CCTC Clinical Practice Index

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

P

Q

R

S

T

U

V

W

XYZ

   
CC COVID-19
 

A

     
  Abdominal Compartment Syndrome    
   

Procedure: Abdominal Compartment Syndrome Monitoring

Checklist: Abdominal Compartment Syndrome Monitoring

Procedure

Checklist

  Acute Pain Services    
   

Resource

Education

Education

  Aerosol Generating Medical Procedures    
   

Guideline: Aerosol Generating Medical Procedure CRITICAL CARE

Table of Precautions During AGMP IN CRITICAL CARE

Link to Intubation Video

Standard

Standard

Procedure

  Air Venting    
    Filters for Venting Vascular Lines: Patients with Intracardiac Shunt Education
  Amiodarone    
    Medical Directive: Procedure for Administration of Amiodarone Medical Directive
  Aminoglycocides    
    Procedure: Drawing Aminoglycocide Levels Procedure
  Anaesthetic Gases    
    Policy: Administration of Anaesthetic Gases in Critical Care RRT Policy Manual
  Analgesia and Sedation    
    Protocol: Analgesia and Sedation in Critical Care (Analgogesia) Protocol 
  ARDS    
    Decision Tree: Management of ARDS Protocol
  Arterial Lines    
   

Checklist/Procedural Note:  Insertion of Central Venous or Arterial Line 

Dressing Change Bundle: Arterial Line 

Deferral of Arterial Line Placement During Vasopressor Use

Standard of Care: Arterial Line Monitoring 

Maintenance Bundle: Arterial Lines

Procedure: Arterial and Central Venous Line Dressings

Procedure: Removal Femoral Arterial Lines

Procedure; Removal Peripheral Arterial Lines

Checklist

Standard

LHSC Policy

Standard

Standard

Standard

Procedure

Procedure

  Atropine    
    Medical Directive: Procedure for Administration of Atropine Medical Directive

B

     
  Beds

Compella Beds Tip Sheet A

Compella Bed Tip Sheet B

Education

Education

  Bedside Assessment Tools    
   

Neuro Assessment Tips

Assessment Tool: Neurological Assessment

Assessment Tool: Agitation using VAMAAS

Assessment Tool: Pain, Sedation and Delirium 

Assessment Tool: PQRST (Self-Reported Pain Tool)

Assessment Tool: Critical Care Pain Observation Tool (CPOT) (patient unable to self-report)

Assessment Tool: Vein Assessment (Peripheral IV) Site 

Education

Tool

Tool

Tool

Tool

Tool

Tool

  Blakemore/Minnesota Tube     
   

Video Setting up Traction Setup (internal access only)

Checklist: Insertion of Blakemore/Minnesota Tube

Education

Checklist

  Blood Cultures    
   

Administration of Antimicrobials in Sepsis

Decision Tree: Blood Culture Collection Protocol

FAQs for blood culture sampling

Procedure: Drawing Blood Cultures 

Education

Protocol

Education

Procedure

  Blood Drawing    
   

Procedure: Blood Gas Sampling

Procedure: Blood Sampling from Indwelling Lines

Procedure

Procedure

  Blood Gases    
   

Procedure: Blood Gas Sampling

About Venous Blood Gas Sampling

Procedure

Education

  Braden Screening    
    Pressure Injury Risk Assessment Screening (Braden): How to enter in Power Chart Education
  Bronchoscopy    
    List of Frequently Ordered Bronchoscopy Tests Education

C

     
  Calculating IV Rate    
    How to calculate IV rates without an infusion pump using drop rate Procedure
  Carbapenemase Producing Enterobacteriaceae Screen (CPET)    
   

How to Collect MRSA or Carbapenemase Produce Enterobacteriaceae Screen (CPET)

Procedure
  Cardiovascular    
    Standards of Care: Cardiovascular Monitoring  Standard
  Cardiac Output    
    Procedure: Measurement of Cardiac Output Procedure
  Catheter: Urinary    
    Safety Bundle: Prevention of Catheter Associated Urinary Tract Infection (CAUTI ) Standard
  Central Venous Lines    
   

