Intensive Care: ICU flowsheets, scoring, ventilator and infusion documentation

Critical care for adults and children: a bed grid by clinical state, APACHE II and SOFA scoring, ventilator settings, vasopressor titrations and infusion drug charts, FASTHUG daily goals, VAP, CAUTI and CLABSI bundles, hourly fluid balance, family communication and step-down plans; PICU scoring with PRISM-III, PIM-3, PEWS and COMFORT-B; remote patient monitoring; and tele-ICU rounding across sites.

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Works with

Wards & Inpatient

Intensive Care in the Bridge HMS Suite: ICU flowsheets, scoring, ventilator and infusion documentation

Paediatric intensive care, scored for children

PRISM-III and PIM-3 mortality scores and the PEWS early-warning score, built for the child, not adapted from the adult.

Ventilation, sedation and fluids for the child

Paediatric ventilation snapshots, COMFORT-B sedation scoring and weight-based fluid balance.

Round from anywhere

Virtual rounding across ICUs with the census in view — an intensivist covering several units at night.

Patients monitored after they leave

Remote devices send readings; alert rules raise alert events to the right clinician when a value crosses the line.

What's inside

Everything in Intensive Care

81 items in 13 areas, every one shipping with the app today.

ICU Admission & Records
- ICU Episode LifecycleDedicated critical-care (ICU) episode linked one-to-one to the base hospital admission, with an auto-generated yearly ICU reference number.
- One-Click Transfer to ICUA button on the base admission spins up an ICU episode (or opens the existing one) carrying over the attending doctor as intensivist.
- ICU Admission CategoriesClassifies each episode as post-op, medical emergency, trauma, cardiac, respiratory failure, sepsis, neurological, metabolic, obstetric or other.
- Nine-State ICU Status MachineTracks admitted, stable, critical, weaning ventilator, weaning vasopressor, step-down ready, transferred out, deceased and DAMA states.
- Length-of-Stay TrackingComputes actual ICU LOS in hours live and compares it against an expected LOS in days set on admission.
- Admission Severity BaselinesStores admission APACHE II and SOFA scores, auto-seeded from the first documented severity score of each type.
Clinical Status Workflows
- Mark Critical / StableHeader buttons flip the patient between critical and stable status with an automatic note in the history.
- Guarded Ventilator WeaningStarts a ventilator-weaning workflow, blocking the action if the patient is not currently ventilated.
- Guarded Vasopressor WeaningInitiates vasopressor weaning only when an active infusion exists, otherwise raises a user error.
- Step-Down Readiness GateMarks the episode step-down ready, refusing while the patient is still on ventilator or vasopressor support.
- Deceased Closure CascadeMarking a patient deceased closes the episode and writes died status, discharge type and mortuary destination to the base admission.
Severity Scoring
- Multi-Score EngineRecords APACHE II, SOFA, SAPS II, GCS, MEWS, NEWS2, SIRS, qSOFA and RASS severity scores per episode.
- Full APACHE II CalculatorAuto-scores 14 physiologic variables from the Knaus 1985 point tables to a total APACHE II score.
- Predicted MortalityDerives predicted hospital mortality from APACHE II via a logistic model and from SOFA via published outcome bands.
- SOFA Six-Organ ScoringSums respiratory, coagulation, liver, cardiovascular, CNS and renal sub-scores with 0-4 clamping.
- qSOFA & SIRS Bedside ScreensComputes qSOFA from RR/MAP/GCS and SIRS from temperature, heart rate, RR and WBC automatically.
- Component Audit DataStores the structured per-variable component breakdown behind every total score for traceability.
Ventilation Management
- Ventilator Settings LogCaptures mode across 13 options (AC-VC, AC-PC, SIMV, PSV, CPAP, BiPAP, PRVC, APRV, NIV, extubated, spontaneous) with timestamped history.
- Full Parameter CaptureRecords tidal volume, set rate, FiO2, PEEP, pressure support/control, plateau and peak pressures, trigger sensitivity and I:E ratio.
- Lung-Protective GuardrailBlocks saving a plateau pressure above 30 cmH2O and enforces FiO2 within 0.21-1.0.
- Spontaneous Breathing Trial TrackingFlags weaning attempts and SBT performance with success/failed outcome buttons that post history to the episode.
- Live Ventilator StatusDerives current ventilator mode and on-ventilator flag on the episode from the latest setting for dashboards and color coding.
Infusions & Drug Charts
- Vasopressor Titration LogTracks each vasopressor infusion with start/stop times, concentration, current rate in mcg/kg/min, weight and titration target.
