Care bundles

• Junior doctors schooled in FASTHUGS
• Supported by checklist on ICU observation chart
• VTE – heparin BD preferred (consider TDS in morbidly obese)
• SUP in intubated patients – ranitidine (either IV or NGT) with low threshold to cease if enteral feeding in place.  PPIs used if previously on them or have GIT bleeding.
  
• Beware prescription by junior doctors of SUP in non-ventilated patient