Checklist:  Insertion of Central Venous or Arterial Line 

Line Cart Signage: Central Venous or Arterial Line Insertion 

Standard of Care: Central Venous Catheter Monitoring 

Insertion Safety Bundle: Central Venous Lines 

Maintenance Safety Bundle: Central Venous Lines

Dressing Safety Bundle: Central Line Dressing Change

Procedure: Central Venous and Arterial Dressing Change

3M Sutureless Securement Dressing Instructions

Procedure: Removal Central Venous Line 

Protocol

Education

Standard

Standard

Standard

Standard

Procedure

Education

Procedure

  Continuous EEG    
    Procedure: Continuous EEG Setup  Procedure
  Chest Tubes    
   

Checklist: Removal of Chest Tube

Procedure: Insertion, Maintenance and Removal of Chest Tubes

Standard of Care: Chest Drainage

Checklist

LHSC Nursing Procedure

Standard

  Clostridium Difficile    
   

Interpretation of Results for Clostridium Difficile Report (LHSC only)

Procedure: Colonic Irrigation Through Diverty Ileostomy Protocol

Education

Procedure

 

CODE STEMI

   
    Checklist: Code STEMI Checklist Checklist
 

CODE Stroke

   
   

Resource Link: Protocol, posters and t-PA dosing information

Education
  Continuous Lateral Rotation    
   

Standard of Care: Continuous Lateral Rotation 

Procedure: Initiation of Continuous Lateral Rotation

Standard

Procedure

  Continuous Renal Replacement Therapy    
 

 

 

 

 

 

 

 

 

 

 

 

 

Antibiotic dosing adjustments and CRRT

Anticoagulation Selection: Decision Tree for Filter Anticoagulation

Citrate Anticoagulation Protocol: Principles of Citrate Protocol

Blood Lead Detector Alarm: Lab Assessment

Fluid Monitoring: How to find my 0700 and 1900 fluid balance?

Ordering Guidelines for CRRT in CCTC

Order Entry Using Electronic CRRT Orders Instructions

Orders for CRRT: Sequence for Signing Orders in Power Chart

Procedure: Accessing Dialysis Line and Initiation of Therapy

Checklist: Accessing a Dialysis Catheter

Procedure: Ending CRRT Treatment/Blocking Dialysis Catheter

Checklist: Ending CRRT Treatment/Blocking Dialysis Catheter

Protocols for Titration: Potassium, Heparin, Citrate and Calcium

Education

Protocol

Education

Education

Protocol

Education

Education

Protocols

Procedure

Checklist

Procedure

Checklist

Protocol

  COVID-19 Resources
CRITICL CARE

Disclaimer: These guidelines and resources have been posted specifically for the Adult Critical Care Program London Health Sciences Centre (LHSC). They may not be applicable to other units or centres.  Documents are the intellectual property of LHSC. In the spirit of supporting colleagues during this world-wide pandemic, you may use these resources to support your own guidelines development. You accept any risk by using all or part of the material and acknowledge that scientific knowledge is changing on a daily basis. 

 
   

PRECAUTIONS

Table of Precautions During AGMP IN CRITICAL CARE

Guideline: Aerosol Generating Medical Procedure CRITICAL CARE

Donning/Doffing Checklist 

Donning/Doffing Checklist for PROTECTED PPE 

CODE Blue in CRITICAL CARE

Extubation (including Heliox)

VIDEO LINKS

Video COVID-19 Intubation (ED VH)

Video (25 seconds): Correct Method of Collecting Viral Swab (NEJM)

Video: Donning PPE

Video: Doffing PPE

COVID-19 Critical Care Education Presentation Videos - You Tube Links

LABORATORY ORDERS

How to Order COVID-19 Samples for Critical Care Patient 

How to Collect Specimen for COVID-19

How to Collect MRSA/ CPET or Bacterial Swabs Using New Swabs

TELEPHONES (PATIENT ROOMS)

How to Use the IN-ROOM Telephones in Negative Pressure Rooms and Bay 3-5

Telephone Extensions for Portable Patient Phones

OTHER CLINICAL INFORMATION

How to calculate IV rates without  infusion pump (drop rate)

 

Standard

Standard

Procedure

Procedure

Algorithm

Procedure

 

