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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]]


*Rapid Response Team (RRT)
===[[Media:SICU Intern Guide.pdf]]===
**[[Harbor:Codes]]


===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
*Medication Reconciliation


===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)


====Disaster & Surge Plan====
===[[TSICU:Clinical Documentation]]===
*[[Harbor:Disaster plan]]
*[[Harbor:Surge plan]]


===Contact Information===
===[[TSICU:Order Sets]]===
*[[Los Angeles ED phone directory]]


==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]]===
*[[Harbor:Labs]]


====Point of Care====
===[[TSICU:Ordering Labs, Tests, & Diagnostic Imaging]]===
*[[Thromboelastography (TEG)]]


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


*Chest X-rays
===[[TSICU:Bedside Procedures]]===
 
*Ultrasound
 
*CT scan
 
*MRI
 
====Bedside Echocardiogram====
 
====EEG (including Ceribell)====
 
====Antibiotics====
*[[Harbor:Antibiogram]]
 
===Equipment & Supplies===
*Line Carts
*Ultrasound Machines
*B-bay Supplies
 
===Procedures===
 
*Informed Consent
**[[Harbor:Consenting a patient]]
 
*iMed Consent
**Blood Transfusion
***[[Harbor:Ordering Blood Products]]
**ICU interventions
 
*ASK NICE
 
===Occupational Exposure===
*[[Harbor:Occupational exposure]]


===Referral to One Legacy===
===Referral to One Legacy===
*[[Brain death]]
*[[Brain death]]
*[[media:Tissue_and_Organ_Donations.pdf]]


===Death Packet Checklist===
===Death Packet Checklist===
=='''[[TSICU:Educational Resources]]'''==


=='''Core Clinical Conditions & Management'''==
=='''Core Clinical Conditions & Management'''==
===Shock===
 
==='''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]]
 
==='''Shock'''===
*[[Undifferentiated shock]]
*[[Undifferentiated shock]]
*Hypovolemic
*Hypovolemic
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===Assessment of Fluid Responsiveness in the ICU===
===Assessment of Fluid Responsiveness in the ICU===


===Pulmonary===
==='''Pulmonary'''===
====Initiating [[Mechanical ventilation (main)]]====
====Initiating [[Mechanical ventilation (main)]]====
*[[Ventilation Settings]]
*[[Ventilation modes]]
*[[Ventilation modes]]
*[[Recruitment maneuver]]
*[[Recruitment maneuver]]
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====Discontinuing Mechanical Ventilation====
====Discontinuing Mechanical Ventilation====
*TSICU Extubation Standard Operating Procedure
**[[media:Standardized_Work_-_3WICU_Morning_Rounds_v.4.pdf]]
*[[Ventilation weaning]]
*[[Ventilation weaning]]
*[[Extubation]]
*[[Extubation]]
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====[[Acute Respiratory Distress Syndrome]]====
====[[Acute Respiratory Distress Syndrome]]====
*[http://www.ardsnet.org/files/ventilator_protocol_2008-07.pdf ARDSnet Ventilator Settings]
====Advanced Modes of Ventilation====
*APRV
**[[media:CCM APRV Algorithm.pdf]]
*[[High frequency oscillation ventilation]]
*Extracorporeal Membrane Oxygenation
==='''Cardio/Vascular'''===
====[[Arrhythmias]]====
====[[Hypertensive Emergency]]====
====[[Nontraumatic thoracic aortic dissection]]====
====[[Acute limb ischemia]]====
====''[[Coming Soon: TSICU Anti-impulse Management Protocol]]''====


===Renal===
==='''Renal'''===
====[[Acute kidney injury]]====
====[[Acute kidney injury]]====
====[[Acid-base disorders]]====
====[[Acid-base disorders]]====
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*IHD
*IHD


===Sepsis & Septic Shock===
==='''Sepsis & Septic Shock'''===
*[[Sepsis (Main)]]
*[[Sepsis (Main)]]
*[[Initial Antibiotics in Sepsis (Main)]]
*[[Initial Antibiotics in Sepsis (Main)]]


