How to Pull Numbers
Introduction
Even if you don’t start your core clinical year with surgery, you will likely run into the phrase “pulling numbers” quickly. Pulling numbers is an essential start to the day on any inpatient rotation and is a core medical student duty, and learning what it entails and how to do it efficiently will make your life easier going forward.
Pulling numbers is essentially data gathering and organizing the information in a way that the rest of the team can understand and in a way that can be distributed to them easily. Usually this involves writing numbers (covered below) on a paper sign out sheet for each patient. Then the medical student organizes the signout sheets in a certain order and photocopies them to provide each member of the team with a list of all patients with the relavent numbers.
Core data
These numbers (data) are what will be pulled on almost any surgical inpatient. Additional service specific considerations are covered below.
- Overnight events, pages, nursing notes, CODES, procedures, orders, overnight lab values, overnight tests
- Vital signs (BP, HR, Temperature, Oxygenation)
- INs and Outs (urine output and bowel movements)
- AM lab results (trend important or abnormal values)
- New diagnostic studies
- PRN medication requirements (pain meds, bowel regiments, etc)
Service speecific numbers
Pediatric surgery
- Urine output is reported in cc/kg/hr
- Include weight as a vital sign. Include the weight difference from the day before, and any trends
CVICU / SNICU
- Include rough ranges of most vital signs, especially those that are abnormal
- Pressor requirements overnight and trends
- Urine output trends by 8 hour shifts
Example
Conclusion
Pulling numbers is an essential role of the medical student. It is one of the few ways we can help our surgical team.