Harbor:Transferring to psych ER - Revision history

Bchap23 at 16:42, 26 July 2022

2022-07-26T16:42:44Z

← Older revision		Revision as of 16:42, 26 July 2022
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	*Psychiatric patients with chronic disorders who require placement are managed in the Psych ED		*Psychiatric patients with chronic disorders who require placement are managed in the Psych ED
	Approved June 2015, Chappell 2/22/16		Approved June 2015, Chappell 2/22/16


			* PROCESS (not policy): '''A patient in the Psych ED requiring admission for medical reasons requires transfer to the AED in order to facilitate admission to the hospital'''

	==See Also==		==See Also==

Andreawu at 19:18, 27 April 2021

2021-04-27T19:18:15Z

← Older revision		Revision as of 19:18, 27 April 2021
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	#Require psych evaluation prior to discharge or transfer to medical unit; this should be done within 30 minutes of request for consult		#Require psych evaluation prior to discharge or transfer to medical unit; this should be done within 30 minutes of request for consult
	*Patients in the psych ED that require medical evaluation (or re-evaluation) should be transferred to the adult ED as soon as a bed is available; prior to the transfer, the psych physician should discuss the case with the ED physician; exceptions will be made on a case-by-case basis		*Patients in the psych ED that require medical evaluation (or re-evaluation) should be transferred to the adult ED as soon as a bed is available; prior to the transfer, the psych physician should discuss the case with the ED physician; exceptions will be made on a case-by-case basis
	*PAGE 4 of POLICY: Patients in the Psychiatric ED who may require treatment with sedating medications and are deemed to be at risk for significant oxygen desaturation when sedated, '''based on clinical evidence''', should be transferred to a monitored bed in the ED.		*PAGE 4 of POLICY: Patients in the Psychiatric ED who may require treatment with sedating medications and are deemed to be at risk for significant oxygen desaturation when sedated, '''based on clinical evidence''', should be transferred to a monitored bed in the ED. Open policy on DHS computer or remote desktop [https://lacounty.sharepoint.com/sites/DHS/Harbor_PP/Forms/AllItems.aspx?id=%2Fsites%2FDHS%2FHarbor%5FPP%2FDEM%20Policy%20Manual%2F03%2E4%20Flow%20of%20Patients%20Between%20the%20Psychiatric%20and%20Adult%20EDs%2Epdf&parent=%2Fsites%2FDHS%2FHarbor%5FPP%2FDEM%20Policy%20Manual Link the ED Policy 3.4]
	***'''Examples of clinical evidence include a credible history of significant obstructive sleep apnea (OSA) or witnessed apnea, hypoxia, or desaturation when sleeping after treatment with sedating medications.'''		***'''Examples of clinical evidence include a credible history of significant obstructive sleep apnea (OSA) or witnessed apnea, hypoxia, or desaturation when sleeping after treatment with sedating medications.'''
	***'''Transfers to the ED from the Psychiatric ED for concerns about OSA should be based on physician clinical judgment, and not solely on body mass index. These patients are co-managed by the physicians from both areas.'''		***'''Transfers to the ED from the Psychiatric ED for concerns about OSA should be based on physician clinical judgment, and not solely on body mass index. These patients are co-managed by the physicians from both areas.'''

Bchap23: /* Guidelines for Flow of patients between the Psychiatric and Adult Emergency Departments (ED Policy 3.4) */

2021-04-27T19:12:35Z

Guidelines for Flow of patients between the Psychiatric and Adult Emergency Departments (ED Policy 3.4)

