template
Event Note
Documentation for acute clinical events in the ICU (respiratory failure, hypotension, unplanned extubation, code, etc.).
On this page
On this page
- Date/Time:*
- Author:*
- Event type:* (Respiratory failure / Hypotension / Unplanned extubation / Cardiac arrest / Other)
- Attending notified:* (yes / no — time: ___)
Event Description
Time of event:* • Brief description:*Section
Event Description
Time of event:* • Brief description:*- Time of event:*
- Brief description:*
Patient Status at Time of Event
Vitals: HR ___ BP ___/___ RR ___ SpO₂ ___% on _Section
Patient Status at Time of Event
Vitals: HR ___ BP ___/___ RR ___ SpO₂ ___% on _- Vitals: HR ___ BP ___/___ RR ___ SpO₂ ___% on __
- Mental status:
- Relevant context:
Assessment
Section
Assessment
- Most likely etiology:
- Differential considered:
Interventions
1. 2. 3.Section
Interventions
1. 2. 3.1. 2. 3.
Patient Response
Vital signs post-intervention: HR ___ BP ___/___ SpO₂ ___%Section
Patient Response
Vital signs post-intervention: HR ___ BP ___/___ SpO₂ ___%- Response to intervention:
- Vital signs post-intervention: HR ___ BP ___/___ SpO₂ ___%
Plan
Attending attestation / co-signature if required.*Section
Plan
Attending attestation / co-signature if required.*- Immediate:
- Ongoing monitoring:
- Attending plan:
- Attending attestation / co-signature if required.*