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Nishika Patel
Critical care pharmacist with a fondness for cats, wine, and all things vintage. Also an insta-nerd who likes to teach ICU tidbits on her IG page @dr.scriptsndrips.
The Pre-brief
Two mnemonics have evolved over the years regarding crucial ICU interventions. By using these mnemonics, you can reduce errors of omission and increase compliance with evidence-based practices which improve outcomes in ICU patients.
Try implementing the following mnemonics the next time you are pre-rounding and rounding to ensure that these crucial interventions are not forgotten.
FAST HUGS BID:
This mnemonic first evolved from FAST HUGS and now encompasses some extra components. I have also thrown in some added variations for good measure.
MAIDENS:
Made solely for medications, this mnemonic is every pharmacist’s sidekick and it goes like this.
De-brief:
- Using the FAST HUGS BID and MAIDENS mnemonics during ICU patient workup can help prevent errors of omission and ensure that crucial ICU interventions are addressed.
- FAST HUGS BID encompasses feeding/fluids, analgesia, sedation, thromboprophylaxis, head of bed elevation, ulcer prophylaxis, glycemic control, spontaneous awakening and breathing trials, bowel regimens, indwelling catheters, and de-escalation of antibiotics/delirium.
- MAIDENS is specific to medications and encompasses medication reconciliation, antimicrobials, indications for medications, drug dosing, electrolytes/hematology/labs, no drug interactions/allergies/duplications/adverse effects, and stop dates.
References:
- Vincent W, Hatton K. Critically ill patients need “FAST HUGS BID” (an updated mnemonic). Crit Care Med. 2009 Jul;37(7):2326-7.
- Mabasa V, Malyuk D, Weatherby E, et al. A Standardized, Structured Approach to Identifying Drug-Related Problems in the Intensive Care Unit: FASTHUG-MAIDENS. Can J Hosp Pharm. 2011 Sep;64(5):366-9.