===Infections in the ICU and Appropriate Selection of Antibiotics===
==='''Infections in the ICU & Appropriate Selection of Antibiotics'''===
====[[Post-operative fever]]====
====[[Post-operative fever]]====
====Ventilator Associated Event (VAE) ''formerly known as [[Ventilator associated pneumonia]] (VAP)''====
====Ventilator Associated Event (VAE) ''formerly known as [[Ventilator associated pneumonia]] (VAP)''====
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====[[Harbor:Infectious Disease Threats]]====
====[[Harbor:Infectious Disease Threats]]====


==='''Cardiovascular'''===
==='''Hepatic & GI'''===
====[[Arrhythmias]]====
====[[Hypertensive Emergency]]====
====[[Nontraumatic thoracic aortic dissection]]====
====[[Acute limb ischemia]]====
 
===Hepatic & GI===
====Liver Failure====
====Liver Failure====
====[[Abdominal compartment syndrome]]====
====[[Abdominal compartment syndrome]]====


===Nutrition Therapy including Stress Ulcer Prophylaxis===
==='''Nutrition Therapy including Stress Ulcer Prophylaxis'''===
====[[FEED ME Protocol]]====
====[[Refeeding syndrome]]====
====[[Refeeding syndrome]]====


===Disseminated Intravascular Coagulopathy===
==='''Disseminated Intravascular Coagulopathy'''===


===Traumatic Brain injury===
==='''Traumatic Brain injury'''===
*[[Glasgow Coma Scale]]
*[[Glasgow Coma Scale]]
====[[Mild traumatic brain injury]]====
====[[Mild traumatic brain injury]]====
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*[[Elevated intracranial pressure]]
*[[Elevated intracranial pressure]]


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


===Neurologic Emergencies===
==='''Neurologic Emergencies'''===
====[[Altered mental status]]====
====[[Altered mental status]]====
====[[Seizure]]====
====[[Seizure]]====
*[[Anticonvulsant levels and reloading]]
*[[Anticonvulsant levels and reloading]]
====[[Alcohol withdrawal seizures]]====
====[[Alcohol withdrawal seizures]]====
*CIWA Protocol
====[[CVA]]====
====[[CVA]]====
*[[NIH Stroke Scale]]
*[[NIH Stroke Scale]]
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*[[Anticoagulant reversal for life-threatening bleeds]]
*[[Anticoagulant reversal for life-threatening bleeds]]


===Pain, Agitation, Delirium, Immobility, and Sleep (PADIS)===
==='''Pain, Agitation, Delirium, Immobility, and Sleep (PADIS)'''===
*[[ICU sedation]]
 
===='''RASS'''====
 
====[[Delirium]]====
====[[Delirium]]====


===Endocrine Emergencies===
*[[media:CAM-ICU.pdf]]
 
==='''Endocrine Emergencies'''===
====[[Diabetic ketoacidosis]]====
====[[Diabetic ketoacidosis]]====
====[[Nonketotic hyperglycemia]]====
====[[Nonketotic hyperglycemia]]====
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====[[Diabetes insipidus]]====
====[[Diabetes insipidus]]====


===Venous Thromboembolism===
==='''[[Venous Thromboembolism]]'''
*DVT
[[Category:Admin]]===
*PE
 
==Educational Resources==
 
===Goals & Objectives - MS3/MS4===
 
===Goals & Objectives - PGY-1/PGY-2===
 
===Goals & Objectives - Fellow===
 
===Online Resources===
 
===Recommended Readings===
 
==Procedures==
 
===Airway & Breathing===
====[[Intubation]]====
*TSICU Intubation Protocol
====Surgical Cricothyroidotomy====
====Bedside Percutaneous Tracheostomy====
====Fiberoptic Bronchoscopy====
====[[Chest tube insertion]]====
====[[Pigtail catheter thoracostomy]]====
*[[Step-by-step instructions]]
*[[Procedure on a real patient]]
*Can be considered for spontaneous or small traumatic pneumothorax
====[[Thoracentesis]]====
 
===Invasive Hemodynamic Monitoring & Access===
====Central Venous Catheterization====
*[[Internal jugular central venous catheter (CVC) insertion]]
*[[Subclavian central venous catheter (CVC) insertion]]
*[[Femoral central venous catheter (CVC) insertion]]
 
====[[Arterial line insertion]]====
 
====Pulmonary Artery Catheter Insertion====
====Dialysis Access====
 
===[[Paracentesis]]===
 
===[[Compartment pressure measurement]]===
 
 
 
[[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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