Harbor:Main: Difference between revisions
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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== | ||
* Frequently used resources | |||
** [[Harbor:Admission_and_consultation_guidelines|Admission Guidelines]] | |||
** [[Harbor:ED_follow-up_options|Discharging to Clinics]] | |||
*** [https://lacounty.sharepoint.com/:w:/s/medicineoutpatientspecialtycare/ESLCad7IJDxCjklxFLNfWwIB1hRf_HGr2t2n8u6MvqNHfw?e=4%3AFvJCKk&fromShare=true ED to Specialty Clinic DC - please check instructions for each specific clinic prior to making an appointment] | |||
*** [https://lacounty.sharepoint.com/:w:/t/EDOperations-HUCLA/ES3s8sXJdKBLpukbDXsHZfoBwhQCS17ogqrR8mC2TVNvcQ?e=xp82nc Ortho Consult Criteria] | |||
** [https://wikem.org/wiki/Harbor:Expedited_Work-up_Clinic_(EWC) Expedited Workup Clinic] | |||
** [https://wikem.org/wiki/Harbor:Placement_patients Placement Patients] | |||
** [[Harbor:STAT_MRI|Ordering a MRI]] | |||
** [https://www.wikem.org/wiki/Template:Harbor_Admission_Guidelines#Breast_abscess.2Fmastitis Breast Abscess] | |||
** [https://www.wikem.org/wiki/Harbor:Admission_and_consultation_guidelines#Breast_mass.2Fmalignancy Breast Mass] | |||
** [https://wikem.org/wiki/Harbor:ED_follow-up_options#ORTHO Ortho: Splint vs Consult] | |||
** [https://wikem.org/wiki/Harbor:Psych_patients Psych: OSA, Covid, & Exodus] | |||
** [https://wikem.org/wiki/Harbor:Infectious_Disease_Threats#Treatment Covid Treatment Options] | |||
** [https://wikem.org/wiki/Harbor:QR_for_Staff QR Code: Equipment issues, Prehospital problems, Med Student evals, Resident Shout-outs] | |||
** [[Harbor:Surge_plan|Surge Criteria/Plan]] | |||
== | OLD TOPICS | ||
* '''ED Request for Specialty Appointment''' order is live 7/25/2023! No more black star in the depart menu. | |||
*[[Harbor: | ** [https://lacounty.sharepoint.com/:w:/s/medicineoutpatientspecialtycare/ESLCad7IJDxCjklxFLNfWwIB1hRf_HGr2t2n8u6MvqNHfw?e=4%3AFvJCKk&fromShare=true Referral Guidance Summary Sheet] | ||
*[[Harbor: | ** [[Harbor:ED_follow-up_options|Details for Specific Clinics ]] | ||
*[[Harbor: | ** How to Make an Appointment: [[:File:ED Request for Specialty Appointment Hot Sheet 7-25-2023.pdf]] | ||
*[[Harbor: | |||
* | * Happy July 4th: [[Harbor:Replantation_Patients|Hand Replant Transfers to LAG]] | ||
**[[Harbor: | |||
**[[Harbor: | * [[Harbor:ED_follow-up_options#ORTHO|Ortho Follow-up Guidelines (5-2023)]] | ||
***[[Harbor: | |||
* '''QR Code Resources''' | |||
** [[Harbor:QR_for_Staff|For Staff (Equipment, EMS, Med Student Evals)]] | |||
** [[Harbor:QR_for_Patients|For Patients]] | |||
* Hyperbaric treatment for CO | |||
** Options - UCLA Westwood, Long Beach Memorial, UCSD, '''NOT MAC to Catalina''' (only for dive injuries) | |||
** UR coordinates the acceptance | |||
** Transfers: UR should help coordinate the transfer - ELTC/HLOC - needs to occur <1-2 hrs | |||
*** Sending facility is supposed to arrange transfer | |||
*** If UR not able to get transfer in a timely manner --> MAC (CDO) - must be approved by house supervisor & Joy; BLS/ALS/CC transport | |||
**** Medics can call the radio for online base medical direction/orders | |||
*New Expedited Work up Clinic referral process: https://www.wikem.org/wiki/Harbor:Expedited_Work-up_Clinic_(EWC) | |||
