Difference between revisions of "Harbor:Main"
Ostermayer (talk | contribs) |
(→Screening EMS Patients) |
||
(230 intermediate revisions by 7 users not shown) | |||
Line 1: | Line 1: | ||
− | ''See [[Harbor:Pediatric ED (main)|Pediatric ED]] for the main Harbor pediatric page.'' | + | ''This is the main page for Harbor-UCLA emergency department; See [[Harbor:Pediatric ED (main)|Pediatric ED]] for the main Harbor pediatric page.'' |
− | == | + | ==Admin Updates== |
− | + | *EWC - 8/5/19 - back to scheduling directly into EWC; Cerner is working again! | |
+ | *Surge Criteria Pilot - 7/10/19: ED census for surge criteria includes R5, R6, R7, & R12; Available med/surg '''OR''' ICU/PCU | ||
+ | (Dr. Peterson, Dr. Stein, Mark Redulla [pt flow]) | ||
+ | *PERT (PE Response Team) Started Monday 6/24 | ||
+ | ** Page the PERT Fellow p9956 for (sub)massive PE when considering thrombolytics | ||
+ | ** for details: https://www.wikem.org/wiki/Harbor:Admission_and_consultation_guidelines#Pulmonary_Embolus | ||
− | ==[[Harbor: | + | ==General Administrative== |
− | *[[Harbor:Administrative resident|Administrative resident directions]] | + | *Pre-hospital |
− | *[[Harbor: Phone Calls|Receiving Phone Calls]] | + | **[[Harbor:Incoming transfers|Incoming transfers]] |
− | *[[Harbor: | + | ===[[Harbor:Screening EMS Patients|Screening EMS Patients]]=== |
− | *[[Harbor:EKG screening|EKG Screening]] | + | ===Administrative duties=== |
− | *[[Harbor:5S|Pre-shift: 5S]] | + | **[[Harbor:Administrative resident|Administrative resident directions]] |
+ | **[[Harbor: Phone Calls|Receiving Phone Calls]] | ||
+ | ***[[Harbor:Critical Result Callback|Critical Result Callback]] | ||
+ | **[[Harbor:EKG screening|EKG Screening]] | ||
+ | **[[Harbor:5S|Pre-shift: 5S]] | ||
+ | **Airway Bag | ||
+ | ***Missing or low on equipment such as McGrath blades or batteries - inform the overall charge nurse (more in nursing office) | ||
+ | ***PURPLE SENIOR - use the laminated checklist to stock AT EACH SHIFT CHANGE on on-call days | ||
+ | ***Locks let you know which compartments to check | ||
+ | ***ED pharmacists help with meds BUT SENIORS should double check. | ||
+ | ***TURN OFF McGRATH AFTER USE! | ||
+ | *** Can use new “GlideScope Go” with a MAC 3 & 4 blade, but bring it back. (It’s not part of bag). | ||
+ | Wu 11/2019) | ||
+ | ===Administrative resources=== | ||
+ | **[[Harbor:RME & TRIAGE|RME & triage]] | ||
+ | **[[Harbor:Direct Admission after Hours]] | ||
+ | **[[Harbor:Core Measures|Core Measures]] | ||
+ | **[[Harbor:ED policy manual|Harbor ED policy manual]] | ||
+ | **[[Harbor:ED attending on call plan|ED attending on call plan]] | ||
+ | **[[Harbor:Legal|Harbor Legal]] | ||
==Managing your Patient== | ==Managing your Patient== | ||
− | === | + | ===General=== |
− | *[[Harbor:Ordering a Formal Ultrasound|Ordering a Formal Ultrasound]] | + | ====[[Harbor:PC Cheat Sheet|PC Cheat Sheet]]==== |
− | *[[Harbor:Ultrasound Approval List|Ultrasound approval list]] | + | ====[[Harbor:Paging|Paging consultants]]==== |
− | *[[Harbor:Ordering a CT|Ordering a CT]] | + | ====[[Harbor:Phone numbers|Phone numbers]]==== |
