General Surgery Consult π₯
Guide for general surgery consultation and referral. Key information to provide, common indications, and referral scripts for NCHDs.
π Key Info to Have Ready
- Patient identifiers: full name, date of birth, location and MRN
- Reason for consult: pain, post-op concern, obstruction, bleeding, etc.
- Timeline of events: onset, progression, interventions so far
- Past Medical/Surgical History: especially abdominal surgeries
- Medications: anticoagulants, recent analgesia, antibiotics
- Observations: vitals, EWS trends, fever pattern
- Recent bloods: FBC, CRP, U&E, Coagulation profile
- Imaging: CXR, AXR, CT if available
- Abdominal exam findings: distension, guarding, tenderness, bowel sounds
π Investigations to Know
- Bloods: FBC, CRP, U&E, LFTs, Amylase, Coag
- Imaging: AXR/CXR/CT depending on presentation
- Urine dip +/- Ξ²HCG if female of reproductive age
- ECG if suspecting electrolyte disturbance or elderly patient
π Example Script
- Hi, this is [Your Name], the intern from [Team Name]. I'm calling regarding a [Age]-year-old patient on [ward] for a general surgical consult.
- They presented with [e.g. abdominal pain, vomiting, distension] for the past [duration].
- They have a background of [e.g. previous bowel surgery], and are currently [hemodynamically stable/unstable].
- Bloods show [e.g. raised CRP, neutrophilia], and imaging shows [e.g. dilated bowel loops].
- Weβre looking for your review regarding [possible obstruction / decision for theatre / further imaging].
π Tips
- Be clear on whether surgical review is urgent or routine
- Have bloods and imaging ready or accessible
- Include history of prior abdominal operations or relevant PMH
- Donβt forget to consider and rule out other causes (e.g. cardiac, urinary, gynae)