- Max-Rate WatermarkAutomatically records the highest rate ever reached for each vasopressor infusion.
- Active Infusion FlagMarks infusions as currently infusing until a stop time is set, feeding the episode's on-vasopressor status.
- Titration Target SelectionTargets MAP, central venous pressure, lactate clearance or urine output for the infusion.
- Continuous Drug ChartsManages sedation, analgesia, paralysis, insulin, heparin, KCl and other continuous infusions with dose, unit and narrative target.
- Dose Adjustment HistoryRecords every dose change with old value, new value, reason and nurse, and posts each adjustment to history.
Nursing, Fluid Balance & Rounds
- Hourly Intake/Output ChartRecords IV, oral/NG, blood, TPN, medication and other intake against urine, stool, NG aspirate, drain and vomit output per hour.
- Automatic Insensible LossAdds a standard 25 mL/hour insensible loss into the total output calculation.
- Net & 24h Cumulative BalanceComputes hourly net balance and a rolling 24-hour cumulative net fluid balance across prior charts.
- ICU Vitals TaggingExtends the nursing vitals chart to auto-tag readings belonging to an ICU episode for filtered critical-care monitoring.
- Daily Goals SheetOne goals sheet per episode per day (enforced unique) capturing multidisciplinary round goals.
- Categorized Goal LinesStructures goals across ten body-system/ethical categories with a responsible owner and status per line.
Infection Prevention Bundles
- VAP Prevention ChecklistTracks head-of-bed elevation, sedation vacation, DVT and ulcer prophylaxis and chlorhexidine oral care with completeness flag.
- CAUTI Prevention ChecklistCaptures catheter necessity review, aseptic insertion, sterile closed system and timely removal with completeness flag.
- CLABSI Prevention ChecklistRecords line insertion bundle observation, intact dressing and daily line review with completeness flag.
- Overall Compliance ScoringComputes a combined compliance percentage across all VAP/CAUTI/CLABSI items plus mobilization and glycaemic control.
- Daily Bundle UniquenessEnforces a single bundle checklist per ICU episode per day.
- Canonical Bundle Reference TextShips WHO/IHI bundle wording as config parameters so on-screen help and reports pull consistent descriptions.
Family Communication, Incidents & Safety
- Family Update LogRecords each family communication with recipient, mode (in person, phone, video, written) and what was discussed.
- Questions CaptureLogs questions raised by family alongside the update content.
- Auto Next-Update DueAutomatically sets the next update due 24 hours after each logged communication.
- Automatic family-Update OverdueA six-hourly job raises an activity when more than 24 hours pass without a family update on an active episode.
- ICU Incident ReportingLogs line infections, pressure ulcers, accidental extubations, falls, medication errors, equipment failures and needle-stick events.
- Severity GradingGrades incidents minor, moderate, major or sentinel with follow-up-required flagging.
Wards & Admissions
- ICU Dashboard
- ICU Census
- Active
- Daily ICU Report
- Weaning
- Severity Scores
- Monthly Outcomes
- Ventilator Settings
- Step-Down Ready
- Vasopressor Titrations
- Mortality Review
- Drug Charts
- Discharged
- Daily Goals
- Bundle Performance
- Bundle Compliance
- All
- Family Updates
- I/O Charts (hourly)
- Incidents
- Step-Down Plans
Documents it prints
- ICU Daily Review
- ICU 72h Summary
- ICU Bundle Compliance
- ICU Mortality Review
It runs by itself
- HMS ICU: Daily severity score reminderRuns daily
- HMS ICU: Step-down eligibility checkRuns daily
- HMS ICU: Family update due (24h)Runs every 6 hours
Roles it ships
- BridgeERP HMS / Intensivist
- BridgeERP HMS / ICU Nurse
More in this app
- Every ICU bed, by clinical stateThe ICU dashboard and the ICU census show each bed with the patient, ventilation, pressors and severity score — the picture the intensivist rounds on.
- The ICU chart, hour by hourAPACHE II and SOFA scores, ventilator settings, vasopressor titrations, infusion drug charts and hourly intake and output — all on the same stay.
- Goals, bundles and the family kept informedFASTHUG daily goals, VAP, CAUTI and CLABSI bundle compliance, family updates recorded, incidents and the step-down plan agreed with the ward.
- Outcomes the ICU can defendThe daily ICU report, monthly outcomes, mortality review and bundle performance, plus every chart in pivot and graph.
- Devices, readings and alerts analysedDevices, alert events and readings in pivot and graph.

Works with

What Intensive Care works with

Intensive Care shares one database with the rest of the Bridge HMS Suite and BridgeERP: these are the apps it already talks to, with nothing to buy in between.