 Hi guys, so I want to do an updated head-to-toe assessment for you guys and this one's gonna be ICU based My assessments have developed and changed over time I had a basic head-to-toe assessment that I did like almost two years ago on this channel Which I will link down below But I want to do an updated ICU head-to-toe assessment because in the ICU you're really looking More into things than you are When you're just working on a menstrual floor or telemedicine floor You really don't have time to do that in depth of an assessment. So first part of assessment is Neuro so this starts from the second you walk into the room is the patient responding to you when you walk in the room Are they answering your questions appropriately? Are they moving their extremities? Can they feel you touched then this really depends if they're on a ventilator or if they're not on a ventilator a lot of times when I start off my shift, we will do sedation vacations and We turn down the sedation medication if they're on a ventilator and just see how they interact also checking pupils especially in ventilated patients because they're sedated so their neural Logical assessment is limited and so you I check the pupils to say see if they're reactive What size are they if they're on a ventilator and I turn down the sedation? I'll check their grips. Can they move all extremities? Can they answer like nod their head yes or no or fall commands? Like can they hold up two fingers or lift their head up the bed? Can they squeeze your hands? I think I already said that and if they're not on a ventilator And if they're not a neuro specific patient meaning like hashtra of things like that Then I just do the basic questions like do you know where you are? Do you know the president is what's your name? What's your date of birth? You know what year it is? Can you lift up your arms? Can you squeeze my hands all those things just checking out a basic neurological assessment? That starts from the second that you walk in the room and then I usually go to Heart and lungs I'll listen to the lung sounds and see how they sound I'll listen to heart sounds I'll listen to bowel tones and see are they present are they not present and of course depending on what your patient's there for You are going to adjust your assessment accordingly. I Also while I'm doing this are looking at any lines like where's the where's the ET tube out if they're ventilated Where's the OG or NG tube at are they on is it on suction? Do they have a central line or an HD catheter or a pick or do they have just peripheral IVs? Do they have any JP drains or other tubes and things like that? I'm looking at the status of those also assessing the skin and Seeing if their skin breakdown or if they have any Incisions looking how the dressings are if they're intact if they were clean if they need to be changed things like that I always have if they're a ventilated patient or someone who's a max assist I always have someone help me turn so I can look at the backside and see how that looks Also while as I'm going down. I am checking pulses I usually typically check the radial pulse and the dorsal pedal pulses on the feet to see because if you have pulses there You have pulses Other places in your body if you don't have those pulses That's when I pull up the Doppler or check up something higher like femoral pulse or the carotid pulses and if you're at that point you either have severe like Circulation compromise or like your blood pressure super low, and you're not perfusing well And that is not a normal assessment finding if you can't find pulses anywhere. That is bad So back to my lines and drains and tubes and all those things I like to check to make sure my NG tube is in the right spot if it hasn't been an X-ray if it's just like on suction I like to maybe aspirate the GI contents or do a little air to check If you if you can hear it in the stomach obviously that's not foolproof But it's just a way to see obviously if you're hooked up to suction and like you're getting loads and loads of GI contents and acid out Then you know here in the right spot, but we still have to check that. I like to Check my central line and all those things and like pull back to see if I get good blood return and flush it Obviously you have to be careful depending on what line you're in if you have a really critical patient You can't just unhook all our vasopressors and stuff because sometimes that can tank them out if they don't have that continuous Medication going and you also have to be careful that you don't flush those medications because that is bad I like to make sure all my lines and medications are compatible with what's going in what and I usually like to label things I could check my monitor to to make sure my alarms are Set to go off and see the limits and make sure sometimes people will turn those things off depending on the circumstance Also looking at the EKG rhythm assessment like what what is their rhythm? Are they science tack are they science Brady are they in a fib are they in a first-degree block also with my skin assessment? When I'm checking pulses, I'm checking to see cap refill and are they refusing. Well, do they look sweaty? Do they look uncomfortable? Are they in pain? All those are different things that I look at. I'm sure I'm missing things that I look at but I Do but that's kind of my basic assessment on my ICU patients I do assessments every four hours and with any change and then our Lines and tubes and all those have to be assessed every two hours to make sure it's not infiltrated It's still working. Obviously if it's not working, that's a bad bad thing depending on the situation So yeah, that is my ICU head to toe assessment. I hope you guys enjoyed it Make sure you give this video a thumbs up and subscribe to my channel and I'll see you guys next time