− | *[[Harbor:Ordering Blood Products| | + | |
− | * | + | |
− | + | ===Tests & Orders=== | |
+ | *[[Harbor:Labs|Labs]] | ||
+ | *Radiology | ||
+ | ====[[Harbor:Entering Prelim Radiology Read|Enter Prelim Rads Read]]==== | ||
+ | *Ultrasound | ||
+ | **[[Harbor:Ordering a Formal Ultrasound|Ordering a Formal Ultrasound]] | ||
+ | **[[Harbor:Ultrasound Approval List|Ultrasound approval list]] | ||
+ | **[[Harbor:Rules for Performing ED Ultrasounds|Formal & ED Ultrasounds]] | ||
+ | **Cleaning Endocavitary Probes | ||
+ | ***Place in Red Bag (above probe cabinet in clean utility room) | ||
+ | ***Place patient sticker on bag | ||
+ | ***Give to area charge nurse | ||
+ | ***Once cleaned, probe comes back in clear bag | ||
+ | ***T. Jang 8/2019 | ||
+ | |||
+ | *[[Harbor:Example text for a discrepancy e-mail|Example text for a discrepancy e-mail]] | ||
+ | *CT | ||
+ | **[[Harbor:Ordering a CT|Ordering a CT]] | ||
+ | **[[Harbor:ED Radiology Specs|CT Specs]] | ||
+ | |||
+ | ====[[Harbor:STAT MRI|STAT MRI]]==== | ||
+ | *[[Harbor:ED Radiology Specs|MRI Specs]] | ||
+ | *Other orders | ||
+ | **[[Harbor:Ordering Blood Products|Blood products]] | ||
+ | **Antibiotics | ||
+ | |||
+ | ====[[Harbor:Antibiogram|Antibiogram]]==== | ||
**[[Harbor:Antibiotics in Sepsis|Harbor antibiotics in sepsis]] | **[[Harbor:Antibiotics in Sepsis|Harbor antibiotics in sepsis]] | ||
***[[Harbor:Sepsis core measures|Sepsis core measures]] | ***[[Harbor:Sepsis core measures|Sepsis core measures]] | ||
+ | *Buprenorphine/Opiate Withdrawal Treatment | ||
+ | **[[Harbor:Opiate Withdrawal/MAT/BUP|Opiate Withdrawal/MAT/BUP]] | ||
+ | |||
+ | ==== Upload Outside Films to PACS==== | ||
+ | *Get form from clerk | ||
+ | *Put patient sticker on Form | ||
+ | *Check "Import" | ||
+ | *Sign | ||
+ | |||
+ | ==== Get Images on Disc (For DC or Transfer)==== | ||
+ | *Same as upload EXCEPT | ||
+ | **Check "Export" | ||
+ | **Write time frame on form you want studies from | ||
+ | |||
+ | ===Finding Equipment/DME=== | ||
+ | *[[Harbor:Equipment|Equipment (AED/RME)]] | ||
+ | *[[Harbor:Equipment and supplies (peds)|Equipment (peds)]] | ||
+ | *[[Harbor:DME|Durable Medical Equipment (DME)]] | ||
+ | |||
+ | ====ED supplies A-Z==== | ||
+ | *A-Z listing for entire ED | ||
+ | ** Glidescopes - trauma 1-7 | ||
+ | ** Slit Lamps - AED 1, teaching lamp in RME 10 | ||
+ | *Main Supply Room A-Z | ||
+ | **[[File:WikEM1.jpg|400px]] | ||
+ | **[[File:WikEM2.jpg|400px]] | ||
+ | **[[File:WikEM3.jpg|400px]] | ||
+ | **[[File:WikEM4.jpg|400px]] | ||
+ | *Main Supply Room by cart | ||
− | + | *Airway Cart | |
− | * | + | *Central Line Cart |
− | * | + | *Ortho/splinting Cart |
− | * | + | *Precipitous Delivery (BOA) Cart |
− | * | + | *RME 1-4 Carts |
+ | *Suture Cart | ||
+ | *Triage Hall Cart | ||
+ | *Triage Room Carts | ||
===Procedures=== | ===Procedures=== | ||
− | |||
*[[Harbor:Consenting a patient|Consenting a patient]] | *[[Harbor:Consenting a patient|Consenting a patient]] | ||
+ | *[[Harbor:Procedures Videos|Procedure Videos]] | ||
− | == | + | ==Special patient types== |