Procedure

Procedure

Procedure

Education

Procedure

 

Procedure

Procedure

Procedure

 

Reference

Education

 

Education

D

     
  Defibrillation    
   

Medical Directive: Procedure for Defibrillation

Medical Directive

  Delirium    
   

Delirium Resources

Assessment Tool: Pain, Sedation and Delirium 

Assessment Tool:  Intensive Care Delirium Screening Checklist

Assessment Tool: Confusion Assessment Method ICU (CAM ICU)

Education

Tool

Tool

Tool

  Discharge or Transfer    
   

Checklist: Discharge to Home, Power Chart Order

Checklist: Discharge from CCTC to Home

Preassessment: Discharge from CCTC to Home

Decision-Tree: Transfer to Medicine Process

How to discontinue critical care orders at transfer

Checklist

Checklist

Checklist

Protoocol

Education

  Documentation

 

 
   

How to create a rapid set of procedural orders in Power Chart

Education

 

Standards

Standards

 

Standards

Policy

E

     
  ECG Monitoring    
    Standard of Care: ECG Monitoring Standard of Care Standard
  Epinephrine    
    Medical Directive: Procedure for Administration of Epinephrine Medical Directive
  End-of-Life Care    
    Checklist: Quality End-of-Life Care Checklist
 

Enteral Feeding

   
   

Standard of Care: Enteral Feeding and Enteral Tube Management 

Procedure: Insertion of Enteral Feeding Tube/Small Bowel Feeding Tube 

Protocol:  Withholding or Continuing Enteral Feed Preoperatively 

Nutritional Supplements

Standard

Procedure

Protocol

Education

  Extravasation Protocol    
   

Protocol: Treatment of Extravasation of Peripheral Vasopressors

Protocol

F

     
  Falls/Treatment Interference     
    Safety Bundle: Critical Care Falls and Treatment Interference Risk Reduction Education
    Falls Risk Screening (Morse): How to enter in Power Chart Education
  Floating CCTC/MSICU    
   

MSICU/CSRU Routines and Floating Guidelines for CCTC Nurses Floating to UH

Map of UH and MSICU/CRSU

CCTC Routines and Floating Guidelines for MSICU/CSRU Nurses Floating to VH

Map of VH and CCTC

Protocol

Education

Protocol

Education

  Fluid Balance    
    Standard of Care: Fluid Balance Monitoring  Standard

G

     

H

     
  Head of Bed    
    Decision Tree:  Head of Bed Positioning Protocol
  Hemodynamic Monitoring    

 

 

Procedure

Standard

Standard

Standard

Standard

  High Flow Oxygen    
    Policy: High Flow Oxygen Therapy RRT Policy
  Hypothermia Protocol    
    Checklist: Therapeutic Hypothermia Protocol  Checklist

I

Intubation Checklist

 

 
   

Intubation Checklist/Aerosol Generating Procedures CRITICAL CARE

Table of Precautions During AGMP IN CRITICAL CARE

Link to Intubation Video

Standard

Standard

Procedure

  Infection Control    
   

Infection Control Supply Cart

Intubation Checklist/Aerosol Generating Procedures CRITICAL CARE

Video: (26 Seconds) Correct Method  for Collecting Viral Swab (NEJM)

LABORATORY ORDERS

How to Order COVID-19 Samples for Critical Care Patient 

How to Collect Specimen for COVID-19

How to Collect MRSA/ CPET or Bacterial Swabs Using New Swabs

Procedures

Education

Education

 

Procedure

Procedure

Procedure

  Infusion Rate Calculation    
    How to calculate IV rates without an infusion pump using drop rate Procedure
  Insulin    
    Protocol: Insulin Titration Protocol Protocol
  Intracranial Pressure Monitoring    
   

QUICK CHECKLISTS FOR SELECTION AND SETUP OF ICP

Checklist: Selection of ICP Catheter and Monitoring Equipment

Checklist: Setup of Codman EDS 3TM CSF Drainage Unit 

Checklist: Insertion Codman Microsensor/Setup Codman ExpressTM 

Checklist: Care of the Patient with Raised ICP

PROCEDURES FOR ICP SETUP AND MANAGEMENT

Procedure: Insertion and Setup of Codman EDS 3TM External Ventricular Drainage Unit

