Shift briefing
11 April 2026 · 07:02 · Generated 22 sec ago · 11 patients · 4 priority
“How does my day look?”
07:01:38 · 1.4s
OmniSense · shift briefing
Good morning Dr. Menon. You have 11 cardiac patients today across CICU and the
cardiac surgical step-down. Four need your attention this morning.
Mr. Pillai in bed 12 — your STEMI from Tuesday — his creatinine bumped from 0.9 to 1.4 overnight. Most likely contrast nephropathy from yesterday’s cath, and he’s still on the ACE-i and metformin.
Mrs. Nair in bed 8 — your decomp heart failure on milrinone — her lactate has come down from 4.1 to 2.3 over the last 24 hours, but the milrinone wean isn’t going as planned and she’s still pretty volume-overloaded. The advanced HF team wants to talk about LVAD versus transplant referral this morning.
Ms. Fatima in bed 1 — the 28-year-old myocarditis admission from last night — her EF dropped from 28 to 22 on the morning echo. She’s on low-dose noradrenaline and dobutamine, and the ECMO team is asking whether to cannulate now or wait another four hours.
Mr. Krishnan in bed 3 goes to the cath lab tomorrow — his eGFR is 38, so I want to flag the contrast load. And Mr. Rao is your CABG case for tomorrow morning — anaesthesia wants clearance on his anti-platelet hold.
The other six are stable. What do you want to tackle first?
Mr. Pillai in bed 12 — your STEMI from Tuesday — his creatinine bumped from 0.9 to 1.4 overnight. Most likely contrast nephropathy from yesterday’s cath, and he’s still on the ACE-i and metformin.
Mrs. Nair in bed 8 — your decomp heart failure on milrinone — her lactate has come down from 4.1 to 2.3 over the last 24 hours, but the milrinone wean isn’t going as planned and she’s still pretty volume-overloaded. The advanced HF team wants to talk about LVAD versus transplant referral this morning.
Ms. Fatima in bed 1 — the 28-year-old myocarditis admission from last night — her EF dropped from 28 to 22 on the morning echo. She’s on low-dose noradrenaline and dobutamine, and the ECMO team is asking whether to cannulate now or wait another four hours.
Mr. Krishnan in bed 3 goes to the cath lab tomorrow — his eGFR is 38, so I want to flag the contrast load. And Mr. Rao is your CABG case for tomorrow morning — anaesthesia wants clearance on his anti-platelet hold.
The other six are stable. What do you want to tackle first?
Illness
Watcher x1 Unstable x3 Stable x7
Watcher
Bed 1 Ms. Fatima Rahman, 28F Acute viral myocarditis, cardiogenic shock. EF 28→22 on AM echo. On norad 0.08 + dobutamine 5. ECMO team at bedside.
Unstable
Bed 12 Mr. Pillai, 62M Post-PCI STEMI day 2. Cr 0.9→1.4. Still on ACE-i + metformin.
Bed 8 Mrs. Nair, 58F Decomp HFrEF EF 25, milrinone + IV furosemide. Lactate 4.1→2.3, wean stalled. HF team 09:00.
Bed 3 Mr. Krishnan, 71M NSTEMI awaiting cath, eGFR 38. Cath booked tomorrow AM.
Bed 8 Mrs. Nair, 58F Decomp HFrEF EF 25, milrinone + IV furosemide. Lactate 4.1→2.3, wean stalled. HF team 09:00.
Bed 3 Mr. Krishnan, 71M NSTEMI awaiting cath, eGFR 38. Cath booked tomorrow AM.
Pre-op
SD-4 Mr. Rao, 68M CABG x3 tomorrow 07:30. 3VD, mild AS. Ticagrelor held since 10 Apr 20:00. Awaiting written sign-off.
Stable
Bed 5 K. George (post-PCI day 4) · Bed 6 A. Varghese (AF rate-controlled) · Bed 9 P. Joseph (NSTEMI day 3) · Bed 11 R. Iyer (pericarditis) · SD-2 T. Mathew (POD-3 CABG) · SD-7 J. Thomas (POD-5 AVR)
Priority — 5 patients · 13 actions
Action queue
8 pending
2 acknowledged
2 done
Auto-resolves from Aster EMR (HL7 ORM) · voice mark-done supported
1
CICU
Ms. Fatima Rahman, 28F
Crashing
ECMO decision pending
Acute viral myocarditis · cardiogenic shock · noradrenaline + dobutamine
EF dropped 28 → 22 on this morning’s echo · trop 14.2 · BP 88/52 · ECMO team activated
⏳
VA-ECMO cannulation decision — Dr. Krishnamurthy + perfusion at bedside
👁
Family update — husband + parents at unit
✓
IVIG 2g/kg prepared in pharmacy
12
CICU
Mr. Sasi Pillai, 62M
AKI rising
Drug-safety flag
Post-PCI STEMI day 2 · LAD stent · T2DM 15y · smoker
Creatinine 0.9 → 1.4 overnight. Still on ACE-i + metformin. Likely contrast nephropathy.
⏳
Hold metformin 1g BD — eGFR 42, below 45 cut-off
⏳
Hold ramipril 5mg 24h — ACE-i in evolving AKI
⏳
Start NaHCO3 hydration 1mL/kg/h · CIN prevention
⏳
Repeat U&E + creatinine at noon
8
CICU
Mrs. Latha Nair, 58F
Wean stalled
HF team consult 09:00
Decompensated HFrEF · EF 25% · milrinone + IV furosemide
Lactate 4.1 → 2.3 (good) but volume-overloaded. LVAD vs transplant decision today.
⏳
LVAD vs transplant referral — advanced HF round 09:00 with Dr. Krishnamurthy
👁
Continue milrinone wean per protocol · reassess at noon
3
CICU
Mr. Hari Krishnan, 71M
Pre-cath risk
CKD 3
NSTEMI awaiting cath · CKD eGFR 38 · DAPT + heparin · frail
Cath booked tomorrow AM. Contrast nephropathy risk — flag for hydration protocol + minimum-volume strategy.
⏳
Confirm cath lab booking · tomorrow 09:00 slot
⏳
Write CIN prevention orders · NaHCO3 1mL/kg/h from 04:00 + hold metformin 24h pre-cath
SD-4
Step-Dn
Mr. Venu Rao, 68M
Pre-op clearance
Anaesthesia waiting
Pre-op CABG x3 tomorrow · T2DM HbA1c 8.4 · mild AS · CKD eGFR 52
DAPT loaded 4 weeks ago. Anti-platelet hold timing + metformin/ACE-i hold needs your call this morning.
⏳
Sign pre-op clearance · submit to Dr. Joseph (anaesthesia) by 09:00
✓
Ticagrelor held since 10 Apr 20:00 (35h pre-op, within ESC window)
Stable overnight — 6 patients
CICU 5
Mr. K. George, 64M · Post-PCI day 4 · troponin trending down · for step-down today
Stable
CICU 6
Mr. A. Varghese, 71M · Atrial fibrillation rate-controlled · CHADS 4 · awaiting anticoag plan
Stable
CICU 9
Mrs. P. Joseph, 55F · NSTEMI day 3 · medical management · for step-down tomorrow
Stable
CICU 11
Mr. R. Iyer, 59M · Pericarditis on ibuprofen + colchicine · pain controlled · echo unchanged
Stable
SD-2
Mr. T. Mathew, 70M · POD-3 CABG x4 · ambulating · for chest tube removal today
Stable
SD-7
Mr. J. Thomas, 66M · POD-5 AVR mechanical · INR 2.4 · for discharge home tomorrow
Stable