*New asthma guidelines | |||
**The preferred DHS controller medication is Symbicort (formeterol – long-acting B-agonist + budesonide – inhaled corticosteroid), 2nd line is Advair (salmeterol + fluticasone). | |||
**If seeing the patient in the ED for an asthma exacerbation, please be sure to refill their controller medication AND the albuterol (if needed). We fall out if they fill more albuterol Rx’s in a year than their controller medication, so we need to make sure they get both when seen in the ED. If prescribing albuterol, do not give refills (you get 200 puffs!). | |||
*Sepsis – remember to do the required components of the sepsis core measure w/in 3 hrs (30ml/kg, bcx, abx), document using the auto text (use “auto text copy utility” to get Brad Chappell’s “ .harsepsis” to go through the reminder guidance text and exclusions for IVF 30ml/kg. Communicate to the admitting team if they need to repeat the lactate and perform the sepsis reassessment exam with time stamp (w/in 6 hrs). | |||
*If UR is suggesting a transfer to Rancho Los Amigos (RLA), then place the ‘consult to Transfer Center’ order. The Transfer Center is a county entity that helps transfer patients between county facilities. | |||
*Synapse got a new look. See link for details. A [https://lacounty.sharepoint.com/:b:/s/dhs-eci/ESN8ppJYxPZGhUcV9ZGyWYMB8do8sVnRqmBWuNyKG5x-7A?e=RpdAsg one-page intro guide] are available on [https://lacounty.sharepoint.com/sites/dhs-eci/Shared%20Documents/Forms/AllItems.aspx?id=%2Fsites%2Fdhs%2Deci%2FShared%20Documents%2FRadiology%2FPACS%205%2E7%20Upgrade%2FGuides%2FQuick%20Start%20Tutorial&p=true&originalPath=aHR0cHM6Ly9sYWNvdW50eS5zaGFyZXBvaW DHS SharePoint] | |||
**Alt+C still works to compare studies. | |||
**Open the PowerJacket (folder icons) and then you can pull up the read on 'reports'. Click the dropdown to switch from 'report' to 'notes' to find a free text prelim read. | |||
**Change your default settings to what PowerJacket looks like and select ‘Notes’ and ‘Reports’ to always open so you can see prelim and final reads, respectively. | |||
*Patient Relations Representatives (PRR) 3p-2a, 7days a week – call Registration for PRR who can help empanel into DHS or change empanelment/network in real time in the ED. PRR can come to bedside to meet with patient or send patient to Registration Windows. During business hours, send patient to Patient Relations Office in Rm 1-B-1. | |||
* '''Harbor's COVID page''' [[Harbor:Infectious_Disease_Threats#Wuhan_Coronavirus_.28nCoV-2019.29|Coronavirus (COVID-19) Info]] | |||
** Paxlovid, Remdesivir, etc ... [[Harbor:Infectious_Disease_Threats#Treatment|COVID Treatment Options]] | |||
* '''Interqual criteria''' [[Harbor:Interqual_Criteria_Tips|Interqual Criteria Tips]] | |||
* '''Monkeypox''' | |||
** See [[Monkeypox]] for medical information & [[Harbor:Infectious_Disease_Threats#Monkeypox|Harbor Monkeypox Plan]] | |||
** Educational Material | |||
*** [http://publichealth.lacounty.gov/acd/Monkeypox.htm LA County Monkeypox] | |||
*** [http://publichealth.lacounty.gov/media/monkeypox/docs/Monkeypox_IntimateContact.pdf LAC DPH Monkeypox] | |||
*** http://publichealth.lacounty.gov/media/monkeypox/resources.htm#reduce | |||
*** [https://www.cdc.gov/poxvirus/monkeypox/resources/print.html CDC Monkeypox] | |||
* '''Active Threat in the ED''' | |||
