View source for Harbor:Involuntary holds

==INVOLUNTARY HOLDS, CODE GOLD, COLD GREEN==

*'''Psychiatric reason:''' 
**5150 (5585 for Peds) only for a '''mental health disorder.''' 
**Voluntary patients usually not placed on a 5150/5585, but can be. 
**Non-psychiatric medical personnel can detain anyone who meets criteria until they can be evaluated by a psychiatrist.
**'''5150 can be placed by''':
*** '''Psychiatrist ONLY INSIDE''' MAIN HOSPITAL BUILDING
*** '''Sheriff ANYWHERE OUTSIDE''' MAIN HOSPITAL BUILDING, including rest of hospital grounds
****Sheriff has independent authority to place the 5150 or not

*'''Medical reason:''' 
**Patients who '''lack capacity''' and are a danger to themselves or others for non-psychiatric reasons. Do not need psych consult to determine capacity when restraining patient for a medical reasons, and psych cannot override decision to restrain a patient for non-psychiatric reasons. DO NOT REFER TO THIS AS A "HOLD" AS THIS MAY LEAD LAW ENFORCEMENT TO BELIEVE THE PATIENT IS ON A 5150. 
**If they try to elope you can detain/restrain, if they become violent or aggressive, call a CODE GOLD (see below). 
**These patients can be held against their will for their own safety no 5150 is required or applies (5150 for psych issues only).
** No specific legal form for restraining medical patients - document reasons in chart. Use '''restraint form''' for restraints. 

*'''Code GOLD:''' 
**For all patients who become physically aggressive, either for psychiatric or medical reasons.
**They will be placed in '''hard restraints''' by CODE GOLD team
**Call x111. 
**'''No requirement''' patient be placed or already on 5150
**LASD (Sheriff) responds but is not part of team, only assists if detect or to prevent criminal activity by patient (assault)
**Behavioral Response Team leader (BRT) should ID themselves on arrival and ED physician or nurse in charge of patient should brief them.  
**BRT leader has option of turning over situation to LASD as needed.

*'''Code GREEN:''' 
**'''Already on or eligible for a 5150/5585''' and attempting to, or have physically left the department. 
**Call x3311 LASD(Sheriff)
**'''On a 5150 hold''' - LASD will return patient
**'''NOT on 5150 hold'''
***'''Inside''' Hospital Building - LASD can only convince patient to return - can't forcibly return. '''Only Psych''' can place 5150 inside hospital building
***'''Outside''' Hospital Building - LASD makes independent determination to place patient on 5150
****Physician or nurse in charge of patient should brief LASD if patient on 5150 or if not, indication for 5150
**If LASD decides not to place patient on 5150, document Code Green in chart and officers involved

*'''Code GRAY'''
**'''ANYONE''' (patient, visitor, staff) who is combative or assaultive and it is not felt due to a medical or psychiatric reason

*'''Above vetted by Law Enforcement, Psychiatry, Behavioral Response Team, ED Leadership, and Nursing leadership'''
*Additional References
**436 Procedures in Cases To Be Reported to Are Investigated by Law Enforcement Authorities
**301 Discharge Policy, Procedures, and Guidelines Including Elopement and AMA
**138 Law Enforcement Use of Force on Harbor-UCLA Campus
**347A The Use of Restraints Including Seclusion
**346 Involuntary Holds on and on Psychiatric Units and Emergency Medical Department
**379 Safety Attendant (Continuous in Person Monitoring)
**453 Patients in Police Custody
**347B Code Gold-Behavioral Response Team
**620 Consent for Medical Treatment for Patient Lacking the Capacity to Provide Consent
**Sheriff "Cheat Sheet" for Code Green and Code Gold

* Public Health
** (213) 745-0800 (Tb)
** 213-974-1234 after hours

Dir OPS 10/15/18
Dir AED, 10/28/16