We had a referral few days ago down south…
The nurse called up our ED and Lem was doing the shift at the moment. The nurse told Lem that the patient was a old-aged female with a pressure sore. The wound looked bad and debridement was needed. However no anesthetist was available so they need to referred the case. As usual Lem asked about the vital sign and GCS. The nurse said the GCS was 10 (not sure about the detail) and Lem asked about the further and the nurse couldn’t answered the question. The nurse then turned to the ED doctor and asked him. The ED doctor took over the phone and answered that the patient was stable and she was “alert” and rudely hung up the phone.
The patient was sent over and ended in ICU. I saw her and the GCS was merely E1V
When Lem shared the referral process with me – I gave him a grin and pacified him… Well, not the first time – it is very impolite for nurses to do the pass over during a ED referral. I had a few bad experiences and usually I won’t asked much when accepting case from the south side– I just told them apart from AMI (EKG showed STT elevation) and patient who need cardiothoracic surgery, we can accept any case….
The next day – during the case conference , the hospital superintendent had told us that the hospital down south had complaint that we tried to push case away …. Well, being rudely treated and stabbed from behind. Lem explained the situation and everyone of us shared a laugh. Our deputy superintendent (Neuro-surgeon ) X had told us that the doctor in ED that day is a orthopedic surgeon and also the deputy superintendent of the local govt hospital(Ops, now everyone knew who he is…). And he happens to be X’s ex classmate….
Today Lem told me that he had another good referral – “There is a XXXX patient who need ICU care and ambulance is on his way….” (Our ICU is +2 at the moment…..)
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