Practical playbook for safe and effective on-call shifts.
Before the shift
- • Sleep, eat, hydrate; pack snacks + water bottle
- • Charge bleep, phone, torch; check pen, stethoscope, ID
- • Review patient list and handover
- • Know who your senior is + bleep
Bleep triage
- • Acutely unwell first — A→E at bedside
- • Pain / fluid / sleep — bundle non-urgent jobs
- • Use SBAR every escalation
- • Document time, conversation, plan
Common calls
- • Hypotension: A→E, IV access, fluid bolus 500 mL, repeat lactate, sepsis screen
- • Falls: A→E, neuro obs, CT head if anticoag / head injury / GCS drop
- • Tachycardia: ECG, ABG, treat cause (pain, sepsis, hypovolaemia, AF)
- • Confusion: glucose, TPR, infection screen, medication review, CT if focal
- • Death verification: pupils fixed dilated, no breath/pulse 1 min, no heart sounds 1 min
Asking for help
- • Never alone with sick patient
- • SBAR + clear ask: 'I need you to come and see…'
- • Document escalation: time, who, response
Self-care
- • Eat at 2 am, take 15 min break
- • Hydrate, toilet, sit down
- • Debrief after difficult cases
