Surgery Websites
Policies »  Resident Supervision »  When to Notify An Attending

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
Site Directory