Author:
Kai Knudsen
Updated:
8 January, 2026
This chapter outlines the structure and purpose of intensive care rounds, focusing on patient assessment, care planning, and multidisciplinary collaboration.
Content:
Checklist
| Overview | What are the current intensive care issues? |
|---|---|
| Evaluation of interventions performed during the care process | |
| Anamnesis | Ongoing and past health problems relevant to intensive care? |
| Background | Patient’s prior level of function |
| STATUS | |
| Respiration | Ventilator settings |
| Lungs | Blood gases |
| Intubation, weaning, extubation, tracheostomy | |
| Respiratory care – interventions? | |
| Pleural drainage? | |
| Circulation | Vasoactive and inotropic drugs |
| Need for extended monitoring? | |
| PiCCO? | |
| Fluid status, fluid therapy | |
| Coagulation | |
| Thromboprophylaxis | |
| Abdominal pressure measurement | |
| Neurology | Level of consciousness? |
| Ongoing sedation? | |
| Pain? | |
| Sleep? | |
| Delirium (manifest, screening) | |
| Wake-up? | |
| CFM? | |
| Renal Function | Renal function and urine output? |
| Fluid Balance | Fluid balance – input vs output |
| Electrolyte Balance | Weight |
| Dose adjustment of medications? | |
| Diuretics? | |
| Electrolytes – Na, K, Ca, Mg, Phosphate. | |
| Blood gases. | |
| Dialysis? – Dialysis documentation in a separate document | |
| Gastrointestinal function | Fasting? |
| Nutrition | Oral intake? Swallowing function? |
| TPN? | |
| Tube feeding? | |
| Abdominal status, gastric retention, bowel function? | |
| Ulcer prophylaxis? | |
| Laxatives? | |
| Blood sugar? | |
| Energy needs, protein needs, nutrition strategy? Insulin | |
| Infection | Infection control? |
| Cultures/antibiotics? | |
| Healthcare-associated infections? | |
| Temperature | |
| Infection markers | |
| Skin | Oral status, skin, wounds, sutures/staples? Pressure ulcers? |
| Tissue | |
| Vascular access | Insert new? Secure, replace, remove? |
| Cultivate? | |
| Activity | Mobilization |
| Physiotherapy | |
| Restrictions? | |
| Psychosocial | Relatives, minor children/child protection report Social worker? |
| Interpreter needed? | |
| PLANNING | |
| Medications | Update/sign the medication list |
| Treatment Strategy | Limited treatment strategy and documentation? Donation? |
| 0 CPR? | |
| Level of care conference? | |
| Target Orders | Update target orders. |
| Are there orders to maintain the goals? | |
| Planning | Order lab tests. |
| Examinations? | |
| Treatments? | |
| Surgery? | |
| Family conversations? | |
| Preparation for transfer, contact with home unit? | |
| Other certificates |
| Overview | What are the current intensive care issues? Evaluation of interventions performed during the care process |
| Anamnesis Background | Ongoing and past health problems relevant to intensive care? Patient’s prior level of function |
| STATUS | |
| Respiration Lungs | Ventilator settings Blood gases Intubation, weaning, extubation, tracheostomy Respiratory care – interventions? Pleural drainage? |
| Circulation | Vasoactive and inotropic drugs Need for extended monitoring? PiCCO? Fluid status, fluid therapy Coagulation Thromboprophylaxis Abdominal pressure measurement |
| Neurology | Level of consciousness? Ongoing sedation? Pain? Sleep? Delirium (manifest, screening) Wake-up? CFM? |
| Renal Function Fluid Balance Electrolyte Balance | Renal function and urine output? Fluid balance – input vs output Weight Dose adjustment of medications? Diuretics? Electrolytes – Na, K, Ca, Mg, Phosphate. Blood gases. Dialysis? – Dialysis documentation in a separate document |
| Gastrointestinal function Nutrition | Fasting? Oral intake? Swallowing function? TPN? Tube feeding? Abdominal status, gastric retention, bowel function? Ulcer prophylaxis? Laxatives? Blood sugar? Energy needs, protein needs, nutrition strategy? Insulin |
| Infection | Infection control? Cultures/antibiotics? Healthcare-associated infections? Temperature Infection markers |
| Skin Tissue | Oral status, skin, wounds, sutures/staples? Pressure ulcers? |
| Vascular access | Insert new? Secure, replace, remove? Cultivate? |
| Activity | Mobilization Physiotherapy Restrictions? |
| Psychosocial | Relatives, minor children/child protection report Social worker? Interpreter needed? |
| PLANNING | |
| Medications | Update/sign the medication list |
| Treatment Strategy | Limited treatment strategy and documentation? Donation? 0 CPR? Level of care conference? |
| Target Orders | Update target orders. Are there orders to maintain the goals? |
| Planning | Order lab tests. Examinations? Treatments? Surgery? Family conversations? Preparation for transfer, contact with home unit? Other certificates |
Breath Sounds
| Type of sound | Description |
|---|---|
| Vesicular | Soft, low-pitched, heard over most of the lungs. Heard during inspiration & expiration. |
| Bronchial | Loud, high-pitched, heard normally over trachea. Heard during inspiration & expiration. |
| Crackles (rales) | Fine or coarse “popping” sounds, often on inspiration (e.g. pulmonary oedema, LRTI, pneumonia). |
| Wheeze | High-pitched, usually expiratory. Narrowed airways (e.g. asthma, COPD). |
| Rhonchi | Low-pitched, snoring/gurgling quality, usually expiratory. |
| Stridor | Harsh, high-pitched inspiratory sound. Upper airway obstruction (e.g. croup, anaphylaxis, foreign body). |
| Pleural rub | Grating, “creaking leather” sound, heard during inspiration & expiration. Inflamed pleural surfaces. |
| Reduced | Reduced airflow (e.g. COPD, pneumothorax, effusion, obesity). |
| Absent | No air entry (e.g. tension pneumothorax, massive effusion, asthma, complete obstruction). |
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