I'm sorry to wake you up but...
Its 3am in the ED and you need to call a consult. What strategies can you use to get great care for your patients and be a good colleague?
Nearly every time I pick up the phone in the ED or the ICU, I create work for someone. Here are my strategies for calling a consult with composure:
1. Prep the consult - Have the patient details at hand and be ready to deliver them concisely. Understand exactly what you’re asking the consultant to do (admit, perform a procedure, provide treatment recommendations, etc.).
2. When the consultant calls back, thank them and introduce yourself.
3. If the consultant introduces themselves by specialty (“This is neurology”), ask who you're talking to - this will be important for both documentation and establishing rapport.
4. Ask if they have time to hear a consult - maybe you paged at a particularly bad time, but in 5-10 minutes they can hear the consult in a better space. As long as the care isn’t going to be delayed you’re doing your consultant a favor.
5. Lead with the consult headline: “I’d like to discuss a case of acute kidney injury with hyperkalemia with you” This immediately frames why you’re calling and gets the consultant’s attention
6. Deliver the pertinent details in a tight fashion. Use the specialty’s language - the Gs and Ps for OB, the difference between pulses and signals for vascular, intraocular pressure or acuity for ophthalmology, an accurate description of the fracture for orthopedics.
7. Let them know what treatment is already in process - show that you know what the initial stabilization steps are.
8. If appropriate, ask if you can get anything ready for them in the ED
9. When the consultant arrives, make a point of greeting and thanking them. This will help build a relationship and close the loop for final recommendations.