** Situational awareness | |||
*** Stand between door and patient | |||
*** Ensure patient is gowned | |||
*** Be aware of long stethoscope, lanyard, long hair, etc | |||
*** Panic buttons at nursing stations/router | |||
*** Run & scream for help | |||
** Hospital Codes | |||
*** Gold x111 - combative/agitated patient | |||
*** Gray x64450 - combative/agitated NON-patient | |||
*** Silver x111 - weapon, active shooter, hostage | |||
==General Administrative== | |||
*Pre-hospital | |||
**[[Harbor:Incoming transfers|Incoming transfers]] | |||
**Exodus Transfers | |||
***Exodus should call Psych ED about transfer, not Med ED | |||
***Med ED will do MSE | |||
*DEM AOD [[Harbor:DEM_Admin_on_Duty_(AOD)|DEM Admin on Duty (AOD)]] | |||
* [[Harbor:Resident responsibilities and transitions of responsibility|Resident Responsibilities]] | |||
===[[Harbor:Screening EMS Patients|Ambulance (EMS) Triage]]=== | |||
=== | ===Administrative duties=== | ||
*[[Harbor: | **[[Harbor:Administrative resident|Administrative resident directions]] | ||
*[[Harbor: | **[[Harbor: Phone Calls|Receiving Phone Calls]] | ||
*[[ | ***[[Harbor:Critical Result Callback|Critical Result Callback]] | ||
*[[Harbor: | **[[Harbor:EKG screening|EKG Screening]] | ||
**[[Harbor:5S|Pre-shift: 5S]] | |||
**Airway Bag [[Harbor:Airway_management_team]] | |||
=== | ===Administrative resources=== | ||
*[[Harbor: | ===[[Harbor:RME & TRIAGE|RME & triage]]=== | ||
*[[Harbor: | **[[Harbor:Direct Admission after Hours]] | ||
**[[Harbor:Core Measures|Core Measures]] | |||
**[[Harbor:Crown Checks in PED|Crown Checks in PED]] | |||
=== | ===[[Harbor:ED policy manual|Harbor ED policy manual]]=== | ||
===[[Harbor:ED attending on call plan|ED attending on call plan]]=== | |||
=== | ===[[Harbor:Legal|Harbor Legal]]=== | ||
==Patient | ==Managing your Patient== | ||
=== | ===General=== | ||
====[[Harbor:PC Cheat Sheet|On shift (PC) Cheat Sheet]]==== | |||
===[[Harbor: | ====[[Harbor:Paging|Paging consultants]]==== | ||
*[[Harbor: | *[[Harbor:Ophtho abbreviation dictionary]] | ||
====[[Harbor:Phone numbers|Phone numbers]]==== | |||
====[[Harbor:Radiology directory|Radiology directory]]==== | |||
===Tests & Orders=== | |||
*[[Harbor:Labs|Labs]] | |||
*[[Harbor: | |||
== | ===Radiology=== | ||
====[[Radiology Hours]]==== | |||
[[https://wikem.org/wiki/Harbor:Radiology_directory#Radiology_Directory| Radiology Directory]] | |||
====US & QPathE==== | |||
* [https://dhsqpath.qpath.cloud '''QPathE Login link'''] | |||
** Login using e# and associated password | |||
** Double-click the exam | |||
** Click "edit" at the top of the page | |||
** Enter MRN in the "patient ID" box | |||
** in "comments" enter trauma FAST | |||
** Click save at top of screen | |||
*Ultrasound | |||
**[[Harbor:Ordering a Formal Ultrasound|Ordering a Formal Ultrasound]] | |||
**[[Harbor:Rules for Performing ED Ultrasounds|Formal & ED Ultrasounds]] | |||
*[[Harbor: | **[[Endocavitary Probes]] | ||
*[[Harbor:Entering Prelim Radiology Read|Enter Prelim Rads Read]] | |||
*[[Harbor: | *[[Harbor:Example text for a discrepancy e-mail|Example text for a discrepancy e-mail]] | ||
*[[Harbor: | *CT | ||
