When to Notify An Attending
For All UCSF Surgical Housestaff
Call an Attending directly (or positively ascertain that an Attending has been notified) upon the following situations:
- Death (even if expected)
- Cardiac arrest
- Respiratory failure either requiring intubation or significantly increased O2 demands
- Severe respiratory distress
- Airway issues
- Transfer to ICU or higher level of care
- Concern that patient needs a procedure or operation
- A new need for acute dialysis
- Bleeding requiring transfusion
- Hypotension/hemodynamic instability
- Symptomatic and severe hypertension
- Significant new arrythmia
- Suspected MI
- Suspected PE
- New onset severe chest pain
- New onset severe abdominal pain
- Abrupt deterioration in neurologic exam or profound decreased mental status
- Significant change in neurovascular exam of extremity
- Patient or family wishes to speak to the attending
- Patient wishes to be discharged AMA
And In addition
- Any other significant change in clinical status of patient that is of major concern.
- Any new admission.
- The arrival of a patient accepted in transfer from another institution.
Service specific criteria, e.g.
- KTU: abrupt loss of urine output in recent kidney transplant pt that was previously making urine; ultrasound showing vascular/ureteral problem.
- LTU: ultrasound showing absence of hepatic arterial flow
- VASCULAR: loss of a pulse or Doppler signal that was present earlier
- PLASTICS: abrupt change in signal /duskiness of free flap