ICU Bed
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Communication
COPD + perforated viscus + ARF + metabolic acidosis.
Prep station, 73 y old brought by daughter. Hx of COPD on steroids / relievers, seen in ED (Emergency) for being "under the weather", unremarkable until ate some food and suddenly had pain in abdomen. Assessment revealed suspected perforated viscus. Urgent Laparotomy was required.
Call ICU Registrar for Preoperative advice and request for ITU bed. (Remember to write down his advice because he will make you repeat them at the end). Pick up the phone and start speaking.
Introduction
• Introduce yourself
• Summary of the question you are calling about.
• SBAR approachEscalation
Hello, I am Dr Z, one of the general surgery SHOs working with Mr X, can I please confirm that I am speaking with the ITU registrar.
I am calling you from Surgical ward A regarding an acutely unwell patient with query bowel perforation/pancreatitis who needs an ITU.
Mr A is a 73-year old, presented off legs with sudden onset abdominal pain, peritonitic abdomen, hypotensive and tachycardiac. His most recent results show lactic acidosis, hypokalaemia of 2.1, raised amylase and AKI. His chest XR shows air under the diaphragm, and the U?S shows free intra-abdominal fluid.
He has a background of COPD and is on salbutamol and steroids.
Due to his current state, he is likely to need laparotomy for the bowel perforation with I ITU bed pre/post and I was wondering if you are able to come assess and let me know about the availability of beds at the moment.
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