**[[Harbor:Ordering a CT|Ordering a CT]] | |||
**[[Harbor:ED Radiology Specs|CT Specs]] | |||
=== | ====Contrast==== | ||
*[[ | * [[Creatinine_screening_prior_to_IV_contrast|IV Contrast]] | ||
** [https://lacounty.sharepoint.com/sites/dhs-harbor-pharm/PrePrinted%20Forms/Forms/AllItems.aspx?id=%2Fsites%2Fdhs%2Dharbor%2Dpharm%2FPrePrinted%20Forms%2FExtravasation%20Management%20Provider%20Order%20Form%20P294%20%2810%2E6%2E20%29%2Epdf&parent=%2Fsites%2Fdhs%2Dharbor%2Dpharm%2FPrePrinted%20Forms| Hyaluronidase for IV Contrast Extravasation order Form] | |||
*[[ | * [[Oral contrast for abdominal and pelvic CT|Oral Contrast]] | ||
==[[ | ==== [[Urgent Outpatient IR]] ==== | ||
== | ====[[Harbor:STAT MRI|STAT MRI]]==== | ||
*[[Harbor:ED Radiology Specs|MRI Specs]] | *[[Harbor:ED Radiology Specs|MRI Specs]] | ||
== | ====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 | |||
===[[Harbor:Ordering Blood Products|Blood products]]=== | |||
===[[Harbor:Antibiogram|Antibiogram]]=== | |||
**[[Harbor:Antibiotics in Sepsis|Harbor antibiotics in sepsis]] | |||
***[[Harbor:Sepsis core measures|Sepsis core measures]] | |||
===Finding Equipment/DME=== | |||
*[[Harbor:Equipment|Equipment (AED/RME)]] | *[[Harbor:Equipment|Equipment (AED/RME)]] | ||
*[[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|ED supplies A-Z]]==== | ||
===[[Harbor:Occupational exposure|Occupational Exposure]]=== | |||
===Procedures=== | |||
*[[Harbor:Consenting a patient|Consenting a patient]] | |||
*[[Harbor:Procedures Videos|Procedure Videos]] | |||
==Special patient types== | |||
===[[Harbor:Codes|Code Activations]]=== | |||
*[[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]] | |||
===[[Harbor:PE Response Team|PE Response Team]]=== | |||
===[[Harbor:Social work|Social Work]]=== | |||
===[[Harbor:Opiate Withdrawal/MAT/BUP|Opiate Withdrawal/MAT/BUP]]=== | |||
===[[Harbor:Alcohol Use Disorder/Withdrawal Treatment]]=== | |||
===[[Harbor:Stimulant Use Disorder Treatment]]=== | |||
===[[Harbor:Baby Safe Surrender Program|Baby Safe Surrender Program]]=== | |||
===[[Harbor: Reporting to DCFS|Reporting to DCFS]]=== | |||
===[[Harbor:Placement patients|'''Placement patients''']]=== | |||
===[[Harbor: Identifying Jane/John Doe, finding next of kin tips]]=== | |||
===[[Harbor:Psych patients|Psych Patients (& Exodus)]]=== | |||
===[[Harbor:Scheduled dialysis patients in ED|Scheduled dialysis patients in ED]]=== | |||
===[[Harbor:NFL Injured Player/Staff Protocol|NFL Injured Player/Staff Protocol]]=== | |||
===Sepsis=== | |||
*[[Harbor:Antibiotics in Sepsis|Harbor antibiotics in sepsis]] | |||
===[[Harbor:Sepsis core measures|Sepsis core measures]]=== | |||
==='''[[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)]] | ||
===Sexual | ==='''[[Harbor:Non-Occupational Exposure|Sexual Assault/STI Exposure (SART)]]'''=== | ||
*[[Harbor: | |||
===[[Harbor:Infectious Disease Threats|Infectious Disease Threats]]=== | |||
*[[Harbor:Infectious_Disease_Threats#Coronavirus_.28COVID-19.29|'''COVID''']] | |||
*[[Harbor:Ebola|Suspected Ebola protocol]] | |||
*[[Harbor:Infectious_Disease_Threats#Monkeypox\Monkeypox]] | |||
==Patient Disposition== | ==Patient Disposition== | ||
=== | ===Discharge=== | ||
====[[Harbor: ED Follow-Up Options|'''ED Follow-Up Options''']]==== | |||
