IC Critical Care Outreach LDH 2022 Online Forms Current User: Not Logged In
Bedfordshire Hospitals
NHS Foundation Trust
Critical Care Outreach - Daily Activity Sheet
Shift
Day
Night
Date
//
Department
Medical
Surgical
Ward
Method of Referral
Bleep
Face to Face
Nerve Centre
AKI Stage 3
Nil
Contacted by
Response Time
0 - 4 mins
5 mins - 29 mins
30 mins - 59 mins
1 hour - 1 hour 59 mins
2 hours - 2 hours 59 mins
3 hours - 3 hours 59 mins
4 hours and over
Time spent with patient
30 mins
1 hour
1 hour 30mins
2 hours
Reason for Review
High News
Sepsis
Pancreatitis
NIV
Cardiac Arrest/
MET Call
Concern Advise
Advise
Follow up
AKI 3
Continued Review
Please add any other additional reasons for review
Early re-admission to CC (=< 48 hrs)
Yes
No
TEP
Yes
No
DNAR Prompted
Yes
No
Critical Care Outreach Intervention Score
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