ICU Routines and Bundles of Care

Document Type

Article

Publication Date

2-16-2023

Abstract

Caring for the critically ill patient is complex and challenging. Every day there are new issues to react to and new treatment plans to provide. Uninterrupted, patient-centered, multidisciplinary daily ward round is the platform where the treatment plan is formulated for each patient. The key element of ICU care is indeed the treatment of the underlying disease (causative treatment) and support or replacement of failing organs. Some parts of care, however, are universal and performed every day in all or almost all ICU patients. This chapter deals with routine aspects of care, management of which is often left with the junior doctor. These include daily assessment of ICU patients (“clerking”), and prescription of fluids, nutrition, patients’ positioning, and implementing bundles of care, i.e., sets of interventions that, when used together, significantly improve ICU patient outcomes. These include ABCDEF bundle of protocolized physiotherapy and early mobilization and the prevention of ventilator-associated pneumonia. To give each patient the best possible care, it has been proven to be beneficial to follow established structures and checklists, especially in such an inter-professional, high-paced, and high-stakes environment as the ICU. In this chapter, we aim to give the novice a practical guide how to safely perform the daily ICU routine in stable patients.

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