Israel's Nurse Guide

Clinical decision support — personal use only
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Select Your Unit

Good shift, Israel.

Active

TICU

Trauma ICU — microsurgery, post-PACU, general surgery

Coming Soon

ICU

Stroke protocols, ventilator, sedation drips

TICU

What's the scenario?

New Patient Admit

Room prep + arrival priority checklist

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Microsurgery Patient

Doppler check frequency + monitoring

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Post-PACU / General Surgery

Head elevation, SCDs, BP params, diet

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Sedation Drips

Propofol, Precedex — dosing + titration

Needs your input tonight
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New Patient Admit

Room Prep — Before They Arrive
Bedding
Patient gown
Blood pressure cuff
Oximetry equipment
Badge linked
Name band ready
Patient record number confirmed
On Arrival — Priority Order
1 — Leads (cardiac monitoring, heart rhythm) First
2 — Oximeter (breathing, respirations) First
3 — Gown
4 — Name band
5 — Review meds, accept all doctor's orders
6 — Labs (draw immediately if ordered)
7 — Sign off from EMS or transferring unit
8 — Talk to family
9 — Write info on board (meds, belongings)
10 — Complete admit process

Microsurgery Patient

How often are you checking pulse with the doppler?

Q1H — Every hour

Immediate post-op, first 12-24 hrs, concern for perfusion

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Q2H — Every 2 hours

Stable, early post-op, progressing well

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Q3H — Every 3 hours

Stable, further along in recovery

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Q4H — Every 4 hours

Stable, later recovery phase

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Israel — confirm: Which conditions bump you to Q1 vs Q2 vs Q3/Q4? Add any specifics tonight and Paula will update.

Doppler Q1H

Frequency

Every 1 hour

Typical Situation

First 12-24 hrs post-op, or any sign of vascular compromise — confirm with Israel

What to Assess

Doppler signal quality, flap color, capillary refill, skin temp — confirm with Israel

Escalate If

No signal, change in signal quality, color or temp change — confirm with Israel

Israel — fill in the real triggers and what you actually check. Paula updates tonight.

Doppler Q2H

Frequency

Every 2 hours

Typical Situation

Stable, progressing post-op — confirm with Israel

What to Assess

Doppler signal, flap color, cap refill, skin temp — confirm with Israel

Escalate If

Confirm with Israel

Doppler Q3H

Frequency

Every 3 hours

Typical Situation

Further along in recovery, consistently stable — confirm with Israel

What to Assess

Confirm with Israel

Escalate If

Confirm with Israel

Doppler Q4H

Frequency

Every 4 hours

Typical Situation

Later recovery, stable, lower monitoring intensity — confirm with Israel

What to Assess

Confirm with Israel

Escalate If

Confirm with Israel

Post-PACU / General Surgery

Room Setup
SCDs applied (sequential compression devices)
Head of bed elevated
IV access confirmed
Foley / drainage verified
Call light within reach
Protocols

Head Elevation

HOB angle — confirm with Israel (e.g. 30 degrees?)

Blood Pressure Parameters

Target range, when to notify — confirm with Israel

Diet

NPO, clears, or other restrictions — confirm with Israel

Pain Management

Confirm with Israel — what's typical for your post-PACU patients?

Israel — these are the protocols you mentioned. Tell Paula the specific values tonight and she'll update.