Guidelines for daily PICU rounds presentations
Overall goal: Filter the data thoughtfully and present the most important information to the team, focusing on your assessment of the patient’s status and your plan for the day.
General structure:
1. Single line ID Statement
2. Interval events
3. Abnormal Vital signs or important trends
4. Ins and outs (breakdown only when pertinent)
5. Pertinent Physical exam findings
6. Morning CXR review
7. Nursing input
8. Assessment
9. Plan by Pertinent Systems (incorporate medications, abnormal labs/cultures, new diagnostics into appropriate system)
Specific instructions:
1. ID: One sentence briefly introducing the pertinent underlying disease, presenting diagnosis, and reason for being in the PICU.
2. Interval Events: Briefly summarize the important events. If the patient had no important events, you don’t need to mention any.
3. Ins and outs: Fluid balance is often very important, but the total in and out is often not important unless it’s out of normal range. For patients with drains, mention drain output and trends. Please always report urine output in mL/kg/hr.
4. Physical exam: If the exam is unremarkable, state that, and please include cardiovascular, respiratory, and abdomen in your exam section at minimum.
5. CXR: Review the morning CXR. If there isn’t one, omit this part.
6. Nursing input: Please ask the nurse for any concerns or other important data.
7. Assessment: What’s most important here is your assessment of what’s going on and how the patient is doing. You don’t need more than 1-2 sentences, but this is your opportunity to convey that you can distill all the information down into what’s most important. End with patient’s trajectory and overarching goals for the day.
8. Plan: By organ system or by problem is ok, depending on the patient’s complexity. Incorporate pertinent medications, labs, diagnostic into the appropriate system.
9. Include:
a. Lines, drains, and Airways: Please mention all central lines, arterial lines, and drains (Foley, peritoneal, surgical, chest tubes), how long each has been in, and whether each is needed.
b. Labs/Diagnostics: Schedule: Present the desired lab schedule and if there should be changes.