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Protocol for "handoff" in the intensive care unit

Protocol for "handoff" in the intensive care unit
Phase 1: Equipment and technology handoff
Monitoring transferred to ICU equipment
Ventilator function initiated
Infusions and fluids checked
Chest drains secured and on suction
Vital signs confirmed to be stable, ventilator functioning well, infusions running appropriately
Anesthesiologist, nurse, surgeon, and intensivist confirm that they are ready for information transfer
Phase 2: Information handoff
Anesthesiologist presents:
  • Patient-specific information (age, weight, medical and surgical history, allergy status, baseline vital signs, pertinent laboratory results, diagnosis, current condition and vital signs)
  • Anesthetic information (intraoperative course and any complications, lines present, blood transfusion and fluid totals, doses of paralytic and opioids, antibiotics, current infusions, vital sign parameters and limits, pain relief plan, laboratory values)
Surgeon presents:
  • Surgical course (diagnosis, operation performed, surgical findings, complications, blood loss, drains)
  • If no intensivist present or if surgeon provides ICU care: further plans (antibiotic plan, deep vein thrombosis [DVT] prophylaxis medication plan, tests to be done, nutrition, key goals for the next 6 to 12 hours)
Intensivist presents:
  • Further plans (antibiotic plan, deep vein thrombosis [DVT] prophylaxis medication plan, tests to be done, nutrition, key goals for the next 6 to 12 hours)
Phase 3: Questions and discussion
ICU: intensive care unit.
Graphic 94973 Version 6.0