A case scenario:
A case is being managed...and the case needs a surgery.
if i get a 5 mins window at these points what do i do
1. tha patient's surgery is planned but ...before i know the outcome the window pops out
2. the surgery is over, but i haven't been able to shift him to ward or whatever
what should be done with the orders now?
do i cancel the iVs and change to oral?
do i give the usual final orders of seat belt, safe sex, smoke alcohol.....
I WILL TELL U WHAT I WILL DO
for 1. if patient needs surgery and pop up 5 mins came up, i will order the surgery and lab test that is required for the procedure during this 5 mins screen and appropriate testing for his age to be done later and if u have time to counsel for later day then it will be ok, if not, then at least ur order the important things.
for 2. if surgery os over and u didnt have time to do shift him, then keep things as is, and u can order in the 5 mins screen important lab orders for follow up after surgery for example, cbc or pt or ptt if patient on heparin or what ever u think u need to f/u with the patients.
and u order counseling for later.
if u surgery is done and u didnt have time to see the patient how he feels or his f/u, then u leave all iv as is and order important lab for monitoring or antibiotic that u think u need to add or what ever u need for his case and then counsel the patient in the rest of the 5 mins screen.
A agree w/ Sami....you have to leave it as is, cause management needs to be rendered based on the pt's current status at his/her point in time (the simulated time). You can't predict what the outcome was of the surgery (& the Step-3 people know you don't have access to the surgical results), so making order changes as if it was a success would be premature. I am more or less quoting Dr. Red's approach to such a scenerio.