Table 1 The DEFAULT mnemonic
From: ‘Safety by DEFAULT’: introduction and impact of a paediatric ward round checklist
D | DNR status clear? |
‘Jimmy is for full resuscitation’ | |
E | Endotracheal tube and cuff is safe |
‘Jimmy’s ETT was retaped yesterday, is secure, the cuff is inflated and the cuff pressures are in range’ | |
F | Fluid strategy/Feeding plan agreed |
‘Jimmy is on 80 mls/kg, to commence feeding, if tolerated, increase to 100 ml/kg. On frusemide infusion aim of 200 mls negative balance by morning’ | |
A | Analgesia/sedation |
‘Jimmy is on morphine and midazolam infusions, to commence enteral sedation and reduce to 20 mcg morphine and 2 mcg midazolam’ | |
U | Ulcer skin and gut |
‘Jimmy is on ranitidine, and nursed on an airflow bed, however, his skin is fragile but not broken’ | |
L | Lines out |
‘Jimmy has one radial arterial, three peripheral and a right femoral line. The femoral line is to be removed today’ | |
T | Tidal volumes <8 ml/kg |
‘Jimmy has tidal volumes of 6 ml/kg’. Or ‘Jimmy is oscillated, tidal volumes not measured’ |