Communication and the critically ill

A new doctor once asked his senior how to treat a patient who had too much beta blocker. The senior was half listening, writing in some notes. Another senior was nearby and asked, "What do you mean - what is the pulse and blood pressure?" The new doctor replied, "Pulse 30, blood pressure unrecordable". Both seniors dashed to the patient's bedside. It is important to communicate well if you want other people to act. When talking to a colleague about a patient who is acutely ill, use the following guide:

• where you are and your request (for example, "Can you come to ...?")

• brief history (for example, "New admission with asthma") and current physiology: conscious level, pulse, blood pressure, respiratory rate, oxygen saturations (and urine output if relevant)

• further details can follow (for example, test results).

It is important to give a summary of the current physiology, which gives the listener a sense of how urgent the case is. It is also important to communicate clearly what help is needed, particularly if you want your colleague to come and see the patient.

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