− | *[[Harbor: | + | *[[Harbor:Whole person care|Whole person care]] |
− | *[[Harbor: | + | *[[Harbor:Social work|Social work]] |
− | + | *Activations | |
− | + | **[[Harbor:Codes|Code Activations]] | |
− | *[[Harbor: | + | ***[[Harbor:Involuntary holds|Involuntary holds]] |
+ | **[[Harbor:Airway management team|Airway management team]] | ||
+ | **[[Harbor:Code stroke|Code Stroke]] | ||
+ | **[[Harbor:Code STEMI|STEMI Activation]] | ||
+ | **[[Harbor:Trauma activations|Trauma Activations]] | ||
*Sepsis | *Sepsis | ||
**[[Harbor:Antibiotics in Sepsis|Harbor antibiotics in sepsis]] | **[[Harbor:Antibiotics in Sepsis|Harbor antibiotics in sepsis]] | ||
**[[Harbor:Sepsis core measures|Sepsis core measures]] | **[[Harbor:Sepsis core measures|Sepsis core measures]] | ||
− | *[[Harbor: | + | *'''[[Harbor:Occupational exposure|Occupational Exposure]]''' |
+ | *[[Harbor:Industrial Accident (IA)|Industrial or On-the-Job Accidents (IA)]] | ||
+ | *'''[[Harbor:Non-Occupational Exposure|Sexual Assault/STI Exposure (SART)]]''' | ||
+ | *[[Harbor:PE Response Team]] | ||
+ | |||
+ | ===Others=== | ||
*[[Harbor:AVF/graft complications|AVF/graft complications]] | *[[Harbor:AVF/graft complications|AVF/graft complications]] | ||
*[[Harbor:Respiratory isolation|Respiratory isolation]] | *[[Harbor:Respiratory isolation|Respiratory isolation]] | ||
+ | *[[Harbor:Scheduled dialysis patients in ED|Scheduled dialysis patients in ED]] | ||
+ | *[[Harbor:Infectious Disease Threats|Infectious Disease Threats]] | ||
+ | **[[Harbor:Ebola|Suspected Ebola protocol]] | ||
+ | *[[Harbor:Replantation Patients|Replantation Patients]] | ||
+ | *[[Harbor:XRT|XRT transfers]] | ||
==Patient Disposition== | ==Patient Disposition== | ||
− | ===[[Harbor: | + | ===Discharge=== |
− | *[[Harbor: ED Follow-Up Options|ED Follow-Up Options]] | + | *[[Harbor:Prescribing|Prescribing]] |
+ | *[[Harbor: ED Follow-Up Options|ED Follow-Up]] | ||
+ | **[https://gallery.mailchimp.com/9d46ba488168336ff904bf5e2/files/f3e83cc1-58eb-404b-99c7-5c1a5542ddaf/ED_followup_flowchart_3_7_18.pdf ED follow up flow chart] | ||
+ | *'''[[Harbor: ED Follow-Up Options|ED Follow-Up Clinics]]''' | ||
+ | *'''[[Harbor:Forms|Forms]]''' | ||
+ | |||
+ | *Follow-up of out patient labs/imaging | ||
+ | **Any imaging or labs requested by a consultant in the ED that will NOT be resulted during the patient's stay in the ED should be ordered by the consultant making the request. Follow-up of outpatient tests can be either performed by the consultant OR by the CCC. | ||
+ | (Peterson 11/19) | ||
+ | |||
+ | *[[Harbor:Opiate Withdrawal/MAT/BUP|Opiate Withdrawal/MAT/BUP]] | ||
+ | *[[Harbor:Substance Use Disorder|Substance Use Disorder]] | ||
+ | *[[Harbor:Medical Legal Partnership|Medical Legal Partnership]] | ||
+ | *[[Harbor:Immigration Legal Assistance|Immigration Assistance]] | ||
+ | *[[Harbor:Hospital Based Violence Intervention Program and Trauma Recovery Center|Hospital Based Violence Intervention Program and Trauma Recovery Center]] | ||
*[[Harbor:Coumadin clinic|Coumadin clinic]] | *[[Harbor:Coumadin clinic|Coumadin clinic]] | ||