===[[Harbor: ED Follow-Up Options|ED Follow-Up | |||
*[[Harbor:Prescribing|Prescribing]] | *[[Harbor:Prescribing|Prescribing]] | ||
=== | ====[[DC with meds in ED]]==== | ||
* Eye drops (vanco & tobra) and STI prophylaxis for home | |||
* | * HIV prophylaxis for sexual assault patients (raltegravir and Truvada) | ||
* | |||
*'''[[Harbor:Forms| Paper Forms]]''' | |||
*[[Harbor:Coumadin clinic|Coumadin clinic]] | |||
*[[Harbor:Expedited workup clinic|Expedited workup clinic]] | |||
*[[Harbor:Law Enforcement Discharge Escort|Law Enforcement Discharge Escort]] | |||
*[[Harbor:Home Health|Home Health]] | |||
*[[Harbor:Home hospice from ED]] | |||
===[[ | ====[[Transportation Needs]]==== | ||
===[[ | ====[[Social EM resources]]==== | ||
===[[Harbor: | ===Admission=== | ||
====[[Harbor:Admission and consultation guidelines|'''Admission Guidelines''']]==== | |||
*[[Harbor:Admitting a patient|Admitting a patient]] | |||
*[[Harbor:Who Goes to Family Medicine|Who Goes to Family Medicine]] | |||
====[[Harbor:Interqual Criteria Tips|Interqual Criteria Tips]]==== | |||
= | ====[[Harbor:Interqual Override Notes|Interqual Override Notes]]==== | ||
===[[Harbor: | |||
===[[Harbor: | ====[[Harbor:Right level of care|Right level of care]]==== | ||
*Admitting to Medicine - use MS Teams (no more clipboard) | |||
*[[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]] | |||
===[[Harbor: | ===[[Harbor:Scheduled_dialysis_patients_in_ED|Dialysis in the ED]]=== | ||
===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:Exodus|Exodus Psych transfers]] | |||
*[[Harbor:Transfer to L&D|Transfer to L&D]] | |||
*[[Harbor:Transfer/Discharge to Specialty Clinic|Transfer/Discharge to Specialty Clinic]] | |||
*[[Harbor:911 STEMI out|911 STEMI out]] | |||
*[[Harbor:MAC Transfer Burn or Replant|MAC Transfer Burn or Replant]] | |||
*[[Harbor:Replantation_Patients|Hand Replant]] | |||
*[[Harbor:Transfer to Comprehensive Stroke Center|Transfer to Comprehensive Stroke Center]] | |||
*[[Harbor:XRT|XRT transfers]] | |||
*[[Harbor:_Hyperbaric_Transfers|Harbor: Hyperbaric Transfers]] | |||
===[[Harbor: | ==Documentation== | ||
*[[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:Consenting a patient|Consenting a Patient]] | |||
**[[File:Harbor-Photo-Consent.pdf|Photo Consent Form]] | |||
===[[Harbor: | ==Disaster & Surge== | ||
*[[Harbor:Disaster plan|Disaster plan]] | |||
*'''[[Harbor:Surge plan|Surge plan]]''' | |||
*[[Harbor:ORCHID Downtime|ORCHID Downtime]] | |||
*[[Harbor:Infectious Disease Threats|Infectious Disease Threats]] | |||
**[[Harbor:Ebola|Suspected Ebola protocol]] | |||
* Environmental Exposure: | |||
** Ask Hazmat Response team or Incident Commander what decon has occurred on scene | |||
** [https://www.atsdr.cdc.gov/toxprofiledocs/index.html CDC Tox Profile Lookup] | |||
==[[Harbor: | ==Resident Education== | ||
*[[Harbor:Teaching Rounds Topics|Teaching Rounds Topics]] | |||
*[[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:Jeopardy Policy|Jeopardy Policy]] | |||
== | ==See Also== | ||
{{Special:Prefixindex/Harbor |hideredirects=1}} | |||
[[Category:Admin]] | |||
Latest revision as of 21:15, 11 April 2024
This is the main page for Harbor-UCLA emergency department; See Pediatric ED for the main Harbor pediatric page.
