From the Guidelines
The FAST HUG BID mnemonic is a valuable tool for critical care providers to ensure comprehensive patient care, with the normal ranges for each component as follows:
- F (Feeding) - 25-30 kcal/kg/day with protein 1.2-2.0 g/kg/day
- A (Analgesia) - pain score <4/10 on numeric scale
- S (Sedation) - RASS score 0 to -2 for mechanically ventilated patients
- T (Thromboprophylaxis) - prophylactic heparin 5000 units SC q8-12h or enoxaparin 40mg SC daily
- H (Head of bed elevation) - 30-45 degrees
- U (Ulcer prophylaxis) - pantoprazole 40mg IV/PO daily or famotidine 20mg IV/PO twice daily
- G (Glycemic control) - blood glucose 140-180 mg/dL, based on the most recent guidelines 1
- B (Bowel regimen) - stool every 1-3 days
- I (Indwelling catheters) - daily assessment for necessity
- D (De-escalation of antibiotics) - narrow spectrum based on culture results within 48-72 hours The glycemic control target is based on the 2018 standards of medical care in diabetes, which recommends a blood glucose target of 140-180 mg/dL for critically ill patients 1.
The provided evidence from 1, 1, 1, and 1 supports the diagnosis of diabetes, but the most recent and relevant guideline for glycemic control in critically ill patients is from 1.
Here is a chart summarizing the FAST HUG BID components:
| Component | Normal Range |
|---|---|
| F (Feeding) | 25-30 kcal/kg/day with protein 1.2-2.0 g/kg/day |
| A (Analgesia) | pain score <4/10 on numeric scale |
| S (Sedation) | RASS score 0 to -2 for mechanically ventilated patients |
| T (Thromboprophylaxis) | prophylactic heparin 5000 units SC q8-12h or enoxaparin 40mg SC daily |
| H (Head of bed elevation) | 30-45 degrees |
| U (Ulcer prophylaxis) | pantoprazole 40mg IV/PO daily or famotidine 20mg IV/PO twice daily |
| G (Glycemic control) | blood glucose 140-180 mg/dL |
| B (Bowel regimen) | stool every 1-3 days |
| I (Indwelling catheters) | daily assessment for necessity |
| D (De-escalation of antibiotics) | narrow spectrum based on culture results within 48-72 hours |
From the Research
Fast Heart Rate (Tachycardia) and Beta-Blockers
- Beta-blockers are a class of medications that can help slow the heart rate and reduce blood pressure 2
- They are commonly used to treat conditions such as hypertension, heart failure, and atrial fibrillation 3, 4
- The normal heart rate range for adults is between 60-100 beats per minute (bpm)
Normal Range for Heart Rate
- The normal range for heart rate can vary depending on factors such as age, fitness level, and medical conditions 2
- For adults, a normal heart rate is typically considered to be between 60-100 bpm
- Beta-blockers can help slow the heart rate and bring it within a normal range for individuals with tachycardia or other heart-related conditions 5, 4
Beta-Blockers and Heart Rate
- Beta-blockers work by blocking the effects of the hormone epinephrine, also known as adrenaline, which can increase heart rate and blood pressure 2
- By blocking the effects of epinephrine, beta-blockers can help slow the heart rate and reduce blood pressure 3
- Different beta-blockers may have varying effects on heart rate and blood pressure, and some may be more suitable for certain individuals or conditions than others 5, 4
Chart of Fast Heart Rate and Beta-Blockers
| Condition | Normal Heart Rate Range | Beta-Blocker Effects |
|---|---|---|
| Tachycardia | 60-100 bpm | Slows heart rate, reduces blood pressure |
| Hypertension | 60-100 bpm | Lowers blood pressure, reduces risk of cardiovascular events |
| Heart Failure | 60-100 bpm | Improves mortality and morbidity outcomes, slows heart rate |
| Atrial Fibrillation | 60-100 bpm | Reduces risk of stroke, slows heart rate |