*[[Harbor:Expedited workup clinic|Expedited workup clinic]] | *[[Harbor:Expedited workup clinic|Expedited workup clinic]] | ||
− | *[[Harbor: | + | *[[Harbor:Law Enforcement Discharge Escort|Law Enforcement Discharge Escort]] |
+ | |||
+ | ===Admission=== | ||
+ | *'''[[Harbor:Admission and consultation guidelines|Admission and consultation guidelines]]''' | ||
+ | *[[Harbor:Admitting a patient|Admitting a patient]] | ||
+ | *[[Harbor:Who Goes to Family Medicine|Who Goes to Family Medicine]] | ||
+ | *[[Harbor:Right level of care|Right level of care]] | ||
+ | *[[Harbor:Internal Medicine Admissions|Internal Medicine Admission Template]] | ||
+ | *[[Harbor:Post-admission management|Post-admission management/Orders on Admitted Patients]] | ||
+ | *[[Harbor:Direct Admission after Hours|Direct Admission after Hours]] | ||
+ | |||
+ | ===OBS & CORE=== | ||
+ | *[[Harbor:Observation placement|Observation placement]] | ||
+ | *[[Harbor:CORE|CORE placement]] | ||
+ | *Observation Patients Direct from UCC | ||
+ | **Do not need an ED MSE - can go direct to OBS | ||
+ | **If no OBS beds available in GOLD - should be made Direct Admits to the Hospital | ||
+ | Peterson 8/2019 | ||
+ | |||
+ | ===Other Disposition=== | ||
+ | *'''[[Harbor:Death Packet Checklist|Death Packet Checklist]] | ||
+ | * [[Harbor:Deceased patients|Deceased patients]] | ||
+ | *[[Harbor:Transferring a patient|Transferring a patient]] | ||
+ | **[[Harbor:Transferring to psych ER|Transferring to psych ER]] | ||
+ | **[[Harbor:XRT|XRT transfers]] | ||
+ | **[[Harbor:Replantation Patients|Replantation patient transfer]] | ||
− | ===[[Harbor: | + | ==Documentation== |
− | *[[Harbor: | + | *[[Harbor:PC Cheat Sheet|PC Cheat Sheet]] |
− | + | **[[Harbor: Macros and Autotext|Macros and Autotext]] | |
− | + | *[[Harbor:Attending documentation|Attending Documentation]] | |
− | + | *[[Harbor:Resident documentation|Resident documentation]] | |
− | *[[Harbor | + | *[[Harbor:Consenting a patient|Consenting a Patient]] |
+ | **[[File:Harbor-Photo-Consent.pdf|Photo Consent Form]] | ||
− | == | + | ==Disaster & Surge== |
− | *[[Harbor: | + | *[[Harbor:Disaster plan|Disaster plan]] |
− | *[[Harbor: | + | *'''[[Harbor:Surge plan|Surge plan]]''' |
+ | *[[Harbor:ORCHID Downtime|ORCHID Downtime]] | ||
+ | *[[Harbor:Infectious Disease Threats|Infectious Disease Threats]] | ||
+ | **[[Harbor:Ebola|Suspected Ebola protocol]] | ||
− | ==[[Harbor: | + | ==Resident Education== |
− | *[[Harbor: | + | *[[Harbor:Teaching Rounds Topics|Teaching Rounds Topics]] |
− | *[[Harbor: | + | *[[Harbor:VA MICU rotation|VA MICU rotation]] |
− | *[[Harbor: | + | *[[Harbor:How to get started in research at Harbor|How to get started in research at Harbor]] |
+ | *[[Harbor:Jeopardy Policy|Jeopardy Policy]] | ||
==See Also== | ==See Also== | ||
− | *[[Harbor: | + | *[[Harbor:RME Manual]] |
− | |||
− | |||
[[Category:Admin]] | [[Category:Admin]] |
Revision as of 17:25, 20 November 2019
This is the main page for Harbor-UCLA emergency department; See Pediatric ED for the main Harbor pediatric page.
Contents
Admin Updates
- EWC - 8/5/19 - back to scheduling directly into EWC; Cerner is working again!
