What does the FASTHUGINBED (Face, Airway, Suction, Tube, Head, Upper body, Give oxygen, Inspect, Needle, Bed, and Equipment) mnemonic represent in Intensive Care Unit (ICU) settings?

FASTHUGINBED Mnemonic in ICU

FASTHUGINBED is not a recognized or validated mnemonic in critical care medicine. The question appears to conflate or misrepresent established ICU mnemonics, as no guideline or research literature supports this specific acronym for ICU patient management.

Established ICU Mnemonics

FASTHUG-MAIDENS: The Evidence-Based Alternative

The validated mnemonic for comprehensive ICU patient assessment is FASTHUG-MAIDENS, not FASTHUGINBED. This tool was specifically developed to ensure systematic evaluation of critically ill patients and has demonstrated superior identification of drug-related problems compared to standard monitoring practices 1.

Original FASTHUG Components:

• Feeding 2, 1
• Analgesia 2, 1
• Sedation 2, 1
• Thromboembolic prophylaxis 2, 1
• Hypoactive or Hyperactive delirium (modified from "Head of bed elevation") 1
• Ulcer prophylaxis (stress) 2, 1
• Glucose control 2, 1

MAIDENS Extension:

• Medication reconciliation 1
• Antibiotics or Anti-infectives 1
• Indications for medications 1
• Drug Dosing 1
• Electrolytes, hematology, and other laboratory tests 1
• No drug interactions, allergies, duplication, or side effects 1
• Stop dates 1

Clinical Validation and Utility

Pharmacy residents using FASTHUG-MAIDENS identified 73.2% of drug-related problems per patient encounter versus 52.4% with standard monitoring (p = 0.008). 1 The implementation of this protocol in ICU settings resulted in detection of 103 drug-related problems, most commonly associated with feeding (21.3%), glucose control (11.7%), and delirium (9.7%) 2.

Airway Assessment Mnemonics

If the question intended to reference airway management, the established tool is MACOCHA, not FASTHUGINBED:

MACOCHA Score Components:

• Mallampati score III or IV (5 points) 3, 4
• Apnoea syndrome/obstructive (2 points) 3, 4
• Cervical spine limitation (1 point) 3, 4
• Opening mouth < 3 cm (1 point) 3, 4
• Coma (1 point) 3, 4
• Hypoxaemia (1 point) 3, 4
• Anaesthesiologist untrained or non-anaesthesiologist (1 point) 3, 4

A MACOCHA score ≥3 has 97-98% negative predictive value and 73-76% sensitivity for ruling out difficult intubation. 4

Alternative Respiratory Assessment: DiapHRaGM

For work of breathing assessment specifically, the validated mnemonic is DiapHRaGM:

• Diaphoresis 5
• Hypoxia 5
• Respiratory rate 5
• Gasping 5
• Accessory Muscle use 5

These five signs explain 71% of variance in respiratory distress in hypoxemic patients. 5

Common Pitfalls

• Using unvalidated mnemonics can lead to incomplete patient assessments and missed critical interventions. The British Journal of Anaesthesia emphasizes standardized protocols and checklists to improve reliability and reduce human factors errors, which were present in all NAP4 critical care cases 3.

• FASTHUG-MAIDENS requires daily systematic review by clinical pharmacists to optimize detection of drug-related problems. 2 Implementation without dedicated personnel may reduce effectiveness.

• Airway assessment tools like MACOCHA should be integrated into intubation protocols with equipment checks and team briefings. 3 The British guidelines mandate standardized difficult airway trolleys and immediate bronchoscope availability 3.