INVOLUNTARY HOLDS: CODE GOLD, & COLD GREEN
- 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
- 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.
- 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.
- 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
- 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
- (213) 745-0800 (Tb)
- 213-974-1234 after hours
Dir OPS 10/15/18 Dir AED, 10/28/16