RAPID EYE: an Aid Memoir for Comprehensive Evaluation of Patient in Post-cardiac Surgery Recovery Unit

Excerpt

Over the last few years, tremendous advancement in information and technology has made it possible to disseminate enormous amount of medical information to healthcare providers as well as the general population. Often times, it is overwhelming for the young trainees to keep track of this glut of information. To prepare the next generation of physicians and surgeons, it is of utmost importance that trainees inculcate sound medical knowledge. It cannot be emphasized enough about the importance of a thorough and complete clinical assessment of patients in cardiac surgery intensive units to help make informed decisions. There are several mnemonics in medicine which assist clinicians to remember common causes of diseases and their differential diagnosis. Also mnemonics are quick checklist and can become part of daily progress report noted in the patient case file, for instance, FAST HUG (feeding, analgesia, sedation, thromboprophylaxis, head up 30 degrees, ulcer prophylaxis, glycemic control) mnemonic to improve the quality of care of critically ill patients in intensive care units (ICU) [1]. Furthermore, every individual critical care unit has its own remedial measures to improve patient care practices, and certainly mnemonics are one such essential tool. This mnemonic had further modified into FAST HUGS BID (feeding, analgesia, sedation, thromboprophylaxis, head up 30 degrees, ulcer prophylaxis, glycemic control, supplement O₂, bowel, indwelling catheter, drugs/delirium) to make it more comprehensive, while others used this mnemonic for early recognition and treatment of ventilator-associated pneumonias [2, 3]. The components of FAST HUGS BID were modified to recognize surgical issues earlier in patients where post-operative care was predominantly undertaken by anesthesiologists [4]. Also the components of FAST HUG mnemonic changed to cover nutritional support of their critically ill patients in ICU [5]. Likewise, the “GHOST CAP” (glucose, hemoglobin, oxygen, sodium, temperature, comfort, arterial blood pressure, acute changes in PaCO₂) mnemonic is used in neurology ICU for the care of brain injury patients [6]. Another “FAST HUG MAIDENS” (feeding, analgesia, sedation, thromboprophylaxis, hyperactive or hypoactive delirium, stress ulcer prophylaxis, glucose control, medication, antibiotics, indications for medications, drug dosing, electrolytes, hematology and other laboratory results, no drug interaction, stop dates) was proposed to identify drug-related issues in ICU care [7]. …