The Pre-brief
In 2005, Jean-Louis Vincent introduced the “FAST HUG” mnemonic to remember key aspects in the general care of our ICU patients. It covered a number of extremely important items that should be considered daily by the multidisciplinary team. The components are very simple aspects of care and require very little explanation; however, they are often forgotten when dealing with complex pathology, unstable hemodynamics, and challenging pathophysiology.

The Derivatives
Since 2005, a number of alternative versions have been proposed. Vincent and Hatton proposed “FAST HUGS BID”:

Chris Nickson put his own spin on the mnemonic and added a few more key pieces of ICU care:

Zepeda et al. came up with some nutrition-specific items to remember. Be sure to share this one with your ICU dietitians! Check out this paper for some useful algorithms.

Check out more mnemonics for the elements of routine care from Deranged Physiology. Which one is your favorite??? Comment below!
The Debrief
- The FAST HUG mnemonic is a great way to remember key aspects of the general care of our ICU patients.
- Use any one of the many variations to help you when you round on your patients!
References
- Vincent JL. Give your patient a fast hug (at least) once a day. Crit Care Med. 2005 Jun;33(6):1225-9. doi: 10.1097/01.ccm.0000165962.16682.46. PMID: 15942334.
- Vincent WR 3rd, Hatton KW. Critically ill patients need “FAST HUGS BID” (an updated mnemonic). Crit Care Med. 2009 Jul;37(7):2326-7; author reply 2327. doi: 10.1097/CCM.0b013e3181aabc29. PMID: 19535943.
- Monares Zepeda E, Galindo MartĂn CA. Giving a nutritional fast hug in the intensiv e care unit. Nutr Hosp. 2015 May 1;31(5):2212-9. doi: 10.3305/nh.2015.31.5.8668. PMID: 25929396.
- FAST HUGS IN BED Please! By Chris Nickson
- Elements of routine care in the ICU: FASTHUG by Deranged Physiology
Thanks much for all your tips!
I use FAST HUG BICoD4, a modification I came up with:
Where Co is code status/family discussion
D4- drug de-escalation, displacement (mobility), home Drugs, disposition