Admin Updates
- Frequently used resources
- Admission Guidelines
- Discharging to Clinics
- Expedited Workup Clinic
- Placement Patients
- Ordering a MRI
- Breast Abscess
- Breast Mass
- Ortho: Splint vs Consult
- Psych: OSA, Covid, & Exodus
- Covid Treatment Options
- QR Code: Equipment issues, Prehospital problems, Med Student evals, Resident Shout-outs
- Surge Criteria/Plan
OLD TOPICS
- ED Request for Specialty Appointment order is live 7/25/2023! No more black star in the depart menu.
- Happy July 4th: Hand Replant Transfers to LAG
- QR Code Resources
- Hyperbaric treatment for CO
- Options - UCLA Westwood, Long Beach Memorial, UCSD, NOT MAC to Catalina (only for dive injuries)
- UR coordinates the acceptance
- Transfers: UR should help coordinate the transfer - ELTC/HLOC - needs to occur <1-2 hrs
- Sending facility is supposed to arrange transfer
- If UR not able to get transfer in a timely manner --> MAC (CDO) - must be approved by house supervisor & Joy; BLS/ALS/CC transport
- Medics can call the radio for online base medical direction/orders
- New Expedited Work up Clinic referral process: https://www.wikem.org/wiki/Harbor:Expedited_Work-up_Clinic_(EWC)
- New asthma guidelines
- The preferred DHS controller medication is Symbicort (formeterol – long-acting B-agonist + budesonide – inhaled corticosteroid), 2nd line is Advair (salmeterol + fluticasone).
- If seeing the patient in the ED for an asthma exacerbation, please be sure to refill their controller medication AND the albuterol (if needed). We fall out if they fill more albuterol Rx’s in a year than their controller medication, so we need to make sure they get both when seen in the ED. If prescribing albuterol, do not give refills (you get 200 puffs!).
- Sepsis – remember to do the required components of the sepsis core measure w/in 3 hrs (30ml/kg, bcx, abx), document using the auto text (use “auto text copy utility” to get Brad Chappell’s “ .harsepsis” to go through the reminder guidance text and exclusions for IVF 30ml/kg. Communicate to the admitting team if they need to repeat the lactate and perform the sepsis reassessment exam with time stamp (w/in 6 hrs).
- If UR is suggesting a transfer to Rancho Los Amigos (RLA), then place the ‘consult to Transfer Center’ order. The Transfer Center is a county entity that helps transfer patients between county facilities.
- Synapse got a new look. See link for details. A one-page intro guide are available on DHS SharePoint
- Alt+C still works to compare studies.
- Open the PowerJacket (folder icons) and then you can pull up the read on 'reports'. Click the dropdown to switch from 'report' to 'notes' to find a free text prelim read.
