Harbor:Diversion for ALS and BLS: Difference between revisions
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Diversion decisions made by MICN, Overall Charge RN and Area Charge RNs, and Attending huddle q4 hours prn | <big>Diversion decisions made by MICN, Overall Charge RN and Area Charge RNs, and Attending huddle q4 hours prn</big> | ||
ALS Diversion | '''ALS Diversion''' | ||
*ED Saturation (aka Diversion) is a process of marking the ED in the countywide ReddiNet system as “closed” to adult Advanced Life Support (ALS) arrivals. | *ED Saturation (aka Diversion) is a process of marking the ED in the countywide ReddiNet system as “closed” to adult Advanced Life Support (ALS) arrivals. | ||
**ED Saturation does NOT redirect BLS arrivals or patients arriving to Harbor as a specialty center (e.g. Trauma, STEMI, Perinatal). | **ED Saturation does NOT redirect BLS arrivals or patients arriving to Harbor as a specialty center (e.g. Trauma, STEMI, Perinatal). | ||
*Up to two hours at a time. At the end of the two-hour diversion, ReddiNet will automatically re-open the hospital to all 9-1-1 traffic. | *Up to two hours at a time. At the end of the two-hour diversion, ReddiNet will automatically re-open the hospital to all 9-1-1 traffic. | ||
*If the nearest two alternative EDs are also noted as “ED Saturation”, ALS ambulances will be directed to the closest ED, regardless of “ED Sat” status on ReddiNet. (everyone is open) | *If the nearest two alternative EDs are also noted as “ED Saturation”, ALS ambulances will be directed to the closest ED, regardless of “ED Sat” status on ReddiNet. (everyone is open) | ||
*Goal of ED Saturation is to ensure safety of current ED patients and of patients being transported by EMS. Diversion facilitates this by: | *'''Goal''' of ED Saturation is to ensure safety of current ED patients and of patients being transported by EMS. Diversion facilitates this by: | ||
**Allowing staff the time to move patients within or through the ED to free up space/staff resources to care for additional patients, without pressure of incoming patients. | **Allowing staff the time to move patients within or through the ED to free up space/staff resources to care for additional patients, without pressure of incoming patients. | ||
**Allowing the ED time to prepare for next round of sick patients. | **Allowing the ED time to prepare for next round of sick patients. | ||
Guidelines for ALS Diversion triggers: | '''Guidelines for ALS Diversion triggers''': | ||
*Not enough space to care for the next critical patient coming by ambulance | *Not enough space to care for the next critical patient coming by ambulance | ||
**Not enough treatment spaces despite decompress patients to other beds/hallway | **Not enough treatment spaces despite decompress patients to other beds/hallway | ||
**Not enough staff (RN, RT, provider, etc.) or supplies (vents, blood, etc.) | **Not enough staff (RN, RT, provider, etc.) or supplies (vents, blood, etc.) | ||
Guidelines for BLS Diversion triggers: | '''Guidelines for BLS Diversion triggers''': Requires hospital administration approval | ||
*Above ALS diversion triggers AND | *Above ALS diversion triggers AND | ||
* Number of ambulance triage and #ESI 2’s in waiting room = 5-8 | * Number of ambulance triage and #ESI 2’s in waiting room = 5-8 | ||
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*WR LOS = >12hrs | *WR LOS = >12hrs | ||
*No trauma bays open | *No trauma bays open | ||
*OCN to notify | *OCN to notify Clinical Nursing Director or designee + Attending to notify DEM AOD --> Approval by CMO/CEO or designee | ||
[[Category:Admin]] | |||
Revision as of 19:09, 25 October 2021
Diversion decisions made by MICN, Overall Charge RN and Area Charge RNs, and Attending huddle q4 hours prn
ALS Diversion
- ED Saturation (aka Diversion) is a process of marking the ED in the countywide ReddiNet system as “closed” to adult Advanced Life Support (ALS) arrivals.
- ED Saturation does NOT redirect BLS arrivals or patients arriving to Harbor as a specialty center (e.g. Trauma, STEMI, Perinatal).
- Up to two hours at a time. At the end of the two-hour diversion, ReddiNet will automatically re-open the hospital to all 9-1-1 traffic.
- If the nearest two alternative EDs are also noted as “ED Saturation”, ALS ambulances will be directed to the closest ED, regardless of “ED Sat” status on ReddiNet. (everyone is open)
- Goal of ED Saturation is to ensure safety of current ED patients and of patients being transported by EMS. Diversion facilitates this by:
- Allowing staff the time to move patients within or through the ED to free up space/staff resources to care for additional patients, without pressure of incoming patients.
- Allowing the ED time to prepare for next round of sick patients.
Guidelines for ALS Diversion triggers:
- Not enough space to care for the next critical patient coming by ambulance
- Not enough treatment spaces despite decompress patients to other beds/hallway
- Not enough staff (RN, RT, provider, etc.) or supplies (vents, blood, etc.)
Guidelines for BLS Diversion triggers: Requires hospital administration approval
- Above ALS diversion triggers AND
- Number of ambulance triage and #ESI 2’s in waiting room = 5-8
- WR #s = 50-60
- WR LOS = >12hrs
- No trauma bays open
- OCN to notify Clinical Nursing Director or designee + Attending to notify DEM AOD --> Approval by CMO/CEO or designee