Intensive Care Unit (ICU) Post-operative Orders for Cardiac Surgery

1. Vital signs q15min, then q1h when stable

2. Urine output q1h until extubation, then q2h
3. Chest tubes at -20 cm H 2 O suction. Record chest tube loss q15min x 1h, then q1h if
hemodynamically stable
4. Auto-transfuse chest drainage
5. Cardiac output calculations now and q6h
6. Check peripheral pulses q1h x 4 then q4h
7. Central line IV D5W TKVO
8. K+ replacement - to be decided depending on urine output and last K + value
9. Peripheral IV NS TKVO
10. 12 lead ECG now then daily x 3 days
11. Ventilation e.g. VT 700 mL, FiO 2 50%, Rate 12/min, Peep 5 cm/H 2O to keep PaCO 2 between 35-45
mmHg
12. Titrate FiO 2 to keep PO 2 > 90 mmHg or O 2 sat > 95%
13. Suction ETT prn and chest care as per assessment
14. Physiotherapy: assessment and treatment
15. Pacemaker connected and checked by MD
16. Morphine sulphate 1-6 mg IV q1h PRN
17. Indomethacin supp 50-100 mg pr q1h x 2 PRN (avoid if diabetic, renal failure, peptic ulcer disease, or
age > 75)
18. Gravol 25-50 mg IV/IM q4h PRN x 2 days
19. Cefazolin 1 g IV q8h in 50 cc D5W x 3 doses (Vancomycin 300 mg to 1 g IV q12h if pen-allergic)
20. Propofol 200 mg IV in 100 cc D5W PRN
21. Sodium nitroprusside 50 mg IV in 250 cc D5W to keep SBP < 140 mmHg
22. Nitroglycerin 100 mg IV in 250 cc D5W PRN
23. Dopamine 200 mg IV in 250 cc D5W PRN to keep SBP > 90 mmHg