Let's back up, shall we!
Post call is the day/ medical-legal term/ state of consciousness that occurs after an overnight shift at the hospital. "Call" has varied meanings in different health systems. For medicine residents, it usually means:
- Coming to work at the normal time of 6:00.
- Working all day.
- Taking care of the hospital service patients at night.
- Staying at the hospital overnight to admit new patients.
- Sleeping from 0-4 hours in a special call sleep room.
- Being available to answer pages from the floor or the ER and responding to codes, if needed.
- Presenting the patients (new and old) the next morning to the regular day team.
- Leaving the hospital no later than 30 hours after arriving.
Well, tonight was my very first overnight call. My two previous rotations set medical student call as morning sign-out until midnight. Since my current hospital has a call room for medical students, I get to stay all night. I admitted one patient, and then checked up on my other three, one of whom had a new finding of elevated liver enzymes. Which brings us to the original point of this post: It is difficult to access information (even the basic stuff) when you are not used to staying up all night. There are a number of reasons liver enzymes could be elevated. And because I'm a nice guy, I'll tell you what they are.
- Drug Toxicity
- Acute Viral Hepatitis
- Steatohepatitis (Alcoholic and Non Alcoholic)
- Biliary Obstruction
- Infarcted Liver
- Traumatic Injury