Multi-Patient Emergency Shift Handover

Patient 1

• Acute Bed 4
• Lachlan Mitchell (URN: 492-810-33)
• 24 years
• Male
• R ankle inversion injury during football match 3 hrs ago; unable to weight bear
• Mild intermittent asthma
• salbutamol (Ventolin®) 100 mcg INH PRN
• NKDA
• HR 78 bpm, BP 124/78 mmHg, RR 16/min, SpO2 99 % RA, Temp 36.8 °C
• XR R ankle: Weber A fracture of distal fibula, no talar shift
• paracetamol (Panadol®) 1,000 mg PO STAT, ibuprofen (Nurofen®) 400 mg PO STAT, ice and elevation
• Fit moonboot, crutches education, discharge with Fracture Clinic f/u in 7 days

Patient 2

• Fast Track Cubicle 2
• Evelyn Vance (URN: 109-482-76)
• 72 years
• Female
• 3 cm laceration to R pretibial area following mechanical fall on garden steps at 10:30
• AF, HTN, T2DM
• apixaban (Eliquis®) 5 mg PO BID, perindopril (Coversyl®) 5 mg PO daily, metformin (Diabex®) 1,000 mg PO BID
• Penicillin (rash)
• HR 82 bpm (irregular), BP 138/84 mmHg, RR 16/min, SpO2 97 % RA, Temp 36.5 °C, BGL 6.8 mmol/L
• Neurovascularly intact distally; nil head strike or LOC; XR R tibia/fibula: no acute fracture
• Wound irrigated with 1,000 mL normal saline, approximated with Steri-Strips™ and dressed; ADT booster 0.5 mL IM STAT
• Observe for 30 mins to ensure haemostasis given anticoagulation; GP f/u in 5 days for wound review

Patient 3

• Short Stay Unit Bed 1
• Chloe Nguyen (URN: 837-291-55)
• 31 years
• Female
• 24 hr hx of profuse watery diarrhoea, nausea, and crampy abdominal pain
• Nil significant
• Levlen ED® 1 tab PO daily
• NKDA
• HR 94 bpm, BP 112/70 mmHg, RR 18/min, SpO2 99 % RA, Temp 37.3 °C
• VBG: pH 7.38, K+ 3.6 mmol/L, Lactate 1.4 mmol/L; Urine β-hCG negative; FBC/UEC pending
• ondansetron (Zofran®) 4 mg IV STAT, 0.9 % sodium chloride 1,000 mL IV over 2 hrs
• Review UEC results, trial of oral fluids at 15:30; if tolerating and observations stable, dc home with gastro advice