- Change your default settings to what PowerJacket looks like and select ‘Notes’ and ‘Reports’ to always open so you can see prelim and final reads, respectively.
- Patient Relations Representatives (PRR) 3p-2a, 7days a week – call Registration for PRR who can help empanel into DHS or change empanelment/network in real time in the ED. PRR can come to bedside to meet with patient or send patient to Registration Windows. During business hours, send patient to Patient Relations Office in Rm 1-B-1.
- Harbor's COVID page Coronavirus (COVID-19) Info
- Paxlovid, Remdesivir, etc ... COVID Treatment Options
- Interqual criteria Interqual Criteria Tips
- Monkeypox
- See Monkeypox for medical information & Harbor Monkeypox Plan
- Educational Material
- Active Threat in the ED
- Situational awareness
- Stand between door and patient
- Ensure patient is gowned
- Be aware of long stethoscope, lanyard, long hair, etc
- Panic buttons at nursing stations/router
- Run & scream for help
- Hospital Codes
- Gold x111 - combative/agitated patient
- Gray x64450 - combative/agitated NON-patient
- Silver x111 - weapon, active shooter, hostage
- Situational awareness
General Administrative
- Pre-hospital
- Incoming transfers
- Exodus Transfers
- Exodus should call Psych ED about transfer, not Med ED
- Med ED will do MSE
- DEM AOD DEM Admin on Duty (AOD)
- Resident Responsibilities
Ambulance (EMS) Triage
Administrative duties
Administrative resources
RME & triage
Harbor ED policy manual
ED attending on call plan
Harbor Legal
Managing your Patient
General
On shift (PC) Cheat Sheet
Paging consultants
Phone numbers
Radiology directory
Tests & Orders
Radiology
Radiology Hours
US & QPathE
- QPathE Login link
- Login using e# and associated password
- Double-click the exam
- Click "edit" at the top of the page
- Enter MRN in the "patient ID" box
- in "comments" enter trauma FAST
- Click save at top of screen
- Ultrasound
- Enter Prelim Rads Read
- Example text for a discrepancy e-mail
- CT
Contrast
Urgent Outpatient IR
STAT MRI
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
Blood products
Antibiogram
Finding Equipment/DME
ED supplies A-Z
Procedures
Special patient types
Code Activations
PE Response Team
Social Work
Opiate Withdrawal/MAT/BUP
Harbor:Alcohol Use Disorder/Withdrawal Treatment
Harbor:Stimulant Use Disorder Treatment
Baby Safe Surrender Program
Reporting to DCFS
Placement patients
Harbor: Identifying Jane/John Doe, finding next of kin tips
Psych Patients (& Exodus)
Scheduled dialysis patients in ED
NFL Injured Player/Staff Protocol
Sepsis
Sepsis core measures
Occupational Exposure
Sexual Assault/STI Exposure (SART)
Infectious Disease Threats
Patient Disposition
Discharge
ED Follow-Up Options
DC with meds in ED
- Eye drops (vanco & tobra) and STI prophylaxis for home
- HIV prophylaxis for sexual assault patients (raltegravir and Truvada)
- Coumadin clinic
- Expedited workup clinic
- Law Enforcement Discharge Escort
- Home Health
- Harbor:Home hospice from ED
Transportation Needs
Social EM resources
Admission
Admission Guidelines
Interqual Criteria Tips
Interqual Override Notes
Right level of care
- Admitting to Medicine - use MS Teams (no more clipboard)
- Post-admission management/Orders on Admitted Patients
- Direct Admission after Hours
OBS & CORE
Dialysis in the ED
