ROUNDING IN ICU, Study notes of Medicine

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ROUNDING IN ICU

Integrating evidenced based practices

using FAST HUGS BID

Jenna Spring and Brian Cuthbertson Department of Critical Care Medicine Sunnybrook HSC University of Toronto

Educational Objectives

1. Learn how to remember evidenced based

practices in ICU using FAST HUG BID system

• FAST HUGS BID is a mnemonic that allows us to check that we are

delivering all the evidence based practices that are appropriate for

patients

What is FAST HUGS BID?

FEEDING

• What feeds or diet is the patient receiving? Can this be optimized?
• If currently nil by mouth, do they still need to be?
• If projected to be nil by mouth for a long time, should TPN be considered?

SEDATION

• Is sedation being minimized as much as possible?
• Is a non-benzodiazepine strategy being used, if possible?

THROMBOEMBOLISM

• Is the patient receiving VTE prophylaxis?
• Does the VTE prophylaxis need to be adjusted for renal function?
• For patients at high bleeding risk, are TEDS or SCDs being used?

STRESS ULCER PROPHYLAXIS

• Does this patient require stress ulcer prophylaxis?
• Can stress ulcer prophylaxis be discontinued?

GLYCEMIC CONTROL

• Is glycemic control adequate (blood glucose target generally 6- 10mmol/L)?

BOWELS

• Is a bowel routine ordered?
• Does it need to be escalated?

INDWELLING LINES

• Can the central line or arterial line be removed?
• Does the patient require a foley catheter?

FAST HUG BID is a mnemonic to identify and check key aspects

of care in the ICU

You can do this anyway you want want as long as you

remember the breadth of interventions that are required for

every patient

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