Orientation
SICU Daily Rounds — Expectations & Presentation Format
Daily workflow and expectations for ICU residents during SICU rotation, including rounding format, progress note expectations, and family connect notes.
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Day-to-Day Responsibilities
The HGH ICU is a twenty-four bed, mixed medical and surgical intensive care unit.Section
Day-to-Day Responsibilities
The HGH ICU is a twenty-four bed, mixed medical and surgical intensive care unit.The HGH ICU is a twenty-four bed, mixed medical and surgical intensive care unit.
- Rounds timing:* During weekdays, ICU + Trauma rounds are typically at 8:15 AM unless otherwise determined by the ICU or Trauma attending.
- Who presents:* ICU residents are expected to present each patient on rounds. They present after the ICU bedside nurse reports updates from a nursing perspective.
Presentation Expectations
In addition to reporting patient data, residents are expected to:Section
Presentation Expectations
In addition to reporting patient data, residents are expected to:In addition to reporting patient data, residents are expected to:
- Synthesize a treatment plan that is evidence-based for each of the patient's active problems
- Use the recommended presentation format to organize reporting in a system-based fashion
Systems-Based Presentation Format
- Overnight events — What happened since last rounds?
- Vital signs — 24-hour trends (temp, HR, BP, O₂ sats, I/O)
- Lines / Tubes / Drains — Type, location, date placed
- Drips / Infusions — Active medications and rates
- Ventilator settings (if applicable) — Mode, FiO₂, PEEP, volumes
- Labs — Key values and trends
- Imaging — CXR and relevant results
- Systems assessment and plan — Neuro, Cardiovascular, Pulmonary, GI/Nutrition, Renal, Heme, ID, Endocrine, Lines/Wounds
- Disposition and goals of care
ICU Progress Notes
In addition to presenting on daily ICU rounds, you will be expected to write an ICU progress note for each patient.Section
ICU Progress Notes
In addition to presenting on daily ICU rounds, you will be expected to write an ICU progress note for each patient.In addition to presenting on daily ICU rounds, you will be expected to write an ICU progress note for each patient.
- Critical documentation expectations:*
- Do NOT cut and paste from previous notes
- Notes should be synthesized new each day based on:
- Overnight events
- Daily progression of the patient's clinical findings
- Radiology: Include only the key findings of imaging studies — NOT the entire radiologist's dictation
Family Connect Notes
In addition to progress notes, each patient should also receive "family connect notes" twice a week:Section
Family Connect Notes
In addition to progress notes, each patient should also receive "family connect notes" twice a week:In addition to progress notes, each patient should also receive "family connect notes" twice a week:
- First note: covers the first half of the week, completed by Tuesday
- Second note: covers the second half of the week, completed by Friday
What Family Connect Notes Should Include
- Document conversations with available family members regarding the patient's status
- Cover the key components of the discussion
- Do not need to be long unless the patient's bio-psycho-social situation demands it
- Function as a log of communications with the family regarding the patient's course in the ICU