Checklist for seeing an ID consult*
Before seeing consult
- Ensure that the consulting team's consultant is aware that the consult
has been requested
- Consults should be a request for advice from one consultant to
another
- Make sure that any necessary documentation (eg, consult sheet) has been
completed
- Check MRSA and VRE alerts; go through previous microbiology if needed
for a year or two
- Always work out exactly what time the initial cultures were taken in
relation to the first dose of antibiotics
While seeing the consult
- Make sure you've asked whether they saw their GP prior to coming in to
hospital
- Find out whether they took any antibiotics prior to presentation
- If there's any possibility the patient had tests outside, then ring
the outside labs
- If the history's unclear, then make sure you've called a relative
- In hospital PUOs, consider drug fever (relative bradycardia,
eosinophilia, other signs of drug toxicity like rash and abnormal LFTs)
After seeing the consult
- If you've proposed new medications, then make sure YOU have checked the
interactions (eg, using
MIMS)
- If antibiotics are on the cards, then make sure you've calculated the
creatinine clearance (click
here) and the doses
- Your first sentence when presenting should include all of the following
(SASPOP):
- Sex
- Age
- Social statement - only the important social context relevant to
solving the patient's ID problems
- Past history - only the background history relevant to solving the
patient's ID problems
- Onset - pay particular attention to time course; dates of onset,
admission, major developments
- The presentation itself
- Make sure someone has written in the general notes that the consult's
been completed (if using a form)
*This saves a lot of time at the bedside. Time wasted = time that could have
been spent teaching