Common Ward Calls

Important Notes

• iSBAR Handover

Common Conditions and Presentations

• Conditions:

  • Acute Pulmonary Oedema
  • Alcohol Withdrawal
  • Hyperglycaemia
  • Hypertension
  • Hypotension

• Emergencies:

  • Advanced Life Support
  • Basic Life Support

• Presenting Complaints:

  • Abdominal Pain
  • Altered Mental Status
  • Arrhythmias
  • Chest Pain
  • Collapse, Syncope, Mechanical Falls
  • Decreased Urine Output
  • Febrile Patient
  • Haematuria
  • Nausea and Vomiting
  • Shortness of Breath, Cough and Haemopytsis
  • Urinary Frequency and Polyuria

• Procedures:

  • IV Cannulation

• Topics:

  • Paediatric Pain Management
  • Pain Management
  • Preparing Patients for Transfer

Medications to Know

• Analgesics
• Anti-Emetics

Documenting on call visits

1. Begin with date, time and who you are: 9 December 2024: 0300 hours. Resident on-call note
2. State who called you and at what time you were called: Called by nursing staff at 02:30 hours to see a patient who ‘fell out of bed’. If the assessment was delayed by more pressing matter, say so
3. Brief summary of the patient’s admission diagnosis and major medical problems:

EXAMPLE

74 year old female Admitted 10 days ago with joint pain and poor mobility Medical history: chronic renal failure, type 2 diabetes mellitus, rehumatoid arthritis

4. HxPC, no different from the documentation in an admission history. Consider any other relevant findings
5. Document the examination findings of your selective physical exam. Consider underlining the abnormal physical findings.
6. Note relevant laboratory, ECG or X-ray findings also underlining the abnormal physical findings
7. Write the provisional or ‘working’ diagnosis, followed by potential differential diagnosis, listing the most likely alternative explanations in order, then any complications

EXAMPLE

1. Unwitnessed fall on the way to bathroom Presumed mechanical fall (?diuretic-induced nocturia, ?contribution of sedation)
2. Large bruise to left thigh, but no obvious bony injury. No other findings

8. State the management and measures taken during the night

EXAMPLE

• Simple analgesia
• Ice pack to thigh haematoma
• Review mobility by inpatient team mane

9. If you informed another resident, registrar or consultant, document the time and whome you spoke and state the recommendations given

EXAMPLE

Discussed with Medical Registrar at 03:30 hours Suggests: team to reassess mobility in the morning, and the role of diuretics and sedation

10. Record whether any of the patient’s family members were informed of the problem and what they were told
11. Sign the clinical note and print name and designation

For reference

Slippery straight catheter wire Females size 12 or 13 Males size 16 to 18 can use curate tip