TSICU:Main: Difference between revisions

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=='''Admin Updates & Reminders'''==
=='''Admin Updates & Reminders'''==
*Please ensure continued and timely use of the OR to TSICU Handoff Tool
*Please review and remember the '''Standardized Work for Morning Rounds'''
**[[media:Standardized_Work_3WICU_Morning_Rounds_v.5.pdf]]
 
*Please ensure continued and timely use of the '''OR to TSICU Handoff Tool'''
**[[media:OR_to_TSICU_RN_Handoff_Tool_.pdf]]  
**[[media:OR_to_TSICU_RN_Handoff_Tool_.pdf]]  


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


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=='''[[TSICU:General Administrative]]'''==
=='''[[TSICU:General Administrative]]'''==
*'''Monthly Call Schedule'''
**Trauma/SICU Attending [[media: TR_07-19.pdf]]
**SICU Fellows  [[media:July 2019_Fellow.pdf]]
*'''TSICU Map''' [[media: TSICU Layout.pdf]]


*'''[[TSICU: Phone Numbers]]'''
*'''[[TSICU: Phone Numbers]]'''
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==='''Assessment & Management of the Injured Patient'''===
==='''Assessment & Management of the Injured Patient'''===
*[[Roles & Responsibilities of the Trauma Team]]
*'''Roles & Responsibilities of the Trauma Team'''
**[[media:Trauma_roles_and_responsibilities_revised.pdf]]
**[[media:Trauma_roles_and_responsibilities_revised.pdf]]
*[[Trauma Team Activation and Response]]
*'''Trauma Team Activation and Response'''
*[[Initial Assessment and Management of the Trauma Patient]]
**[[media:Trauma_team_activation_and_response.pdf]]
*[[Blunt Head Trauma Evaluation]]
*'''Initial Assessment and Management of the Trauma Patient'''
*[[Traumatic Intracranial Hemorrhage Algorithm]]
**[[media:Initial_assessment_and_management_of_the_trauma_patient.pdf]]
*[[Blunt Neck Trauma Evaluation]]
*'''Blunt Head Trauma Evaluation'''
*[[Blunt Cerebrovascular Injury Evaluation and Management]]
**[[media:Blunt_head_trauma_evaluation.pdf]]
*[[Cervical Spine Evaluation and Injury Management]]
*'''Traumatic Intracranial Hemorrhage Algorithm'''
*[[Penetrating Neck Trauma evaluation and management]]
**[[media:Traumatic_Intracranial_Hemorrhage.pdf]]
*[[Evaluation of the thoracolumbar spine after blunt trauma management]]
*'''Blunt Neck Trauma Evaluation'''
*[[Blunt Chest Trauma Evaluation and Management]]
**[[media:Blunt_Neck_Trauma_.pdf]]
*[[Rib Fractures and Flail Chest]]
*'''Blunt Cerebrovascular Injury Evaluation and Management'''
*[[Pneumothorax or Hemothorax]]
**[[media:BCVI_Evaluation_and_Management.pdf]]
*[[Pneumomediastinum Evaluation and Management]]
*'''Cervical Spine Evaluation and Injury Management'''
*[[Blunt Cardiac Injury]]
**[[media:C-Spine_Injury_Evaluation_and_Managment.pdf]]
*[[Penetrating Precordial Trauma]]
*'''Penetrating Neck Trauma Evaluation and Management'''
*[[Blunt Aortic Injury]]
**[[media:Penetrating_neck_trauma_evaluation_and_management.pdf]]
*[[Blunt Abdominal Trauma]]
*'''Blunt Chest Trauma Evaluation and Management'''
*[[Solid Organ Injury Management (Kidney, Spleen, Liver)]]
**[[media:Blunt_Chest_Trauma_.pdf]]
*[[Genitourinary Trauma (Kidney, Ureter, Bladder)]]
*'''Rib Fractures and Flail Chest'''
*[[Penetrating abdominal/flank/back injury evaluation and management*]]
**[[media:Rib_Fractures_&_Flail_Chest.pdf]]
*[[Pelvic Fractures]]
*'''Pneumothorax or Hemothorax'''
*[[Blunt Peripheral Vascular Trauma]]
**[[media:Pneumothorax_and_Hemothorax.pdf]]
*[[Penetrating Peripheral Vascular Trauma]]
*'''Pneumomediastinum Evaluation and Management'''
*[[Traumatic Injury Potentially Requiring Catheter Based/Endovascular Intervention (Algorithm excludes patients requiring emergent operative management)]]
**[[media:Pneumomediastinum.pdf]]
*[[Evaluation and Management of Extremity Compartment Syndrome]]
*'''Blunt Cardiac Injury'''
*[[REBOA]]
**[[media:Blunt_Cardiac_Injury.pdf]]
*[[Harbor-UCLA Medical Center Massive Transfusion Protocol Fact Sheet]]
*'''Penetrating Precordial Trauma'''
*[[The Continuous Process of Performance Improvement]]
**[[media:Penetrating_Precordial_Trauma.pdf]]
*[[ACS TQIP: Orthopedic Best Practices in the Management of Orthopedic Trauma]]
*'''Blunt Aortic Injury'''
*[[ACS TQIP: Geriatric Trauma Management Guidelines]]
**[[media:Blunt_Aortic_Injury.pdf]]
*[[ACS TQIP: Geriatric Trauma Management Guidelines]]
*'''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]]


==='''Shock'''===
==='''Shock'''===
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====[[Diabetes insipidus]]====
====[[Diabetes insipidus]]====


==='''Venous Thromboembolism'''===
==='''[[Venous Thromboembolism]]'''
 
[[Category:Admin]]===
====Chemical Prophylaxis====
*Lovenox 30mg SubQ q12 hrs (if Cr Clearance > 30)
**Check AntiXa level every week EXACTLY 4 hours after 3rd dose of lovenox
***prophylactic goal: 0.2-0.6
***therapeutic goal: 0.6-1.2
*Recheck AntiXa level after each 3rd dose if dose is changed until you are at goal
*Recheck level every week (usually qMonday) for all patients
*If renal dysfunction order heparin 5000 Units SubQ q8 hrs (search “SURG DVT/VTE prophylaxis” order set)
 
====DVT====
 
 
====PE====

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===