← Older revision		Revision as of 19:12, 27 April 2021
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	*Patients in the psych ED that require medical evaluation (or re-evaluation) should be transferred to the adult ED as soon as a bed is available; prior to the transfer, the psych physician should discuss the case with the ED physician; exceptions will be made on a case-by-case basis		*Patients in the psych ED that require medical evaluation (or re-evaluation) should be transferred to the adult ED as soon as a bed is available; prior to the transfer, the psych physician should discuss the case with the ED physician; exceptions will be made on a case-by-case basis
	*PAGE 4 of POLICY: Patients in the Psychiatric ED who may require treatment with sedating medications and are deemed to be at risk for significant oxygen desaturation when sedated, '''based on clinical evidence''', should be transferred to a monitored bed in the ED.		*PAGE 4 of POLICY: Patients in the Psychiatric ED who may require treatment with sedating medications and are deemed to be at risk for significant oxygen desaturation when sedated, '''based on clinical evidence''', should be transferred to a monitored bed in the ED.
	***Examples of clinical evidence include a credible history of significant obstructive sleep apnea (OSA) or witnessed apnea, hypoxia, or desaturation when sleeping after treatment with sedating medications.		***'''Examples of clinical evidence include a credible history of significant obstructive sleep apnea (OSA) or witnessed apnea, hypoxia, or desaturation when sleeping after treatment with sedating medications.'''
	***Transfers to the ED from the Psychiatric ED for concerns about OSA should be based on physician clinical judgment, and not solely on body mass index. These patients are co-managed by the physicians from both areas.		***'''Transfers to the ED from the Psychiatric ED for concerns about OSA should be based on physician clinical judgment, and not solely on body mass index. These patients are co-managed by the physicians from both areas.'''
	*Psychiatric patients with chronic disorders who require placement are managed in the Psych ED		*Psychiatric patients with chronic disorders who require placement are managed in the Psych ED
	Approved June 2015, Chappell 2/22/16		Approved June 2015, Chappell 2/22/16

Bchap23: /* Guidelines for Flow of patients between the Psychiatric and Adult Emergency Departments (ED Policy 3.4) */

2021-04-27T19:10:29Z

Guidelines for Flow of patients between the Psychiatric and Adult Emergency Departments (ED Policy 3.4)

← Older revision		Revision as of 19:10, 27 April 2021
Line 8:		Line 8:
	#Require psych evaluation prior to discharge or transfer to medical unit; this should be done within 30 minutes of request for consult		#Require psych evaluation prior to discharge or transfer to medical unit; this should be done within 30 minutes of request for consult
	*Patients in the psych ED that require medical evaluation (or re-evaluation) should be transferred to the adult ED as soon as a bed is available; prior to the transfer, the psych physician should discuss the case with the ED physician; exceptions will be made on a case-by-case basis		*Patients in the psych ED that require medical evaluation (or re-evaluation) should be transferred to the adult ED as soon as a bed is available; prior to the transfer, the psych physician should discuss the case with the ED physician; exceptions will be made on a case-by-case basis
	*PAGE 4 of POLICY: Patients in the ~~Psych~~ ED who require treatment with ~~sedatives~~ and are deemed to be at risk for significant oxygen desaturation should be transferred to a monitored bed in the ~~adult~~ ED; ~~these~~ patients are co-managed by the physicians from both areas		*PAGE 4 of POLICY: Patients in the Psychiatric ED who may require treatment with sedating medications and are deemed to be at risk for significant oxygen desaturation when sedated, '''based on clinical evidence''', should be transferred to a monitored bed in the ED.
			***Examples of clinical evidence include a credible history of significant obstructive sleep apnea (OSA) or witnessed apnea, hypoxia, or desaturation when sleeping after treatment with sedating medications.
			***Transfers to the ED from the Psychiatric ED for concerns about OSA should be based on physician clinical judgment, and not solely on body mass index. These patients are co-managed by the physicians from both areas.
	*Psychiatric patients with chronic disorders who require placement are managed in the Psych ED		*Psychiatric patients with chronic disorders who require placement are managed in the Psych ED
	Approved June 2015, Chappell 2/22/16		Approved June 2015, Chappell 2/22/16

Bchap23: /* Guidelines for Flow of patients between the Psychiatric and Adult Emergency Departments (ED Policy 3.4) */

2019-08-17T04:10:03Z

Guidelines for Flow of patients between the Psychiatric and Adult Emergency Departments (ED Policy 3.4)

← Older revision		Revision as of 04:10, 17 August 2019
Line 8:		Line 8:
	#Require psych evaluation prior to discharge or transfer to medical unit; this should be done within 30 minutes of request for consult		#Require psych evaluation prior to discharge or transfer to medical unit; this should be done within 30 minutes of request for consult
	*Patients in the psych ED that require medical evaluation (or re-evaluation) should be transferred to the adult ED as soon as a bed is available; prior to the transfer, the psych physician should discuss the case with the ED physician; exceptions will be made on a case-by-case basis		*Patients in the psych ED that require medical evaluation (or re-evaluation) should be transferred to the adult ED as soon as a bed is available; prior to the transfer, the psych physician should discuss the case with the ED physician; exceptions will be made on a case-by-case basis
	*Patients in the Psych ED who require treatment with sedatives and are deemed to be at risk for significant oxygen desaturation should be transferred to a monitored bed in the adult ED; these patients are co-managed by the physicians from both areas		*PAGE 4 of POLICY: Patients in the Psych ED who require treatment with sedatives and are deemed to be at risk for significant oxygen desaturation should be transferred to a monitored bed in the adult ED; these patients are co-managed by the physicians from both areas
	*Psychiatric patients with chronic disorders who require placement are managed in the Psych ED		*Psychiatric patients with chronic disorders who require placement are managed in the Psych ED
	Approved June 2015, Chappell 2/22/16		Approved June 2015, Chappell 2/22/16


