Presenting high volume labs to your attending?

[NNguyenMD]

Hey Guys,

I know being a fourth year and all I should know how to present something as freaking simple as laboratory data. But I've been on a bit of a dry spell of motivation lately, and can't for the life of me present pertinent laboratory data competently. I'm on MICU too and some of these patients that transfer in from other services have a freaking book of labs and radiology reports. Any of you all have a system you use to make sure you're get just the most important stuff out there? I'm pretty tempted to just hand over the lab sheet to the attending and tell him/her "enjoy". Any input would be much appreciated.

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[madcadaver]

that's the art of doing well in internal medicine-- figuring out what's important and what's not. It will come with practice. A good way to think about it for MICU: you will be doing a systems based assessment and plan, right? You should present whatever labs are pertinent to your assessment and plan. I.e. if renal failure is one of the problems you are going to want to present all the urine studies, the trend in creatinine, etc. If anemia is one of the problems you will need to present all of the labs that were ordered for the anemia workup. Same goes for imaging. Good luck.

 

[Nerdoscience]

You can always just suck it up ask the attending. Say something like, "Labs: Do you want all of them or just the pertinent ones?" In the MICU, there are going to be a lot of labs. I usually give many but not all of them, and give trends where relevant. "ABG was bla bla bla on such-and-such percent O2. The respiratory acidosis picture is improved from yesterday when the pH was whatever and the CO2 was whatever." "CBC - Whites -- which is trending up, H and H --, holding, and --, Platelets --." If there are really a lot, or trends that are hard to describe, ask the attending if he.she wants to see the printout.

 

[Dr JPH]

You can always just suck it up ask the attending. Say something like, "Labs: Do you want all of them or just the pertinent ones?"

This is good advice assuming you know what the pertinent labs are.

As a 4th year you should be developing a sense of this. The attending may not be totally interested in the BMP of an otherwise healthy person here for cholecystitis whereas the WBC and LFTs are hugely important. Just the opposite for a dialysis patient.