Dr Fragen in the operating room

Communicate with your Consultants


I’m on call this week. Oh joy. Call isn’t one of those things used to build a practice anymore — but that’s a topic for another day.
I was consulted, “General Surg consult to on-call surgeon.” The patient is in the ICU, came in via the ED the night before last but they (ED) didn’t think a surgeon was needed. I call the ICU, nurse is gone. I get some info from the unit clerk. Essentially normal labs, elevated glucose, normal WBCs, normal LFTs. No imaging yet done. Patient admitted with “abdominal pain.” I call back later, nurse now at lunch. I call back a third time, nurse there. I have a nice discussion with the nurse who doesn’t really understand why a surgeon would need to see the patient yet either. Some imaging back all essentially negative. I leave a message with the attending asking to have her call me back — nada.
I see the patient. Lots of voluntary guarding, no real evidence either objective or subjective of an acute intraabdominal process. Oh yeah, history of drug/EtOH use/abuse per family and hepatitis.
I’m done but I still haven’t heard from the attending. Please speak to your consultants. Tell ’em what you want and what you’re thinking about.