ICU · STRUCTURED CHART · 24-72H · LIVE
Structured chart
Cumulative trends · vitals 30s polling · meds q.i.d. · events chronological · labs delta · notes timeline
ICU-02
SPH00482720
CRITICAL
LIVE · 30s polling
Lakshmi Narayana Bhat · 67 M
Vitals · 24-hour cumulative trend
Heart rate
118bpm
08:0014:0020:0002:0008:00
Blood pressure (sys)
92/58 mmHg
08:0014:0020:0002:0008:00
SpO₂
91%
08:0014:0020:0002:0008:00
Respiratory rate
24/min
08:0014:0020:0002:0008:00
Temperature
38.7°C
08:0014:0020:0002:0008:00
Medication administration · last 24h
Piperacillin-Tazobactam 4.5g IV q6h · D2 of 7
06:00 ✓ RN-12
12:00 ✓ RN-12
18:00 ✓ RN-08
00:00 ✓ RN-08
06:00 due
Noradrenaline 0.18 mcg/kg/min IV continuous
running · titrated 4× last 24h
last bag change 04:30
Hydrocortisone 100mg IV q8h
08:00 ✓ RN-12
16:00 ✓ RN-08
00:00 ✓ RN-08
08:00 due
Pantoprazole 40mg IV o.d.
08:00 ✓ RN-12
08:00 due
Enoxaparin 40mg SC o.d. · DVT prophylaxis
22:00 ✓ RN-08
Paracetamol 1g IV q6h PRN · T > 38.5
10:30 ✓ RN-12
16:45 ✓ RN-08
22:00 ✓ RN-08
04:15 ✓ RN-08
Insulin Actrapid sliding scale q4h · target 140-180 mg/dL
08:00 ✓ 4u
12:00 ✓ 6u
16:00 ✓ 4u
20:00 ✓ 2u
00:00 ✓ 0u
04:00 ✓ 4u
Event log · chronological · last 24h
-
07:31
CODE BLUECode blue called · VT arrest · ROSC at 2m08s after 2 shocks 200J
-
04:18
VENTFiO₂ 0.45 → 0.55 · PEEP 6 → 8 cmH₂O · SpO₂ trending down
-
19:00
FAMILYFamily visit · son (Mr. R. Bhat) + daughter-in-law · 25 min
-
14:42
PRESSORNoradrenaline titrated up · 0.12 → 0.18 mcg/kg/min · MAP target 65
-
11:30
ROUNDMorning round complete · plan: continue Pip-Tazo D2, escalate if no clinical improvement by 48h
-
10:15
LABProcalcitonin reported · 8.4 ng/mL (high · severe sepsis range)
-
02:30
ALARMTachycardia alarm · HR 118 sustained >5 min · acked <30s
-
22:00
SHIFTShift handover · D-shift to N-shift · 14 active issues reviewed
-
15:20
CONSULTPulmonology consult · review weaning readiness in 24-48h
Most recent labs
CBC + Differential
WBC
18.4 ×10⁹/L
ref 4-11 · ↑ 2.1 vs prev
Hgb
9.8 g/dL
ref 13-17 · stable
Plt
142 ×10⁹/L
ref 150-450 · ↓ 22
Neutrophils
88 %
ref 40-70 · left-shift
Chemistry · electrolytes
Na⁺
132 mmol/L
ref 135-145
K⁺
4.2 mmol/L
ref 3.5-5.0
Creatinine
1.8 mg/dL
ref 0.7-1.3 · ↑ 0.4 (AKI)
Urea
68 mg/dL
ref 15-40 · ↑
Glucose
168 mg/dL
target 140-180
Sepsis markers + ABG
Procalcitonin
8.4 ng/mL
severe sepsis · ↑↑
CRP
186 mg/L
ref <5 · ↑ 12 vs prev
Lactate
3.1 mmol/L
ref <2 · ↓ 0.4
pH
7.31
ref 7.35-7.45 · resp acidosis
PaO₂
68 mmHg
on FiO₂ 0.55 · P/F 124
Free-text notes timeline
2026-04-30 · 11:30
PROGRESS
Day 2. Septic shock secondary to community-acquired pneumonia, presumed bacterial. Continues on Pip-Tazo, hydrocortisone, noradrenaline. Lactate trending down (3.5 → 3.1). Procalcitonin remains elevated. AKI improving. Plan: continue current regimen, ABG q6h, blood cultures pending sensitivity, escalate to meropenem if no clinical improvement by 48h. Family update at 19:00 — discussed prognosis, code status full code per family preference.
2026-04-30 · 15:20
CONSULT
Reviewed at request of ICU team. Bilateral lower-zone consolidation on CXR consistent with CAP. Recommendations: continue current antibiotics, daily CXR, consider weaning trial in 24-48h if FiO₂ ≤ 0.40 and PEEP ≤ 5 sustained for 6h. Add chest physiotherapy q6h. Will follow-up tomorrow AM.
2026-04-30 · 22:00
SHIFT NOTE
D-shift summary. Patient remained on assisted ventilation throughout shift. Hemodynamics required noradrenaline titration ×2 (0.12 → 0.15 → 0.18 mcg/kg/min). Family visited at 19:00 — counseling provided by Dr. Mehta. All scheduled meds administered on time. Tachycardia alarm fired at 02:30 — sustained, observed, escalated as appropriate.
2026-04-30 · 07:31
CODE EVENT
Code Blue · 07:31. Witnessed VT arrest. ACLS initiated immediately. CPR ×2 cycles, 2 shocks at 200J biphasic. Adrenaline 1mg ×1. ROSC achieved at 2m08s. Post-arrest: HR 124, BP 86/52 → noradrenaline up-titrated to 0.18. ABG drawn. Cardiology informed. 12-lead ECG: NSR, no acute ST changes. Patient stabilized; transferred care back to D-shift at 08:00.
2026-04-29 · 14:22
ADMISSION
Admission note. 67M, k/c/o T2DM, HTN. Presented with 3 days of high-grade fever, productive cough, increasing dyspnea. On arrival in ER: SpO₂ 84% RA, BP 92/58, HR 124. Diagnosed with severe community-acquired pneumonia with septic shock. Admitted to ICU, intubated for hypoxic respiratory failure (FiO₂ 0.45 RA → SpO₂ 91% post-intubation). Started on Pip-Tazo + Hydrocortisone + Noradrenaline per Surviving Sepsis Campaign protocol. Cultures sent. CXR shows bilateral lower-zone consolidation.