Harbor:Main: Difference between revisions

(25 intermediate revisions by 5 users not shown)
Line 1: Line 1:
''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==
*EWC - 8/5/19 - back to scheduling directly into EWC; Cerner is working again!
* Wuhan Coronavirus (nCoV-2019):  fever + URI + travel from China in past 14 days
*Surge Criteria Pilot - 7/10/19:  ED census for surge criteria includes R5, R6, R7, & R12;  Available med/surg '''OR''' ICU/PCU
**https://www.wikem.org/wiki/Harbor:Infectious_Disease_Threats#Wuhan_Coronavirus_.28nCoV-2019.29
(Dr. Peterson, Dr. Stein, Mark Redulla [pt flow])  
 
*PERT (PE Response Team) Started Monday 6/24
* iSTAT:  as of Sunday 1/26/20, the blue cartridges will be pulled from the floors (Chem 8 & CG4 - lactate, pH, CO2, pO2, HCO3, base excess)
** Page the PERT Fellow p9956 for (sub)massive PE when considering thrombolytics
** please use the EC7 as needed (Na, K, iCa, H/H, pH, CO2, pO2, HCO3, base excess)  
** for details:  https://www.wikem.org/wiki/Harbor:Admission_and_consultation_guidelines#Pulmonary_Embolus
** You will have to wait for serum lactate from lab
** https://www.pointofcare.abbott/shared/static-assets/other/APOC2020-001%20CHEM8+%20CG4+%20capillary%20and%20CLIA%20notification%20letter%20FINAL.pdf
*New auto-page for Whole Person Care - please page directly for substance abuse issues (not social work)


==General Administrative==
==General Administrative==
*Pre-hospital
*Pre-hospital
**[[Harbor:Incoming transfers|Incoming transfers]]
**[[Harbor:Incoming transfers|Incoming transfers]]
**Exodus Transfers
***Exodus should call Psych ED about transfer, not Med ED
***Med ED will do MSE
===[[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]]
Line 18: Line 23:
**[[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:RME & TRIAGE|RME & triage]]
**[[Harbor:Direct Admission after Hours]]
**[[Harbor:Direct Admission after Hours]]
Line 31: Line 44:
====[[Harbor:Paging|Paging consultants]]====
====[[Harbor:Paging|Paging consultants]]====
====[[Harbor:Phone numbers|Phone numbers]]====
====[[Harbor:Phone numbers|Phone numbers]]====
 
====[[Harbor:Radiology directory|Radiology directory]]====


===Tests & Orders===
===Tests & Orders===
Line 52: Line 65:
**[[Harbor:Ordering a CT|Ordering a CT]]
**[[Harbor:Ordering a CT|Ordering a CT]]
**[[Harbor:ED Radiology Specs|CT Specs]]
**[[Harbor:ED Radiology Specs|CT Specs]]
*Oral contrast
**No more gastrograffin, replaced by omnipaque. Must place an order for it. If you need to obtain a retrograde urethrogram, order a KUB.
**Below is the suggested/usual volume of omnipaque used for certain indication sent to us by Dr. Putnam:
***For use in bowel obstruction, a volume of 100cc of Omnipaque 300 is used.
***For use in tube contrast studies, a volume anywhere between 50-200cc of Omnipaque 300 would likely be used.
***For a CT with po contrast, the order is for 30cc of Omnipaque 300 in 970cc of water.


====[[Harbor:STAT MRI|STAT MRI]]====
====[[Harbor:STAT MRI|STAT MRI]]====
Line 64: Line 85:
*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===
Line 69: Line 101:
*[[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)]]
====[[Harbor:ED supplies A-Z|E supplies A-Z]]====


===Procedures===
===Procedures===
Line 75: Line 109:


==Special patient types==
==Special patient types==
===[[Transferring_to_psych_ER#Guidelines_for_Flow_of_patients_between_the_Psychiatric_and_Adult_Emergency_Departments_.28ED_Policy_3.4.29]]
*[[Harbor:Whole person care|Whole person care]]
*[[Harbor:Whole person care|Whole person care]]
*[[Harbor:Social work|Social work]]
*[[Harbor:Social work|Social work]]
Line 91: Line 124:
*[[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|PE Response Team]]
*[[Harbor:Psych patients|Psych Patients (Exodus)]]


===Others===
===Others===
Line 108: Line 143:
*'''[[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:Substance Use Disorder|Substance Use Disorder]]
Line 116: Line 155:
*[[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]]
*[[Harbor:Home Health|Home Health]]


===Admission===
===Admission===
Line 161: Line 201:
*[[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==
*[[Harbor:RME Manual]]


[[Category:Admin]]
[[Category:Admin]]

Revision as of 09:22, 24 January 2020

This is the main page for Harbor-UCLA emergency department; See Pediatric ED for the main Harbor pediatric page.

Admin Updates

General Administrative

  • Pre-hospital
    • Incoming transfers
    • Exodus Transfers
      • Exodus should call Psych ED about transfer, not Med ED
      • Med ED will do MSE

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

Radiology directory

Tests & Orders

Enter Prelim Rads Read

  • Oral contrast
    • No more gastrograffin, replaced by omnipaque. Must place an order for it. If you need to obtain a retrograde urethrogram, order a KUB.
    • Below is the suggested/usual volume of omnipaque used for certain indication sent to us by Dr. Putnam:
      • For use in bowel obstruction, a volume of 100cc of Omnipaque 300 is used.
      • For use in tube contrast studies, a volume anywhere between 50-200cc of Omnipaque 300 would likely be used.
      • For a CT with po contrast, the order is for 30cc of Omnipaque 300 in 970cc of water.


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

E supplies A-Z

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