Summary Writer: Sam Orton
Editor: Nhi Nguyen
Interviewee: Oliver Flower
James talks to Dr Oliver Flower about a task that many junior doctors may find daunting – making an ICU consult.
Oliver Flower is a staff specialist in Intensive Care Medicine at Royal North Shore Hospital, Sydney.
He is a believer in the power of the big crit care community and a believer in Cadogan’s FOAMed ethos. Oli runs the educational and networking crit care website Intensive Care Network.
With Dr Oliver Flower, Staff Specialist Intensivist, Royal North Shore Hospital
The ICU consult can be a daunting task for junior doctors in the hospital and requires recognition of the sick patient, formulation of an issues list within a complicated and acute scenario and communication of management priorities to the ICU team.
Case – You are the Orthopaedic Intern and have been asked to review a 75 year old patient on the ward who is 48 hours post NOF repair. The patient has become confused. On arrival at the bedside you note the patient is disoriented, agitated and is trying to get out of bed.
Review of observations at the bedside
Your Registrar asks you to make an ICU consult.
Do not leave the patient to go and do other ward jobs at this point. The unwell patient needs ongoing care and assessment of response to resuscitation.
Whilst waiting for ICU, the patient deteriorates. Although saturations increase to 92% on a non-rebreathermask, the patient is increasingly agitated and is trying to take off the oxygen mask. You call the ICU registrar who will be there in 15 minutes. The nurses ask you to consider sedation.
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