- Surge Criteria Pilot - 7/10/19: ED census for surge criteria includes R5, R6, R7, & R12; Available med/surg OR ICU/PCU
(Dr. Peterson, Dr. Stein, Mark Redulla [pt flow])
- PERT (PE Response Team) Started Monday 6/24
- Page the PERT Fellow p9956 for (sub)massive PE when considering thrombolytics
- for details: https://www.wikem.org/wiki/Harbor:Admission_and_consultation_guidelines#Pulmonary_Embolus
General Administrative
- Pre-hospital
Screening EMS Patients
Administrative duties
- Administrative resident directions
- Receiving Phone Calls
- EKG Screening
- Pre-shift: 5S
- Airway Bag
- Missing or low on equipment such as McGrath blades or batteries - inform the overall charge nurse (more in nursing office)
- PURPLE SENIOR - use the laminated checklist to stock AT EACH SHIFT CHANGE on on-call days
- Locks let you know which compartments to check
- ED pharmacists help with meds BUT SENIORS should double check.
- TURN OFF McGRATH AFTER USE!
- Can use new “GlideScope Go” with a MAC 3 & 4 blade, but bring it back. (It’s not part of bag).
Wu 11/2019)
Administrative resources
Managing your Patient
General
PC Cheat Sheet
Paging consultants
Phone numbers
Tests & Orders
- Labs
- Radiology
Enter Prelim Rads Read
- Ultrasound
- Ordering a Formal Ultrasound
- Ultrasound approval list
- Formal & ED Ultrasounds
- Cleaning Endocavitary Probes
- Place in Red Bag (above probe cabinet in clean utility room)
- Place patient sticker on bag
- Give to area charge nurse
- Once cleaned, probe comes back in clear bag
- T. Jang 8/2019
STAT MRI
- MRI Specs
- Other orders
- Blood products
- Antibiotics
Antibiogram
- Buprenorphine/Opiate Withdrawal Treatment
Upload Outside Films to PACS
- Get form from clerk
- Put patient sticker on Form
- Check "Import"
- Sign
Get Images on Disc (For DC or Transfer)
- Same as upload EXCEPT
- Check "Export"
- Write time frame on form you want studies from
Finding Equipment/DME
ED supplies A-Z
- A-Z listing for entire ED
- Glidescopes - trauma 1-7
- Slit Lamps - AED 1, teaching lamp in RME 10
- Main Supply Room A-Z
- Main Supply Room by cart
- Airway Cart
- Central Line Cart
- Ortho/splinting Cart
- Precipitous Delivery (BOA) Cart
- RME 1-4 Carts
- Suture Cart
- Triage Hall Cart
- Triage Room Carts
Procedures
Special patient types
- Whole person care
- Social work
- Activations
- Sepsis
- Occupational Exposure
- Industrial or On-the-Job Accidents (IA)
- Sexual Assault/STI Exposure (SART)
- Harbor:PE Response Team
Others
- AVF/graft complications
- Respiratory isolation
- Scheduled dialysis patients in ED
- Infectious Disease Threats
- Replantation Patients
- XRT transfers
Patient Disposition
Discharge
- Follow-up of out patient labs/imaging
- Any imaging or labs requested by a consultant in the ED that will NOT be resulted during the patient's stay in the ED should be ordered by the consultant making the request. Follow-up of outpatient tests can be either performed by the consultant OR by the CCC.
(Peterson 11/19)
- Opiate Withdrawal/MAT/BUP
- Substance Use Disorder
- Medical Legal Partnership
- Immigration Assistance
- Hospital Based Violence Intervention Program and Trauma Recovery Center
- Coumadin clinic
- Expedited workup clinic
- Law Enforcement Discharge Escort
Admission
- Admission and consultation guidelines
- Admitting a patient
- Who Goes to Family Medicine
- Right level of care
- Internal Medicine Admission Template
- Post-admission management/Orders on Admitted Patients
- Direct Admission after Hours
OBS & CORE
- Observation placement
- CORE placement
- Observation Patients Direct from UCC
- Do not need an ED MSE - can go direct to OBS
- If no OBS beds available in GOLD - should be made Direct Admits to the Hospital
Peterson 8/2019