Sick Patient Checklist
When you’re called to an unwell patient at 2am, your brain will feel slower.
You might feel overwhelmed.
That’s normal.
This page is your reset.
Not theory.
Not guidelines.
Just:
👉 What to do, in order, every single time
Follow this structure and you’ll manage most ward emergencies safely.
🟢 Before you walk
When bleeped:
Don’t rush blindly.
Ask:
✅ What’s the NEWS?
✅ What are the observations?
✅ What exactly is wrong?
✅ Stable or deteriorating?
Then decide:
🔴 Go now
🟠 Go soon
🟢 Can wait
Triage first. Move second.
🟡 At the bedside – First 30 seconds
Don’t open notes.
Don’t log into computer.
Just look.
Ask yourself:
✅ Do they look sick?
✅ Talking normally?
✅ Breathing comfortably?
✅ Pale/sweaty/drowsy?
Your first impression is often right.
If they look unwell → treat urgently.
🔴 A–E Assessment (every patient, every time)
Do this in order. Always.
A — Airway
✅ Talking normally?
✅ No choking/gurgling?
If not:
👉 sit up + suction + oxygen + call for help
B — Breathing
✅ RR
✅ sats
✅ oxygen requirement
If low:
👉 oxygen immediately ± ABG/neb
Don’t wait for CXR.
C — Circulation
✅ BP
✅ HR
✅ cap refill
✅ urine output
If hypotensive:
👉 IV access + bloods + fluids
Access early. Always.
D — Disability
✅ AVPU/GCS
✅ glucose
✅ pupils
Low glucose?
👉 treat immediately
Never forget glucose.
E — Exposure
✅ temperature
✅ rash
✅ bleeding
✅ abdomen
✅ infection source
Look properly. Don’t guess.
🟠 Immediate actions (do before investigations)
If abnormal, fix now:
✅ Oxygen
✅ IV cannula
✅ Bloods
✅ Fluids
✅ Antibiotics (if sepsis suspected)
✅ Glucose
✅ Analgesia
Treat first. Diagnose later.
🔴 Reassess
After treatment always ask:
✅ Are obs improving?
✅ Does patient look better?
✅ Still unstable?
If not improving → escalate
Never “treat and walk away”.
📞 Escalate early if
Don’t hesitate if:
✅ NEWS ≥5–7
✅ hypotension persists
✅ increasing oxygen needs
✅ low GCS
✅ active bleeding
✅ you feel out of depth
✅ gut feeling says “not right”
Early calls prevent crashes.
Late calls create them.
📝 Document clearly
Before leaving:
Write:
✅ time
✅ why called
✅ A–E findings
✅ actions taken
✅ plan
✅ escalation discussed
If it’s not documented, it didn’t happen.
🧠 Quick mental reset phrase
When stressed, just think:
👉 A–E → Treat → Reassess → Escalate → Document
That’s 90% of safe on-call medicine.
Nothing fancy.
Just system.
🚨 Common reminders
✅ Sick patients first, paperwork last
✅ Trust nurses’ concerns
✅ Write everything down
✅ Slow down when tired
✅ Ask for help early
Safe beats clever.
Always.
One-line take-home
On call, you don’t need to be brilliant.
You need to be systematic.
Follow this checklist every time and you’ll manage most sick patients safely — even at 4am when your brain isn’t at its best.
Structure keeps patients safe.