Referring to Medics

Scenario

A 65 year old female patient is 5 days post total hip arthroplasty. They have shortness of breath, chest pain, a swollen calf and tachycardia. Their observations are as follows: O2 93% (RA), HR 100, BP 110/80, RR 22, Temp 37.3.

PMH

  • Hypertension
  • High cholesterol

A blood gas has been performed:

pH

7.48

7.35 – 7.45

PaO2

12.4

10.6 – 13.4 kPa

PaCO2

3.4

4.0 – 6.0 kPa

Bicarbonate

22

22 – 26 mmol/L

For referrals we would recommend the SBAR format.

  • Introduce yourself
  • Situation: I would like to refer a 65 year old female who I suspect has a pulmonary embolism.
  • Background: The patient is 5 days post total hip arthroplasty.
  • Assessment: Their current observations are as follows: O2 93% (RA), HR 100, BP 110/80, RR 22, Temp 37.3. They have a swollen calf ? DVT. We have performed an ABG which shows Metabolic alkalosis.
  • Request: We are going to arrange a CTPA. Please can you advise on further management and review the patient.

“I will inform the consultant who was supervising the total hip arthroplasty. However, the chest/life threatening injury should take priority.”