Here you go ... a day shift (8a-4p) from New Zealand! Daily volume ~330 pts, I was the consultant supervising one of the three zones in the ED, one of two "monitored" pods of ~20 beds and 3 resuscitation bays with a team of 2 to 4 trainees (1 had to leave mid-shift d/t family emergency).
Handover
38 y/o paresthesia awaiting neurology consult, d/c
82 y/o undifferentiated abdominal pain, CT nondiagnostic, d/c
14 y/o escalating pelvic pain and vaginal bleeding, admit gynae
2 y/o unexplained hypoglycemia and ketosis in mild illness, admit peds obs
New Pts
77 y/o COPD family concerns over self-care, no indication for admission, d/c
79 y/o COPD and HF, grossly fluid overloaded, admit medicine
88 y/o pneumonia and delirium, admit medicine
73 y/o COPD and HF, improved, mild fluid overload, trial of outpatient diuretic, d/c [my patient]
39 y/o paroxysmal AF with RVR, rate control, d/c with cards f/u
81 y/o recent EVAR new leg swelling, U/S eval pseudoaneurysm -> seroma, d/c [my patient]
54 y/o 2:1 Aflutter, on sotalol, cards consult: sedation, DC cardioversion, d/c [my patient]
66 y/o renal transplant/BKA/SPC fever likely UTI, admit medicine
89 y/o chest pain/RUQ pain, labs normal, pain gone, d/c
71 y/o first seizure, CT head negative, remained altered, admit neurology
84 y/o likely diverticular bleed on clopidogrel, stable, admit surgery
41 y/o STEMI call from field, ECG normal, troponin normal, d/c [my patient]
54 y/o atraumatic knee pain, gout, d/c
74 y/o COPD exacerbation, improved, d/c
55 y/o chest pain, flank pain, back pain, UTI, d/c
82 y/o chest pain 8 hours PTA, troponin undetectable, d/c [my patient]
42 y/o transfer 20% 2nd degree burns, admit
76 y/o diarrhea and neutropenia on chemo, admit oncology
29 y/o DM1 feeling vaguely unwell, IVF, no objective findings, d/c
25 y/o cyclic vomiting, d/c
91 y/o abdominal pain 1 week after hemicolectomy, admit surgery
81 y/o prostate CA, obstructive lymphedema, AKI, admit oncology
89 y/o knee gave way, fall, no injury or objective findings, d/c
46 y/o atypical chest pain, d/c
79 y/o new onset afib RVR, rate control, d/c with cards f/u
24 y/o abdominal pain, biliary colic, not settling, admit surgery
65 y/o infective bronchiectasis, admit respiratory
72 y/o neutropenic fever, admit oncology
68 y/o isolated open tib/fib motorcycle accident, admit orthopedics
41 y/o neutropenic fever, admit oncology
20 y/o dysfunctional uterine bleeding, d/c
74 y/o afib AKI, anasarca, severe sepsis, DNR, admit medicine [my patient]
31 y/o gastroenteritis, d/c
57 y/o pelvic pain, dysfunctional uterine bleeding, d/c
72 y/o atraumatic foot pain, found hypoxic, new severe anemia, admit medicine
51 y/o COPD exacerbation, d/c
) if this were the case.
