Dr. Tanner Mortenson, Dr. Dinithi Iddawela
See separate email for zoom link!
IPASS Hand-off Sheet Template
& Contingency Planning
Synthesis by Receiver
68 M Doe, John
Adm Date: 3/13/15
Attending: Brown, Ella
Wt: 40 kg
Resident: Smith, Nick
|Acuity||Sick, not sick, watcher?||The patient had a rapid response today and seems to be stabilized.|
What is the main reason for the patient being in the hospital?
Patient is here for a bleeding peptic ulcer.
Where is the patient in the course of his illness?
The patient was scoped today and has been transfused to a hgb of 8. He is now starting a clear liquid diet.
What are the other problems we are actively managing?
-History of Atrial Fibrilliation, Coumadin is held
-Acute Kidney Injury, worsening
Any changes or events that are significant?
Urine output was low today, but responded to fluid bolus.
Based on your experience with the patient, what are you concerned might happen overnight?
If UOP < 0.5 mL/kg per hour, start normal saline at 100 ml/hr
What would you like me to check on overnight?
f/u on Hgb at midnight, transfuse 1 unit PRBC if < 7
Allow the receiver to ask any questions.
“What questions do you have?”