Today’s post is more targeted towards the interns but may serve as a good refresher for everyone.
This is a skill that we as emergency physicians need proficiency with because it's as much a part of our job as intubating someone or putting in a central line.
Today we're talking about how to call a new consult!
Introducing the 5 Cs of calling a consult:
I stick with pretty much the same format every time I call a new consult and I use the 5 Cs except that I like to bring up the timeframe/stability of the patient earlier on in the conversation:
Contact: Hello this is David calling from the ED. Who am I speaking with?
Communicate: Hi [name] I'm calling you for a new consult. I have a patient here who [I suspect of having/I'm concerned for/has] [diagnosis]. The patient's MRN/name/location are...
The patient is [stable for now/unstable].
This is a [age/gender] patient with [pertinent history/physical/labs/studies]. (Note: This is much less extensive then a presentation to an attending or a signout to another provider. You're providing the consultant with just the key information).
Core Question: Could you please evaluate this patient for [admission/procedure/other] (Note: Most of the time the reason for the consult will be obvious to the consultant but you should know why you are calling the consult).
Do you have any questions/need any other information at this time?
Collaboration: What can I do before you come see the patient to help expedite things?
Closing the Loop: My callback is x5555. I'll go ahead and order those extra labs you suggested. Thank you. See you in a bit.
The easier you make the work for the consultant, the happier everyone will be and the easier the work will be for you.
Just a few more tips/reminders:
1) Consultants are exactly what they sound like...they are consultants. This means that just because they provide certain recommendations, it does not mean that you have to follow their plan blindly. Having a consultant on board is a way to ask for help that leads to shared responsibility and collaborative decision-making, so if you don't agree with certain recommendations, you are still in charge of the plan.
2) Calling a consultant doesn't mean you're passing your patient over to someone else. They're still your patients and you are responsible for their care until they are dispositioned and out of the ED.
3) It helps if you speak the 'language' of the consultant and can predict the specific information they require to evaluate the case. This comes with experience and you will learn what this information is with the more consults you call.
Great informational video: https://youtu.be/YHCRluo6MM4
And if that's not enough, here's another cool mnemonic you could use to help you in your consult-calling journey:
source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4507900/
Welcome to Emergency Medicine :)
