User Guide

ICU

The first of the four specialty boards — critical-care patient chart, vitals, and orders.

A.1 What an ICU doctor / nurse owns

Responsibility	Detail
ICU board	The single screen they sign in to. One row per ICU patient, colour-coded by severity (critical / serious / stable).
Patient chart	A popup that opens when they click a patient name. Holds vitals, allergies, conditions, nursing assessments, current medications, lab/imaging orders, results, care plans, consents.
Recording observations	They can add new vitals, allergies, conditions, and nursing assessments directly from the chart popup — no page hop.
Placing orders	The `+ Order` button on each row opens Quick Orders (Prescription / Lab / Imaging). The order is routed to Pharmacy / Laboratory / Radiology, but those receiving departments are invisible to the ICU clinician.
Transfer to ward	When the patient stabilises, the row’s Transfer to Ward button moves them out of ICU into a regular wing.
Discharge	When the patient is going home from ICU directly (rare), the Discharge button finalises the encounter.

A.2 What they cannot do

The ICU shell is intentionally narrow — it’s a kiosk, not a full clinical workstation:

No sidebar, no global navigation, no dashboard.
No access to lab, pharmacy, radiology, billing, HR, or admissions screens.
No access to other wards (Emergency, Maternity, Operations).
No access to patients who are not in ICU.

If they try to type a forbidden URL into the address bar, the system responds with the standard Forbidden page.

A.3 What the screen looks like

When an ICU doctor or nurse logs in:

┌─────────────────────────────────────────────────────────────────────────────┐
│ M  Mando · ICU      [ Intensive Care ]                  🔔   Dr. Layla H ┄  │
├─────────────────────────────────────────────────────────────────────────────┤
│                                                                             │
│   Intensive Care Unit                                  + ICU Admission     │
│   3 patients in ICU • 1 critical                                            │
│                                                                             │
│   ┌─ Critical (1) ─────────────────────────────────────────────────────┐   │
│   │  John Smith    Dr. Karim N • Room 401                  [critical]  │   │
│   │  Ventilator: BiPAP   O2 Flow: 6 L/min   Vitals: 92/58, 110, 39°C   │   │
│   │  ────────────────────────────────────────  [+ Order] [Transfer]    │   │
│   └────────────────────────────────────────────────────────────────────┘   │
│                                                                             │
└─────────────────────────────────────────────────────────────────────────────┘

Top bar: brand → single static tab “Intensive Care” → notification bell → user pill → Sign out.

The bell still fires for admission alerts, deposit-collected callbacks, lab/imaging acknowledgements that target the doctor.

A.4 The day, end to end

Sign in. The system bounces them straight to /icu. There is no dashboard intermediate step.
Read the board. A coloured strip on each card says critical / serious / stable. The header counts all three.
Click the patient name. A popup opens with ten clinical category cards (Vitals, Allergies, Conditions, Nursing Assess., Medications, Lab Orders, Imaging Orders, Results, Care Plans, Consents). Each card shows a count.
Click a category. The popup swaps content to that category’s list. If the category is editable (Vitals / Allergies / Conditions / Nursing Assess.), an + Add button appears top-right of the list. Read-only categories (Medications, Orders, Results, Care Plans, Consents) just show the existing items.
Add a vital (or allergy / condition / nursing score). The form opens inline below the list header. Quick chips at the top of the vitals form (BP, HR, Temp, SpO2, RR, Wt, Pain) prefill the LOINC code, display name, and unit so the user only has to type the value.
Save. The list refreshes; the count badge on the category card updates.
Place an order. Back on the board, click + Order on the row. Three tabs: Prescription, Lab, Imaging. Submit. Pharmacy / Lab / Radiology gets the alert; the ICU clinician sees nothing about who’s working on it until results show up under Results.
Transfer or discharge when ready.

A.5 Notifications

Inbound (the bell flashes):

New ICU admission landed on the wing — fired by the Reception/Admissions Officer at admit time.
A stat lab result was finalised on one of their patients (planned — see WORKFLOWS.md §14).
A prior-auth or eligibility check came back relevant to one of their patients.

Outbound (they create them implicitly):

Placing a Lab order notifies Laboratory.
Placing an Imaging order notifies Radiology.
A new prescription enters the MAR / pharmacy queue.

A.6 Common pitfalls

“I don’t see a sidebar.” Correct — the ICU role is kiosk-style. Click the patient name on the board to drill in.
“I tried to open the lab page and got Forbidden.” Correct — ICU staff can place orders but never browse lab/pharmacy/radiology. Use + Order on the patient row instead.
“The patient I’m looking for isn’t in the list.” They aren’t admitted to ICU. Reception admits patients into ICU using admission_type = icu — until that happens, the patient won’t appear on this board.
“Why is the count badge 0 on Allergies but the patient clearly has allergies?” The patient may have allergies recorded against a prior chart that wasn’t migrated. Click the card → + Add to record the current set.