“Patient received from ITU, appeared very poorly on admission. It was mentioned that patient was scoring 2
on handover but when we checked obs was scoring 10 and neuro obs 6. Blood sugar level monitored 6.8 mmol recorded, insulin given. Patient's body appeared very oedematous on assessment - unable to move all limbs.

Patient was on 15 litres humidified oxygen, NG Tube was also in situ, NBM for NG feeding. Tried to aspirate to start the feeding but no aspirate obtained, hence night meds not given. IV ABX administered. I find this patient consuming most of my time, compromising other patients’ care as I had ten patients to look after.”

There is a lack of detail here, but it does serve as a reminder that transition of care should be a planned procedure, occurring in hours with good communications between the parent and destination medical and nursing teams, ensuring sufficient resource is in place at the destination. Even with good planning, patients can deteriorate after step down and may need reassessment by the critical care team and readmission.