| 00:00 - 00:03 | Dr. Malik, we just ran the list with the NCCU |
| 00:04 - 00:05 | They're saying they won't push sodiums |
| 00:05 - 00:07 | on Ms. Houghton |
| 00:08 - 00:12 | This morning's sodium came back at 142 and her exam has been |
| 00:12 - 00:15 | rock solid: intact, perrl, and moves spont |
| 00:17 - 00:19 | We must communicate our recommendations |
| 00:19 - 00:21 | to push sodiums above 165 |
| 00:24 - 00:26 | Dr. Malik... |
| 00:27 - 00:28 | she has been..... |
| 00:31 - 00:33 | She has been transferred to main 7 under neurology |
| 00:34 - 00:36 | Thanujaa is the NCCU attending |
| 00:53 - 00:58 | Everyone leave the room except Rahul, Rohaid, and Carlin |
| 01:13 - 01:15 | How can our team not be aware?! |
| 01:15 - 01:17 | Our team should be made aware! |
| 01:18 - 01:23 | How can we accept for a patient with amyloid angiopathy to be transferred to a neurology floor?! |
| 01:25 - 01:28 | The sodium isn't at goal... |
| 01:29 - 01:31 | The patient told me she was nauseous! |
| 01:31 - 01:34 | and she had a heart rate of 65 last night |
| 01:34 - 01:37 | which was not picked up by our team!!! |
| 01:37 - 01:40 | Don't even get me started on the UA which was never sent!!! |
| 01:40 - 01:42 | Dr. Malik she has been asymptomatic..... |
| 01:42 - 01:46 | DID YOU EVEN READ THE IDSA GUIDELINES I SENT YOU?! |
| 01:46 - 01:48 | No, Dr. Malik, I had to do a LICOX instead |
| 01:48 - 01:52 | that should take you 5 minutes... |
| 01:53 - 01:54 | and speaking of your inability to perform procedures |
| 01:56 - 01:57 | I ask for arterial lines on every ICH |
| 01:57 - 02:00 | and you consistently fail to place them |
| 02:00 - 02:03 | How can call yourself a neurosurgical resident |
| 02:04 - 02:08 | and not do all the lines on all our patients |
| 02:08 - 02:13 | My recommendations are the only thing between these patients and death |
| 02:14 - 02:16 | and they are constantly being ignored |
| 02:17 - 02:21 | and then you wonder why we aren't a national TBI center of excellence |
| 02:27 - 02:29 | I don't even know why I try |
| 02:30 - 02:34 | What can we do to ensure appropriate care |
| 02:34 - 02:36 | for the patients who trusted us with their lives |
| 02:41 - 02:42 | it's hopeless |
| 02:43 - 02:47 | for I have communicated my recommendations to Carlin every morning |
| 02:48 - 02:53 | I just do not understand why we can't keep running hypertonic saline |
| 02:54 - 02:56 | through the peripherals |
| 02:56 - 02:59 | it's not enough I have given up on our team placing |
| 03:00 - 03:02 | central lines like any competent resident would |
| 03:04 - 03:07 | it's ok, we can still get the UA |
| 03:14 - 03:16 | I must accept our team's deficiencies |
| 03:19 - 03:23 | and learn to liberalize my recommendations |
| 03:25 - 03:26 | let's ask neurology |
| 03:31 - 03:33 | to push the sodiums to 150 instead |
| 03:40 - 03:46 | start salt tabs 10 g q4H |
| 03:46 - 03:49 | go book her urgent within 3 hours |
| 03:53 - 03:56 | call me when she's in pre op |
