Harbor:Main: Difference between revisions
(25 intermediate revisions by 3 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==
* Coronavirus (nCoV-2019) Info: https://www.wikem.org/wiki/Harbor:Infectious_Disease_Threats#Wuhan_Coronavirus_.28nCoV-2019.29
* [[Harbor:Infectious_Disease_Threats#Wuhan_Coronavirus_.28nCoV-2019.29|Coronavirus (COVID-19) Info]]
 
*Transitional Dialysis in the ED/5W,Room10: [[Harbor:Scheduled_dialysis_patients_in_ED]]  Starting Wednesday, 7/8/2020
 
*GOLD closed for ED use. Only for inpatient boarders
 
*OBS Update (6/2/2020) - for patients being admitted to the new '''short-stay medicine team, page the ED hospitalist at 204-9753, order "PLACE IN OBS" (just like we did pre-COVID)'''; the medicine team will order the "request for admit" once they get the COVID test results.  Drs. Spiegel & Chappell
 
*[https://www.wikem.org/wiki/Harbor:Admission_and_consultation_guidelines|Updated Admission and Consultation Guidelines - May 2020]
 
* Whole Blood coming 5/11 (ED fridge) - limited to use for trauma patients, 2 units max per patient


* 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)
* 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)
Line 7: Line 17:
** You will have to wait for serum lactate from lab
** 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
** 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==
Line 31: Line 40:
Wu 11/2019)
Wu 11/2019)
===Administrative resources===
===Administrative resources===
**[[Harbor:RME & TRIAGE|RME & triage]]
===[[Harbor:RME & TRIAGE|RME & triage]]===
**[[Harbor:Direct Admission after Hours]]
**[[Harbor:Direct Admission after Hours]]
**[[Harbor:Core Measures|Core Measures]]
**[[Harbor:Core Measures|Core Measures]]
Line 37: Line 46:
**[[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]]
**[[Harbor:Ophtho abbreviation dictionary]]


==Managing your Patient==
==Managing your Patient==
===General===
===General===
====[[Harbor:PC Cheat Sheet|PC Cheat Sheet]]====
====[[Harbor:PC Cheat Sheet|On shift (PC) Cheat Sheet]]====
 
====[[Harbor:Paging|Paging consultants]]====
====[[Harbor:Paging|Paging consultants]]====
====[[Harbor:Phone numbers|Phone numbers]]====
====[[Harbor:Phone numbers|Phone numbers]]====
Line 140: Line 151:
*[[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]]'''


Line 157: Line 168:


===Admission===
===Admission===
*'''[[Harbor:Admission and consultation guidelines|Admission and consultation guidelines]]'''
====[[Harbor:Admission and consultation guidelines|'''Admission Guidelines''']]====
*[[Harbor:Admitting a patient|Admitting a patient]]
*[[Harbor:Admitting a patient|Admitting a patient]]
*[[Harbor:Who Goes to Family Medicine|Who Goes to Family Medicine]]
*[[Harbor:Who Goes to Family Medicine|Who Goes to Family Medicine]]
Line 173: Line 184:
Peterson 8/2019
Peterson 8/2019


===[[Harbor:Scheduled_dialysis_patients_in_ED|Dialysis in the ED]]===
===Other Disposition===
===Other Disposition===
*'''[[Harbor:Death Packet Checklist|Death Packet Checklist]]
*'''[[Harbor:Death Packet Checklist|Death Packet Checklist]]
Line 203: Line 215:


==See Also==
==See Also==
{{Special:Prefixindex/Harbor |hideredirects=1}}


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

Revision as of 23:52, 11 September 2020

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

Admin Updates

  • GOLD closed for ED use. Only for inpatient boarders
  • OBS Update (6/2/2020) - for patients being admitted to the new short-stay medicine team, page the ED hospitalist at 204-9753, order "PLACE IN OBS" (just like we did pre-COVID); the medicine team will order the "request for admit" once they get the COVID test results. Drs. Spiegel & Chappell
  • Whole Blood coming 5/11 (ED fridge) - limited to use for trauma patients, 2 units max per patient

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

RME & triage

Managing your Patient

General

On shift (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

ED Follow-Up Clinics

  • 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

Admission Guidelines

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

Dialysis in the ED

Other Disposition

Documentation

Disaster & Surge

Resident Education

See Also

Retrieved from "https://www.wikem.org/w/index.php?title=Harbor:Main&oldid=272975"