Shift Report [Annotated]

Report  @ 1900 CLINICAL CARE LEADER: [TorontoEmerg] BEDS AVAILABLE: None. [5 North and 5 South are short-staffed and in the event, are over their census anyway. ICU has too many vents. 3 South is at census, but has an outbreak. 3 North can’t bed space. L&D and Paeds are full. NOTE: the ED is never over census. Nor can we refuse to take patients.] ADMITS —- 24

Medicine: 8 [one is dying: all we can do is find a hospital bed and an isolation room. Dying on an emergency stretcher is grosteque.]

Telemetry: 7 [One patient is Day 4 and a no code and has been asymptomatic for 48 hours. Physician refuses to take off telemetry.]

Surgery: 4 [all upper GI bleeds]

ICU: 1 [Intubated.]

HOLDS — 8

Ortho: 3

Medical: 4 [out which 3 will be telemetry]

Psychiatry: 1 [a frequent flyer psych OD who will get the boot as soon as her ethanol level drops below 20.0]

EMS OFFLOAD: 4 [EMS supervisor has called twice, looking for non-existent stretchers. No dice.] Comments: 16 patients in waiting room; 4 will be probable admissions; 1 active chest pain is being treated on the triage stretcher waiting for a monitored bed. Hip night, previous [3 fractures, elderly ladies tripping the light fantastic.] Trauma: pedestrian versus SUV, shipped to Holy Somolians downtown. Code Blue, v tach arrest at triage, cardioverted in two minutes, to to ICU alert, oriented and happy [(and on an amiodarone drip.) Never happens. But it did.] Toilet in the waiting room overflowing.

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