TICU progress note assessment and plan

This is a *** year old *** who presents on *** as a *** after ***.
Patient has a history of ***
Trauma bay course remarkable for ***.

Injuries (by system):
Head: ***
Spine: ***
Chest: ***
Intraperitoneal: ***
Retroperitoneal: ***
MSK: ***

Consults: ***

# Neuro
GCS:
Sedation
gtt: ***
sch: ***
prns: ***

Pain
gtt: ***
sch: ***
prns: ***

# Cardiovascular
MAP: ***
HR: ***
Pressors: ***
Trops: ***
EKG: ***
ECHO: ***

# Respiratory
Vent settings: ***
ABG: ***
CXR: ***

# GI
Diet: ***
NGT/OGT: ***
BM: ***
Bowel reg: ***

# Renal
UOP: ***
Foley: ***
BMP: ***
Mg/Ph: ***
IVF: ***
Free water flushes: ***
Fluid Status: ***
Diuresis: ***

# Hematology
Hgb: ***
Platelets: ***

# Infectious
Temperature: ***
WBC: ***

Cx Blood Sputum Wound
date

# Endocrine
Blood glucose range last 24 hrs: ***
Insulin: ***
Insulin requirements in last 24 hrs: ***
POC BG Schedule: ***

# MSK
PT/OT

# PPx
DVT: ***
GI: ***

# Access
***
# Disposition
TICU

Service: TICU

Author: Garrett Skinner

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