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Table 2 Surgical ward care: an overview of facilities

From: Effect of intermediate care on mortality following emergency abdominal surgery. The InCare trial: study protocol, rationale and feasibility of a randomised multicentre trial

Observation Monitoring level Treatments goalsa Comments
Level of consciousness Every 8 h GCS: 15  
Respiratory rate Every 8 h RR: 10 to 20  
Oxygenation Every 8 h SpO2 ≥94% Continuous pulse oximetry is not available
Blood pressure Every 8 h MAP: 65 to 110 mmHg  
Heart rate Every 8 h HR: 50 to 100 Continuous ECG is not available. Diagnostic ECG on indication. If arrhythmia or ischaemia is detected the treatment goals are adjusted to current recommendations
No ischaemia
Diuresis Every 8 h ≥0.5 mL/kg/h  
Temperature Every 8 h 36°C to 38°C  
Pain Visual Assessment Score Every 8 h VAS: 0 to 2 during rest Epidural: Able to move both legs  
Central venous pressure Not available   
Central venous oxygen saturation Not available
Standard blood samples Every 24 h Within normal reference values Hgb ≥4.5 mmol/L
Hgb ≥6.0 during sepsis or heart disease
Treatment (if needed) Maximal treatment level Treatments goals Comments
Infusion of sympathomimetic drugs Not available   
Oxygen therapy on open air systems Continuously SpO2 ≥94% Unless contraindicated. Oxygen therapy is discontinued when oxygenation is above ≥94% without oxygen therapy. During nights: minimum 2 L supplemental oxygen is given
Positive Expiratory Pressure (PEP) therapy Assistance to PEP therapy: every fourth hour during day and evening shift SpO2 ≥94% If the patient does not need assistance with PEP therapy, guidance in self-administration of PEP therapy is available
Non-invasive ventilation Not available   
Volume / Fluid therapy Continuously Systolic blood pressure: ≥100 mmHg Fluid balance: Evaluation frequency in accordance with monitoring level and vital signs
Diuresis: ≥12 mL/kg/day
  1. During evening and night shifts: Resident in surgery on in-house duty and staff specialist in surgery on call. Staff specialist in anaesthesiology/intensive care medicine on call from in-house duty.
  2. aAll treatment goals are adjusted to the individual patient’s co-morbidities, physiological status and in the event of complications in agreement with current recommendations.