discharge summary

ICU Transfer Arrives with Hospital Summary on a Napkin

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SALT LAKE CITY, UT – An 83-year-old man was transferred to the University Hospital Critical Care Unit from an outside hospital on Tuesday, with a small napkin describing relevant aspects of his 14-day course.

discharge summary
Discharge summary from an outside hospital

The ICU transfer, who arrived intubated, on ECMO, an intra-aortic balloon pump in place, and with a blood pressure of 56/39, reportedly has a past medical history notable only for “CAD, HTN.”  Also mentioned in the highly-detailed document were the results of his recent cath, which were apparently “stent placed,” and his echocardiogram, which was reportedly “abnormal.”

Fortunately, the outside hospital did include a list of active medications, including “gtt @ 20” and “?Coumadin.”

Pertinent lab values were also listed, notable for hemoglobin of either a 5 or 9, as well as a troponin of “+.”  An undated EKG, sketched on the back of the napkin, appears to show some sort of QRS complex.

Based on the large, recent surgical scar and wound VAC on his abdomen, the admitting team was able to deduce that “s/p co” may indicate the patient had a colectomy of some variety, for some indication.

The lone word “kidney” was written at the bottom, suggesting that the patient may have renal dysfunction, or perhaps was included simply to indicate that he has one or more kidneys.

Given his tenuous status, as may be indicated by what is either “lact 13” or “lact 1.3,” depending if the dot was BBQ sauce or ink.  The napkin also thoughtfully includes emergency contact info for his next of kin: “wife,” followed by a six-digit telephone number running off the napkin.

In addition to the this comprehensive hospital course were discharge instructions for the soon-to-be deceased man.  Written within the restaurant’s logo one can make out recommendations such as “advance activity as tolerated,” eat a “low-fat, sodium-controlled diet,” and “take all medications as directed” (presumably referring to fentanyl drip at 400 mcg/hour).

Also included was a 12-page document prepared by the paramedics during the 45-minute drive, including q5min vital signs, detailed drip titrations, ventilator settings, and a detailed physical exam.

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  • Show Comments

  • Avatar
    Bethany Worthington

    Haha!!!

  • Avatar
    Cynthia

    #zerowaste

  • Avatar
    Candace Biggs

    lmao ! Love it

  • davefromcamp
    davefromcamp

    Perfect! Instead penises with medical information, be practical with your practical jokes

  • Avatar
    Diana Webster

    Hahaha! Yep! That should get you started. Just pretend you are in the ED.

  • Avatar
    William Tessier Sr.

    That’s really cool and weird mostly weird

  • Avatar
    Patricia McCormick-Lee

    This is really quite common. Such a bonus on the correct form. But reusing a paper napkin counts as recycle.

  • Avatar
    John Day

    I have seen these things written on the sheets also

  • Avatar
    Becca Harrington

    Omg, Sharon

  • Avatar
    Leslie Baxter

    Ok, I’m a layperson here, but why didn’t they sharpie all of that right on the patients face? No napkin to lose.

  • Avatar
    Veronica Nicole Fries

    Yep, love my paper towels!

  • Avatar
    Colleen Maughan

    Oh man we hate it when they send this crap in a medical record LOL

  • Avatar
    Judith Jacobi Mowry

    Thank goodness they did not send the nurse’s scrub pants with all the vitals written on it.

  • Avatar
    Kim Lor

    BBQ sauce

  • Avatar
    Kesa Wilson

    I hope that’s ketchup!!!!

  • Avatar
    Mike Hill

    ?coumadin…lol

  • Avatar
    Mike Hill

    ?coumadin…lol

  • Avatar
    Kezia Jhugdeo Smith

    That’s what the fitted sheets are for! Just write the report beside their head! Duh!

  • Avatar
    Jennifer Lorette

    My stationary of choice !!

  • Avatar
    Natalie Outcelt

    Is that poop or chocolate?

  • Avatar
    Susan Mayes

    Most complete.

  • Avatar
    Susan Mayes

    Most complete.

  • Avatar
    Rissa Stackhouse

    I’m thinkin’, is there a problem?

  • Avatar
    Clealus Lee Ford

    Lol! That really is high class! I always used paper towels or in hospital scrubs ink on the thigh of scrub pants worked in a pinch!

  • Avatar
    Alex Harris Robbins

    This is better than some reports I’ve received from an outside hospital lol.

  • Avatar
    Kristine Hall

    Mary Jo Gover
    Well yeah?

  • Avatar
    Kristine Hall

    Mary Jo Gover
    Well yeah?

  • Avatar
    Shariq I. Chudhri

    Usually we just get the patient, napkin is a bonus

  • Avatar
    Tracey Sunde

    I do my best work om paper towels

  • Avatar
    Erin McDowell Coleman

    Wow!

  • Avatar
    Elizabeth Jane Welch

    I’ve had vent settings to mini reports on pillowcases.

  • Avatar
    Angela Ve

    That’s gotta be the worst ever

  • Avatar
    Kelli Dalrymple

    Wow this is hilarious

  • Avatar
    Khalid Manzoor

    Treatments given include: “fluid, shock, vent, antibiotic & s/p abd surgery”. Accepting physician: Dr. Doomed

  • Avatar
    Janie Dill

    I’ve done it. 2 GI bleeders. 3 chest pains and no paper. Whatever works.

  • Avatar
    Angela Barrett

    At least they didn’t lose the napkin. Makes for a bad day when your paper towel gets thrown out!

  • Avatar
    Katie Koy Allen

    Danielle

  • Avatar
    Danielle Thompson

    Katie, I’m dying!

  • Avatar
    Gina Cotton Simpson

    We once received a post CPR transfer from another facility whose entire CPR record was written on “nursing stationary” ( a paper towel.) As you can imagine, HIM, medical record, and legal document jokes dominated the rest of our shift.

  • Avatar
    Corinne Lanier

    That’s more of a report than I’ve gotten on some pts.

  • Avatar
    Mechelle Miller

    That looks like my handwriting…

  • Avatar
    Jackie Hairr

    I like a piece of tape down the scrub pant leg as a nursing turnover report in the OR

  • Avatar
    Angela Witham Collins

    What else do you need to know?

  • Avatar
    Sheila David Churchill

    Very like the UCF: paper towel, everyone’s universal chart form.

  • Avatar
    Alison Hickey

    WTF???????

  • Avatar
    Bonnye Thomas

    Sounds normal to me.

  • Avatar
    Katrina Britt

    hahahahaha

  • Avatar
    Chris Marsh

    What’s the problem, sounds like a typical Epic EHR report. HIEs be damned.

  • Avatar
    Angie Stratton

    Discharge Instructions for the soon to be deceased man…

  • Avatar
    Cris Jackson

    It’s like a real life Pop quiz. With someone’s actual Pop.

  • Avatar
    Des Fines

    Anything helps.

  • Avatar
    Kait Sherrard

    Holy smokes haha!!

  • Avatar
    Holly Freuler

    A step down from the pillowcase…

  • Avatar
    Jordan Safirstein MD

    clearly written by a PGY3 #Onlytheimprotantstuff

  • Avatar
    Phil Petty

    I remember this patient.

  • Avatar
    Brittany Leigh Crandell

    This!

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