Morning Ward Round

Registrar Stethoscope
Digit Clock 21
Digit Clock 4
Digit Clock 5
Digit Clock 9
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Assessment Adequate fluid Escalating care Analysis of care

Assessment of

Click on the items on the left to view the overall assessment of 's situation as at the time shown above.

Noradrenaline of 10 mls/hr, resulting in:

  • MAP of 65 mmHg
  • Urine output of 10 mls/hr
  • CVP is 14 mmHg

Questions that need to be thought about on the ward round are the following...

Is adequately filled?

Yes, 's CVP reading shows she has sufficient fluid. 's mean arterial pressure remains lower than ideal although she's on high levels of noradrenaline (10 mls/hr). Her urine output is also lower than ideal at 10mls per hr (ideal urine output should be around ½ ml/kg which should produce around 35 mls urine per hr).

N/A.

Does her care need to be escalated?

Yes. There should be discussion about transferring to intensive care to further support her blood pressure using inotropes (e.g. Dobutamine). Potentially, also needs support for her kidneys as there is the possibility that she may develop renal failure.

N/A.

The decision taken was to ask ICU to review 's situation and she was transferred to the Intensive Care Unit at 10am for further treatment. This treatment aimed to support and review:

  • Cardio-vascular status further – to include further inotropes – dobutamine
  • Renal status
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