Procedure: Insertion of Codman MicrosensorTM EVD or Intraparenchymal monitor and Setup of Codman ExpressTM 

Procedure: Measurement of ICP Using Fluid Filled EVD Monitoring System (standard transducer)

Procedure: Obtaining a sample of CSF sample from EDS 3TM

Procedure: Lumbar ICP Monitoring

TROUBLESHOOTING/EDUCATION

Troubleshooting ICP Monitoring Systems

Care of the Patient with Raised ICP

STANDARD OF CARE

Standard of Care: Intracranial Pressure Monitoring 

Product Information

Codman Express Product Information

MRI Compatibility and Codman Microsensor Product Information

 

Checklist

Checklist

Checklist

Checklist


Procedure

Procedure


Procedure

Procedure

Procedure

 

Education

Education

Standard

 

Education

Education

  Intravenous (Peripheral)

Overview and tips for insertion of BD Nexiva in CCTC

Assessment Tools: Peripheral IV Insertion Assessement Tools and Standards 

Documentation: Peripheral Vasopressor Infusions

Protocol: Treatment of Extravasation of Peripheral Vasopressors

Protocol: Peripheral Vasopressors

Education

Standard

Standard

Protocol

Protocol

L

     
  Laboratory Orders    
   

CCTC Care sets

LABORATORY ORDERS

How to Order COVID-19 Samples for Critical Care Patient 

How to Collect Specimen for COVID-19

How to Collect MRSA/ CPET or Bacterial Swabs Using New Swabs

Education

 

Procedure

Procedure

Procedure

  Lidocaine     
   

Lidocaine Infusion for Pain

Medical Directive: Procedure for Administration of Lidocaine

Education

Medical Directives

  Lumbar ICP    
   

Procedure: Setup of Lumbar CSF/ICP Monitoring and Drainage

Procedure

M

     
  Massive Transfusion Protocol    
   

Checklist: Massive Transfusion Protocol Kit

Ordering Guidelines: Massive Transfusion Protocol 

Procedure:  Setup of Level 1 Rapid Infusor

Protocol: Massive Transfusion 

Tracking Sheet: Recording Blood Products/Prompting Lab/Interventions

Checklist

Education

LHSC BTL Protocol

Tool

  Medical Directives    
   

Medical Directive: Procedure for Administration of Amiodarone

Medical Directive: Procedure for Administration of Atropine

Medical Directive: Procedure for Defibrillation

Medical Directive: Procedure for Administration of Lidocaine

Medical Directive: Procedure for Administration of Epinephrine

Non-ACLS Medical Directives for RNs in Adult Critical Care

Medical Directive

Medical Directive

Medical Directive

Medical Directive

Medicial Directive

Medical Directive

  Minnesota/Blakemore Tube    
   

Video Setting up Traction Setup (internal access only)

Checklist: Insertion of Blakemore/Minnesota Tube

Education

Checklist

  Monitors (Philips)    
   

GENERAL

Equipment Location

Overview of Monitoring Hardware and Configuration

Central Station and Data Storage

Admitting, Discharging, Standby and Transferring

Display and Navigation

Printing

Changing Profiles and Using Comfort Mode

Alarm Management Tips

Disabling Alarms

 

MEASUREMENT FUNCTIONS

ECG Troubleshooting

ECG 5 Lead Placement

ECG 12 Lead Placement

CEEG Continuous (CEEG): Setting Up the Monitor

CEEG Lead Placement: Quick Guide

ICP Monitoring: Connecting to Philips Monitor

CPP Monitoring: Enabling CPP

Respiratory Monitoring

Temperature Monitoring

 

Education

Education

Education

Education

Education

Education

Education

Education

Education

 

 

Education

Education

Education

Education

Education

Education

Education

Education

Education

  MRI    
   

MRI Compatible Tracheostomies

MRI Incompatible Tracheostomies

Education

Education

       
  MRSA Swabs

How to Collect MRSA/ CPET or Bacterial Swabs Using New Swabs

Procedure

N

     
  Nasopharyngeal Swab

Video: 26 Second Video Showing Correct Method of Collecting Viral Swab (NEJM)

