**[[media:Catheter-based-Endovascular Interventions.pdf]]
*'''Evaluation and Management of Extremity Compartment Syndrome'''
**[[media: Extremity_compartment_syndrome.pdf]]
*'''REBOA'''
**[[media: REBOA.pdf]]
*'''Harbor-UCLA Medical Center Massive Transfusion Protocol Fact Sheet'''
**[[media:Massive_Transfusion_Protocol_HUCLA.pdf]]
*'''The Continuous Process of Performance Improvement'''
**[[media:PIPS.pdf]]
*'''ACS TQIP: Orthopedic Best Practices in the Management of Orthopedic Trauma'''
**[[media:TQIP_Best_Practices_Ortho_Trauma.pdf]]
*'''ACS TQIP: Geriatric Trauma Management Guidelines'''
**[[media:TQIP_Geriatric_Trauma.pdf]]


====EEG (including Ceribell)====
==='''Shock'''===
*[[Undifferentiated shock]]
*Hypovolemic
**[[Hemorrhagic Shock]]
**[[Massive Transfusion]]
*Cardiogenic
**[[Acute coronary syndrome (main)]]
**[[ACLS (Main)]]
*Distributive
*Resuscitation Endpoints
**[[IV fluid resuscitation]]
**[[IVF composition]]
*[[Ultrasound: In Shock and Hypotension]]


====Antibiotics====
===Assessment of Fluid Responsiveness in the ICU===


===Equipment & Supplies===
==='''Pulmonary'''===
*Line Carts
====Initiating [[Mechanical ventilation (main)]]====
*Ultrasound Machines
*[[Ventilation modes]]
*B-bay Supplies
*[[Recruitment maneuver]]
*[[Ventilator associated lung injury]]
*[[Ventilator high pressures]]


===Procedures===
====Discontinuing Mechanical Ventilation====
*TSICU Extubation Standard Operating Procedure
**[[media:Standardized_Work_-_3WICU_Morning_Rounds_v.4.pdf]]
*[[Ventilation weaning]]
*[[Extubation]]


*Informed Consent
====[[Noninvasive ventilation]]====


*iMed Consent
====[[Acute Respiratory Distress Syndrome]]====
**Blood Transfusion
*[http://www.ardsnet.org/files/ventilator_protocol_2008-07.pdf ARDSnet Ventilator Settings]
**ICU interventions


*ASK NICE
====Advanced Modes of Ventilation====
*APRV
**[[media:CCM APRV Algorithm.pdf]]


===Occupational Exposure===
*[[High frequency oscillation ventilation]]


===Referral to One Legacy===
*Extracorporeal Membrane Oxygenation


===Death Packet Checklist===
==='''Cardio/Vascular'''===
====[[Arrhythmias]]====
====[[Hypertensive Emergency]]====
====[[Nontraumatic thoracic aortic dissection]]====
====[[Acute limb ischemia]]====
====''[[Coming Soon: TSICU Anti-impulse Management Protocol]]''====


=='''Core Clinical Conditions & Management'''==
==='''Renal'''===
===Shock===
====[[Acute kidney injury]]====
*Hypovolemic
====[[Acid-base disorders]]====
*Cardiogenic
*[[Anion gap acidosis]]
*Distributive
*[[Non anion gap acidosis]]
*Resuscitation Endpoints
====[[Electrolyte abnormalities]]====
**[[IV fluid resuscitation]]
*Hyper
**[[Hypernatremia]]
**[[Hyperkalemia]]
**[[Hypercalcemia]]
**[[Hypermagnesemia]]
**[[Hyperphosphatemia]]


===Assessment of Fluid Responsiveness in the ICU===
*Hypo
**[[Hyponatremia]]
**[[Hypokalemia]]
**[[Hypocalcemia]]
**[[Hypomagnesemia]]
**[[Hypophosphatemia]]