	==See Also==		==See Also==

Rossdonaldson1: Text replacement - "Harbor:Operations manual" to "Harbor:Main"

2019-01-31T06:21:18Z

Text replacement - "Harbor:Operations manual" to "Harbor:Main"

← Older revision		Revision as of 06:21, 31 January 2019
Line 14:		Line 14:

	==See Also==		==See Also==
	*[[Harbor:~~Operations manual~~]]		*[[Harbor:Main]]

	==References==		==References==

Rossdonaldson1 at 21:14, 7 January 2019

2019-01-07T21:14:21Z

← Older revision		Revision as of 21:14, 7 January 2019
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	==Guidelines for Flow of patients between the Psychiatric and Adult Emergency Departments (ED Policy 3.4)=		==Guidelines for Flow of patients between the Psychiatric and Adult Emergency Departments (ED Policy 3.4)==
	*Ambulatory Patients: Patients presenting with abnormal behavior WITHOUT prior psych diagnoses or with acute ALOC are initially evaluated in the adult ED		*Ambulatory Patients: Patients presenting with abnormal behavior WITHOUT prior psych diagnoses or with acute ALOC are initially evaluated in the adult ED
	*Patients with a known psych history and behavior consistent with their previous diagnosis, without apparent acute medical condition requiring intervention, are initially evaluated by the Psych ED		*Patients with a known psych history and behavior consistent with their previous diagnosis, without apparent acute medical condition requiring intervention, are initially evaluated by the Psych ED

Rossdonaldson1: Created page with "==Guidelines for Flow of patients between the Psychiatric and Adult Emergency Departments (ED Policy 3.4)= *Ambulatory Patients: Patients presenting with abnormal behavior WI..."

2019-01-07T21:14:10Z

Created page with "==Guidelines for Flow of patients between the Psychiatric and Adult Emergency Departments (ED Policy 3.4)= *Ambulatory Patients: Patients presenting with abnormal behavior WI..."

New page

==Guidelines for Flow of patients between the Psychiatric and Adult Emergency Departments (ED Policy 3.4)=
*Ambulatory Patients: Patients presenting with abnormal behavior WITHOUT prior psych diagnoses or with acute ALOC are initially evaluated in the adult ED
*Patients with a known psych history and behavior consistent with their previous diagnosis, without apparent acute medical condition requiring intervention, are initially evaluated by the Psych ED
*Patients arriving by ambulance with psych complaints but not under a 5150 should be triaged by a physician in the adult ED then directed to appropriate location
*Psychiatric Consultations in the ED: patients requesting voluntary evaluation by a psychiatrist are transferred to the psych ED after medical clearance for evaluation and should be transferred to the psych ED as soon as there is space available; ED physician to psych physician discussion should occur prior to transfer
*All patients on a 5150 hold
#With ETOH>200, delirium, complicated alcohol withdrawal, drug overdose, or acute medical problems should be evaluated in the adult ED
#Require psych evaluation prior to discharge or transfer to medical unit; this should be done within 30 minutes of request for consult
*Patients in the psych ED that require medical evaluation (or re-evaluation) should be transferred to the adult ED as soon as a bed is available; prior to the transfer, the psych physician should discuss the case with the ED physician; exceptions will be made on a case-by-case basis
*Patients in the Psych ED who require treatment with sedatives and are deemed to be at risk for significant oxygen desaturation should be transferred to a monitored bed in the adult ED; these patients are co-managed by the physicians from both areas
*Psychiatric patients with chronic disorders who require placement are managed in the Psych ED
Approved June 2015, Chappell 2/22/16

==See Also==
*[[Harbor:Operations manual]]

==References==
<references/>

[[Category:Admin]]