LABORATORY ORDERS

How to Order COVID-19 Samples for Critical Care Patient 

How to Collect Specimen for COVID-19

How to Collect MRSA, CPET Screen or Bacterial Swabs Using New Swabs

Education

 

Procedure

Procedure

Procedure

  Neurological System    
   

Neuro Assessment Tips

Assessment Tool: Neurological Assessment

Neurologic System Monitoring Standard of Care

Education

Education

Standard

  Neuromuscular Blockers    
   

Standard of Care: Neuromuscular Blocking Agent Use

Neuromuscular Blocking Drug Selection and Comparison

Education

Standard

  Nursing Care    
    Standard of Care: General Nursing Standard for All Patients Standard

O

     
  Obstetrical Patients    
   

Accessing critical care services

Checklists and Guidelines for the care of the PREGNANT PATIENT requiring critical care support

Checklist: Admission of Pregnant Patient in CCTC

Admission Guidelines for Pregnant Patient in CCTC (details  for points on checklist)

Checklist: Q Shift assessmetn of Pregnant Patient in CCTC

Obstetrical Emergencies 

Emergency Response and CODE OB

ACLS/Cardiac Arrest During Pregnancy

Common Obstetrical Problems Overview

Neonatal Medication Chart

Checklists and Guidelines for the care of the POSTPARTUM PATIENT requiring critical care support

Checklist: Admission of a Postpartum Patient to CCTC

Checklsit: Q Shift care of the Postpartum Patient in CCTC

DOCUMENTATION IN CCTC for Obstetrical Patients (CCTC Flowsheets)

CCTC Flowsheet for Pregnant Patient

CCTC Flowsheet for Postpartum patient

Protocol

 


Checklist

Education

 

Checklist


Protocol

Education

Education

Education

 


Checkist

Checklist

 

Documentation

Documentation

  Oral Care    
    Procedure: Oral Care Routine Procedure
  Orders    
    How to create a rapid set of procedural orders in Power Chart Education
  Organ Donation    
    Link to Organ Donation Corporate Policy (Internal access) Resource

P

     
  Pain    
   

Assessment Tool: Pain, Sedation and Delirium 

Assessment Tool: PQRST (Self-Reported Pain Tool)

Assessment Tool: Critical Care Pain Observation Tool (CPOT) (patient unable to self-report)

Tool

Tool

Tool

  Patient/Family Experience    
   

Creating Word Clouds 

How to use Worditout or WordArt to make word clouds

How to Make a Word Cloud (using Wordle)

Tips on Taking Hand Photos

Heart Rhythms

Newsletters

Family Brochure

 

Education

Education

Education

Education

Education

Resource

  Peripheral IVs    
   

Overview and tips for insertion of BD Nexiva in CCTC

Assessment Tools: Peripheral IV Insertion Assessement Tools and Standards 

Documentation: Peripheral Vasopressor Infusions

Protocol: Treatment of Extravasation of Peripheral Vasopressors

Protocol: Peripheral Vasopressors

Education

Standard

Standard

Protocol

Protocol

  Peripheral Vasopressors    
 

 

Documentation: Peripheral Vasopressor Infusions

Protocol: Treatment of Extravasation of Peripheral Vasopressors

Protocol: Peripheral Vasopressors

Standard

Protocol 

Protocol

  Pet Therapy    
   

Policy: Refer to LHSC Policy Manual for "Therapy Dog Program" (visit by therapy dog)

Policy: Refer to LHSC Policy Manual for "Pet Visitation" (visit by patient's own Pet)

Guidelines: For Therapy Dog Visitation in CCTC

Consent: For Visit by Therapy Dog

Consent: Decline Therapy Dog Visits

Tracking Sheet: Therapy Dog Visits

Policy

Policy

Protocol

Standard

Standard

Standard

  Procedural Safety    
    Checklist: Procedural Safety Pause (self and team assessment) Checklist
  Prone Positioning    
   

CHECKlSTS

Checklist: Preparation, Proning and Supination

Checklist: Proning

Checklist: Supination

PROCEDURES

Procedure: Turning a Patient Prone

Procedure: Turning a Patient Supine

 