===Pulmonary===
====[[Rhabdomyolysis]]====
====Initiating [[Mechanical Ventilation]]====
====[[Uremia]]====
*[[Ventilation Settings]]
====Discontinuing Mechanical Ventilation====
====Assessing Readiness for [[Extubation]]====


====[[Acute Respiratory Distress Syndrome]]====
====Renal Replacement Therapy====
 
*CVVHD
===Acute Kidney Injury===
*IHD
 
===Sepsis & Septic Shock===


===Infections in the ICU and Appropriate Selection of Antibiotics===
==='''Sepsis & Septic Shock'''===
*[[Sepsis (Main)]]
*[[Initial Antibiotics in Sepsis (Main)]]


====Ventilator Associated Event (VAE) ''formerly known as Ventilator Associated Pneumonia (VAP)''
==='''Infections in the ICU & Appropriate Selection of Antibiotics'''===
====[[Post-operative fever]]====
====Ventilator Associated Event (VAE) ''formerly known as [[Ventilator associated pneumonia]] (VAP)''====
====Catheter Associated Urinary Tract Infection====
====Catheter Associated Urinary Tract Infection====
====Central Line Associated Bloodstream Infection====
====Central Line Associated Bloodstream Infection====
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*Organ Space
*Organ Space
====C- difficile Infection====
====C- difficile Infection====
====[[Harbor:Infectious Disease Threats]]====


==='''Hepatic & GI'''===
====Liver Failure====
====[[Abdominal compartment syndrome]]====


===Spinal Cord Injury===
==='''Nutrition Therapy including Stress Ulcer Prophylaxis'''===
===Venous Thromboembolism===
====[[FEED ME Protocol]]====
*DVT
====[[Refeeding syndrome]]====
*PE
===Traumatic Brain injury===
===Liver Failure===
===Pain, Agitation, Delirium, Immobility, and Sleep (PADIS)===
===Nutrition Therapy including Stress Ulcer Prophylaxis===
===Disseminated Intravascular Coagulopathy===
===Management of Hemorrhage in Patients on Antithrombotic Therapy===
===Acute Limb Ischemia===
===Aortic Dissection===
===Arrhythmias in the ICU===
===Endocrine Emergencies===
===Neurologic Emergencies===
 
==Educational Resources==
 
===Goals & Objectives - MS3/MS4===
 
===Goals & Objectives - PGY-1/PGY-2===


===Goals & Objectives - Fellow===
==='''Disseminated Intravascular Coagulopathy'''===


===Online Resources===
==='''Traumatic Brain injury'''===
*[[Glasgow Coma Scale]]
====[[Mild traumatic brain injury]]====
====[[Moderate-to-severe traumatic brain injury]]====
*[[Elevated intracranial pressure]]


===Recommended Readings===
==='''Spinal Cord Injury'''===
*ASIA Score
*[[Spinal cord syndromes]]


==Procedures==
==='''Neurologic Emergencies'''===
====[[Altered mental status]]====
====[[Seizure]]====
*[[Anticonvulsant levels and reloading]]
====[[Alcohol withdrawal seizures]]====
*CIWA Protocol


===Airway & Breathing===
====[[CVA]]====
====[[Intubation]]====
*[[NIH Stroke Scale]]
*TSICU Intubation Protocol
====Management of Hemorrhage in Patients on Antithrombotic Therapy====
====Surgical Cricothyroidotomy====
*[[Anti-platelet agent reversal]]
====Bedside Percutaneous Tracheostomy====
*[[Anticoagulant reversal for life-threatening bleeds]]
====Fiberoptic Bronchoscopy====
====Chest Tube Insertion (including pigtail)====


===Invasive Hemodynamic Monitoring & Access===
==='''Pain, Agitation, Delirium, Immobility, and Sleep (PADIS)'''===
====Central Venous Catheterization====
*[[ICU sedation]]
====Arterial Line Insertion====
====Pulmonary Artery Catheter Insertion====
====Dialysis Access====


