Difference between revisions of "Harbor:Main"

(Other Disposition)
(Screening EMS Patients)
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''This is the main page for Harbor-UCLA emergency department; 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==
 
==Admin Updates==
*PERT (PE Response Team) Starts Monday 6/24
+
*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
 
** 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
 
** for details:  https://www.wikem.org/wiki/Harbor:Admission_and_consultation_guidelines#Pulmonary_Embolus
Line 9: Line 12:
 
**[[Harbor:Incoming transfers|Incoming transfers]]
 
**[[Harbor:Incoming transfers|Incoming transfers]]
 
===[[Harbor:Screening EMS Patients|Screening EMS Patients]]===
 
===[[Harbor:Screening EMS Patients|Screening EMS Patients]]===
*Administrative duties
+
===Administrative duties===
 
**[[Harbor:Administrative resident|Administrative resident directions]]
 
**[[Harbor:Administrative resident|Administrative resident directions]]
 
**[[Harbor: Phone Calls|Receiving Phone Calls]]
 
**[[Harbor: Phone Calls|Receiving Phone Calls]]
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**[[Harbor:EKG screening|EKG Screening]]
 
**[[Harbor:EKG screening|EKG Screening]]
 
**[[Harbor:5S|Pre-shift: 5S]]
 
**[[Harbor:5S|Pre-shift: 5S]]
*Administrative resources
+
**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:Core Measures|Core Measures]]
 
**[[Harbor:ED policy manual|Harbor ED policy manual]]
 
**[[Harbor:ED policy manual|Harbor ED policy manual]]
**[[Harbor:RME & TRIAGE|RME & triage]]
 
 
**[[Harbor:ED attending on call plan|ED attending on call plan]]
 
**[[Harbor:ED attending on call plan|ED attending on call plan]]
 
**[[Harbor:Legal|Harbor Legal]]
 
**[[Harbor:Legal|Harbor Legal]]
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**[[Harbor:Ultrasound Approval List|Ultrasound approval list]]
 
**[[Harbor:Ultrasound Approval List|Ultrasound approval list]]
 
**[[Harbor:Rules for Performing ED Ultrasounds|Formal & ED Ultrasounds]]
 
**[[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]]
 
*[[Harbor:Example text for a discrepancy e-mail|Example text for a discrepancy e-mail]]
 
*CT
 
*CT
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*Buprenorphine/Opiate Withdrawal Treatment
 
*Buprenorphine/Opiate Withdrawal Treatment
 
**[[Harbor:Opiate Withdrawal/MAT/BUP|Opiate Withdrawal/MAT/BUP]]
 
**[[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===
 
===Finding Equipment/DME===
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*[[Harbor:Equipment and supplies (peds)|Equipment (peds)]]
 
*[[Harbor:Equipment and supplies (peds)|Equipment (peds)]]
 
*[[Harbor:DME|Durable Medical Equipment (DME)]]
 
*[[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===
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==Special patient types==
 
==Special patient types==
===[[Harbor:Whole person care|Whole person care]]===
+
*[[Harbor:Whole person care|Whole person care]]
 
*[[Harbor:Social work|Social work]]
 
*[[Harbor:Social work|Social work]]
 
*Activations
 
*Activations
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**[[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:Occupational exposure|Occupational Exposure]]===
+
*'''[[Harbor:Occupational exposure|Occupational Exposure]]'''
 
*[[Harbor:Industrial Accident (IA)|Industrial or On-the-Job Accidents (IA)]]
 
*[[Harbor:Industrial Accident (IA)|Industrial or On-the-Job Accidents (IA)]]
===[[Harbor:Non-Occupational Exposure|Sexual Assault/STI Exposure (SART)]]===
+
*'''[[Harbor:Non-Occupational Exposure|Sexual Assault/STI Exposure (SART)]]'''
 +
*[[Harbor:PE Response Team]]
  
 
===Others===
 
===Others===
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*[[Harbor: ED Follow-Up Options|ED Follow-Up]]
 
*[[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]
 
**[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: ED Follow-Up Options|ED Follow-Up Clinics]]'''
====[[Harbor:Forms|Forms]]====
+
*'''[[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:Opiate Withdrawal/MAT/BUP|Opiate Withdrawal/MAT/BUP]]
 +
*[[Harbor:Substance Use Disorder|Substance Use Disorder]]
 
*[[Harbor:Medical Legal Partnership|Medical Legal Partnership]]
 
*[[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:Law Enforcement Discharge Escort|Law Enforcement Discharge Escort]]
 
*[[Harbor:Law Enforcement Discharge Escort|Law Enforcement Discharge Escort]]
  
===Admission, OBS, & CORE ===
+
===Admission===
 
*'''[[Harbor:Admission and consultation guidelines|Admission and consultation guidelines]]'''
 
*'''[[Harbor:Admission and consultation guidelines|Admission and consultation guidelines]]'''
 
*[[Harbor:Admitting a patient|Admitting a patient]]
 
*[[Harbor:Admitting a patient|Admitting a patient]]
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*[[Harbor:Direct Admission after Hours|Direct Admission after Hours]]
 
*[[Harbor:Direct Admission after Hours|Direct Admission after Hours]]
  
====OBS & CORE====
+
===OBS & CORE===
 
*[[Harbor:Observation placement|Observation placement]]
 
*[[Harbor:Observation placement|Observation placement]]
 
*[[Harbor:CORE|CORE 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===
 
===Other Disposition===
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==Disaster & Surge==
 
==Disaster & Surge==
 
*[[Harbor:Disaster plan|Disaster plan]]
 
*[[Harbor:Disaster plan|Disaster plan]]
===[[Harbor:Surge plan|Surge plan]]===
+
*'''[[Harbor:Surge plan|Surge plan]]'''
 
*[[Harbor:ORCHID Downtime|ORCHID Downtime]]
 
*[[Harbor:ORCHID Downtime|ORCHID Downtime]]
 
*[[Harbor:Infectious Disease Threats|Infectious Disease Threats]]
 
*[[Harbor:Infectious Disease Threats|Infectious Disease Threats]]
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*[[Harbor:VA MICU rotation|VA MICU rotation]]
 
*[[Harbor:VA MICU rotation|VA MICU rotation]]
 
*[[Harbor:How to get started in research at Harbor|How to get started in research at 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==

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.

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])

General Administrative

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

Enter Prelim Rads Read

STAT MRI

Antibiogram

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
    • WikEM1.jpg
    • WikEM2.jpg
    • WikEM3.jpg
    • WikEM4.jpg
  • 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

Others

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)

Admission

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

Other Disposition

Documentation

Disaster & Surge

Resident Education

See Also