Procedure

Procedure

Procedure

 

Checklist

Checklist

 

  Pulmonary Artery Catheter    
   

Overview, Insertion, Management and Waveform Information

New Set-up for PA and CVP (2 transducer no bridge)

Standard of Care: Pulmonary Artery Catheter Monitoring 

Checklist: Insertion of a Pulmonary Artery Catheter

Checklist: Measurement of Cardiac Output

Procedure: Removal Pulmonary Artery Catheter

Procedure: Withdrawal of a Pulmonary Artery Catheter from a Wedged or RV Placement

Education/Procedure

Procedure

Standard

Checklist

Checklist

Procedure

Procedure

R

     
  Removal of Vascular Devices    
   

Procedure: Removal Central Venous Catheters (jugular, subclavian or femoral)

Procedure: Removal Femoral Arterial Lines

Procedure; Removal Peripheral Arterial Lines

Procedure: Removal Pulmonary Artery Catheter

Procedure

Procedure

Procedure

Procedure

  Respiratory System    
    Standard of Care: Respiratory System Monitoring  Standard

 

Restraints    
    Standard of Care: Restraint Use  Standard

S

     
  Safety

Patient, Visitor and Health Care Worker Safety

Procedural Safety Pause

Safety Bundles

Arterial and Central Venous Line Insertion Bundle

Arterial and Central Venous Line Maintenance Bundle

Arterial and Central Venous Line Dressing Change Bundle

Catheter Associated Urinary Tract Infection (CAUTI)

Central Venous or Arterial Line Insertion Checklist

Falls and Treatment Interference Risk Reduction

Ventilator Associated Pneumonia Prevention Bundle

Education

Checklist

 

Standard

Standard

Standard

Standard

Checklist

Standard

Standard

  Sedation    
   

Decision Tree: Sedation Weaning Assessment Protocol (SWAP)

Protocol: Sedation and Analgesia in CCTC (Analgogesia)

Assessment Tool: Pain, Sedation and Delirium 

Assessment Tool: Agitation/Sedation (Ventilator Adjusted Motor Activity Assssment Scale -VAMAAS)

Protocol

Protocol

Tool

Tool

  Spontaneous Breathing Trial (SBT)    
    Decision Tree: Spontaneous Breathing Trial Protocol Protocol
  Subglottic Secretion Drainage Tube    
    Subglottic Secretion Drainage Tube (SSD) Education

T

     
  Telephones in CCTC    
   

How to Use the IN-ROOM Telephones in Negative Pressure Rooms and Bay 3-5

Telephone Extensions for Portable Patient Phones

Procedure

Protocol

  Therapy Dog Program    
   

Policy: Refer to LHSC Policy Manual for "Therapy Dog Program" (visit by therapy dog)

Policy: Refer to LHSC Policy Manual for "Pet Visitation" (visit by patient's own Pet)

Guidelines: For Therapy Dog Visitation in CCTC

Consent: For Visit by Therapy Dog

Consent: Decline Therapy Dog Visits

Tracking Sheet: Therapy Dog Visits

Policy

Policy

Protocol

Standard

Standard

Standard

  Total Parenteral Nutrition    
    Total Parenteral Nutrition Dose Calculator (requires MS Excel TM) Tool
  Transfers    
   

 

Decision-Tree: Transfer to Medicine Process

How to discontinue critical care orders at transfer

 

U

     
  Urinary Tract    
    Safety Bundle: Prevention of Catheter Associated Urinary Tract Infection (CAUTI) Standard

V

     
  VAP 

Procedure: Oral Care Routine

Safety Bundle: Ventilator Associated Pneumonia (VAP) Prevention 

Subglottic Secretion Drainage Tube (SSD)

Procedure

Standard

Education

  Viral Culture

Video: 26 Second Video Showing Correct Method of Collecting Viral Swab (NEJM)

Education

W

     
  Wound Care    
   

Wound Care Resources

V.A.C. Ulta (Overview of Changes)

Resource

Education

 

Last update:  June 16, 2020

Brenda Morgan, CNS, CCTC