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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
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