===Paracentesis===
===='''RASS'''====


===Compartment Pressure Monitoring===
====[[Delirium]]====


*[[media:CAM-ICU.pdf]]


==='''Endocrine Emergencies'''===
====[[Diabetic ketoacidosis]]====
====[[Nonketotic hyperglycemia]]====
====[[Hyperosmolar hyperglycemic state]]====
====[[Hypoglycemia]]=====
====[[Diabetes medications]]====
*[[Insulin]]
====[[Adrenal crisis]]====
====[[Pheochromocytoma]]====
====[[Thyroid storm]]====
====[[Myxedema coma]]====
====[[Hypothyroidism]]====
====[[Diabetes insipidus]]====


[[Category:Admin]]
==='''[[Venous Thromboembolism]]'''
[[Category:Admin]]===

Latest revision as of 21:58, 31 August 2022

This is the main page for Harbor-UCLA Trauma SICU

Admin Updates & Reminders

Media:SICU Intern Guide.pdf

Coming Soon: TSICU Orientation & Welcome Video-Dr. Dennis Kim

TSICU:General Administrative

TSICU: Weekly Schedule

TSICU:Educational Conferences

TSICU:Clinical Documentation

TSICU:Order Sets

TSICU:Mandatory Call Criteria

TSICU:Equipment & Supplies

TSICU:Miscellaneous

TSICU:Patient Care Management

TSICU:Admissions

*Every admission to the TSICU requires Trauma/SICU Attending approval

TSICU:Transfers & Downgrades

TSICU:Ordering Labs, Tests, & Diagnostic Imaging

TSICU:Antibiotic Stewardship

TSICU:Bedside Procedures

Referral to One Legacy

Death Packet Checklist

TSICU:Educational Resources

Core Clinical Conditions & Management

Assessment & Management of the Injured Patient

Shock

Assessment of Fluid Responsiveness in the ICU

Pulmonary

Initiating Mechanical ventilation (main)

Discontinuing Mechanical Ventilation

Noninvasive ventilation

Acute Respiratory Distress Syndrome

Advanced Modes of Ventilation

  • Extracorporeal Membrane Oxygenation

Cardio/Vascular

Arrhythmias

Hypertensive Emergency

Nontraumatic thoracic aortic dissection

Acute limb ischemia

Coming Soon: TSICU Anti-impulse Management Protocol

Renal

Acute kidney injury

Acid-base disorders

Electrolyte abnormalities

Rhabdomyolysis

Uremia

Renal Replacement Therapy

  • CVVHD
  • IHD

Sepsis & Septic Shock

Infections in the ICU & Appropriate Selection of Antibiotics

Post-operative fever

Ventilator Associated Event (VAE) formerly known as Ventilator associated pneumonia (VAP)

Catheter Associated Urinary Tract Infection

Central Line Associated Bloodstream Infection

Surgical Site Infections

  • Superficial
  • Deep
  • Organ Space

C- difficile Infection

Harbor:Infectious Disease Threats

Hepatic & GI

Liver Failure

Abdominal compartment syndrome

Nutrition Therapy including Stress Ulcer Prophylaxis

FEED ME Protocol

Refeeding syndrome

Disseminated Intravascular Coagulopathy

Traumatic Brain injury

Mild traumatic brain injury

Moderate-to-severe traumatic brain injury

Spinal Cord Injury

Neurologic Emergencies

Altered mental status

Seizure

Alcohol withdrawal seizures

  • CIWA Protocol

CVA

Management of Hemorrhage in Patients on Antithrombotic Therapy

Pain, Agitation, Delirium, Immobility, and Sleep (PADIS)

RASS

Delirium

Endocrine Emergencies

Diabetic ketoacidosis

Nonketotic hyperglycemia

Hyperosmolar hyperglycemic state

Hypoglycemia=

Diabetes medications

Adrenal crisis

Pheochromocytoma

Thyroid storm

Myxedema coma

Hypothyroidism

Diabetes insipidus

===Venous Thromboembolism===

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