Calling your consultant
You are the night oncall ST3. A patient has been admitted with a perilunate dislocation after a fall from standing. The patient has median nerve symptoms. They are otherwise neurovascularly intact. However, they require urgent decompression and reduction. You have attempted closed reduction and this has failed. Unfortunately, you do not know how to perform an open reduction.
We would recommend using the SBAR approach to inform the consultant of the situation.
Furthermore, we would recommend you do not allow yourself to be put into an unsafe situation. If the consultant tries to make you do an operation you are not comfortable performing.
- Introduction: Hi Mr. X my name is … I am the ST3 on call.
- Situation: I have a patient who has sustained a perilunate dislocation.
- Background: After a fall from standing height
- Assessment: The patient has median nerve symptoms. I have attempted closed reduction but this was unsuccessful. I have never performed an open reduction of a perilunate dislocation.
- Request: Please can you come into hospital to perform an open reduction of this patients’ perilunate dislocation.
I would apologies to the consultant and explain that I am not happy to continue unsupervised. I would then request that he comes in again.