Situational monitoring involves medical professions at all levels of care, including administration, medical assistants, nurses, doctors, etc. When care providers at all levels engage with patients and aren't afraid to speak up if a situation seems out of the ordinary, patient safety nets are created. It encourages healthcare teams to check-in with each often, to communicate and ask questions when unsure, and to increase accountability within the team.
Some of the students present tonight gave examples of situational monitoring from their own experiences. One talked about doing surgical prerounds early in the morning and discovering a patient had aspirated overnight. The patient was able to be quickly transferred to the ICU. Another talked about an ICU nurse who had talked extensively with a patient and discovered some undocumented medical allergies. She was able to prevent a drug from being given that would have been detrimental to the patient's health.
Our final case of the night centered around a patient with a history of two heart attacks who presented to CCC clinic and was visibly short of breath and uncomfortable in the waiting room. When asked how the team would proceed, students were in agreement about disregarding the regular order of clinic nights and taking the following measures to make sure the patient received prompt care: 1) contacting the attending immediately, 2) evaluating vitals to make sure patient was stable, 3) rushing the patient to the ED if needed.
Some final clinical pearls for risk factors of high-risk patients who present with atypical heart attack signs:
1) diabetic/ patient with hyperlipidemia
2) males, younger than age 70
Some of these atypical signs may be: abdominal pain, dyspnea, indigestion, and syncope.
-Yun Xue MSII
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