Other Disposition
Transferring a patient
- Transferring to psych ER
- Exodus Psych transfers
- Transfer to L&D
- Transfer/Discharge to Specialty Clinic
- 911 STEMI out
- MAC Transfer Burn or Replant
- Hand Replant
- Transfer to Comprehensive Stroke Center
- XRT transfers
- Harbor: Hyperbaric Transfers
Documentation
Disaster & Surge
- Disaster plan
- Surge plan
- ORCHID Downtime
- Infectious Disease Threats
- Environmental Exposure:
- Ask Hazmat Response team or Incident Commander what decon has occurred on scene
- CDC Tox Profile Lookup
Resident Education
See Also
- Harbor-UCLA
- Harbor:5S
- Harbor:911 STEMI out
- Harbor:AB 2760: Naloxone for patients at risk for opioid overdose
- Harbor:AVF/graft complications
- Harbor:Administrative resident
- Harbor:Admission and consultation guidelines
- Harbor:Admitting a patient
- Harbor:Adults
- Harbor:Adults results/symptom phone follow up
- Harbor:Adverse event mandatory reporting
- Harbor:Airway management team
- Harbor:Alcohol Use Disorder/Withdrawal Treatment
- Harbor:Antibiogram
- Harbor:Attending documentation
- Harbor:BUP
- Harbor:Baby Safe Surrender Program
- Harbor:Burns
- Harbor:CCC
- Harbor:CORE
- Harbor:Code STEMI
- Harbor:Code stroke
- Harbor:Codes
- Harbor:Consenting a patient
- Harbor:Consultation of subspecialists (peds)
- Harbor:Core Measures
- Harbor:Coroners' case
- Harbor:Coumadin clinic
- Harbor:Creatinine screening prior to IV contrast
- Harbor:Critical Result Callback
- Harbor:Crown Checks in PED
- Harbor:DC with meds in ED
- Harbor:DEM Admin on Duty (AOD)
- Harbor:DHS-Eligible patient needing Primary Care
- Harbor:DHS Visitor Policy
- Harbor:DME
- Harbor:Death Packet Checklist
- Harbor:Deceased patients
- Harbor:Direct Admission after Hours
- Harbor:Direct book without consultant discussion
- Harbor:Disaster plan
- Harbor:Discrepancy Review Process
- Harbor:Diversion for ALS and BLS
- Harbor:ED Radiology Specs
- Harbor:ED attending on call plan
- Harbor:ED follow-up options
- Harbor:ED policy manual
- Harbor:ED supplies A-Z
- Harbor:EKG screening
- Harbor:Ebola
- Harbor:Empiric antibiotics
- Harbor:Endocavitary Probes
- Harbor:Entering Prelim Radiology Read
- Harbor:Equipment
- Harbor:Equipment and supplies (peds)
- Harbor:Example text for a discrepancy e-mail
- Harbor:Exodus
- Harbor:Expedited Work-up Clinic (EWC)
- Harbor:Expedited workup clinic
- Harbor:Forms
- Harbor:Hip fractures
- Harbor:Home Health
- Harbor:Home hospice from ED
- Harbor:Hospital Based Violence Intervention Program and Trauma Recovery Center
- Harbor:How to NERF
- Harbor:How to get started in research at Harbor
- Harbor:How to submit CCC referral
- Harbor:Immigration Legal Assistance
- Harbor:Incoming transfers
- Harbor:Industrial Accident (IA)
- Harbor:Infectious Disease Threats
- Harbor:Instructions for clerk requesting/booking an appointment
- Harbor:Insurance Codes
- Harbor:Internal Medicine Admissions
- Harbor:Interqual Criteria Tips
- Harbor:Interqual Override Notes
- Harbor:Involuntary holds
- Harbor:Jeopardy Policy
- Harbor:Labs
- Harbor:Law Enforcement Discharge Escort
- Harbor:Legal
- Harbor:MAC Transfer Burn or Replant
- Harbor:Main
- Harbor:Medical Legal Partnership
- Harbor:NERF
- Harbor:NFL Injured Player/Staff Protocol
- Harbor:Non-Occupational Exposure
- Harbor:OOP follow up options
- Harbor:ORCHID Downtime
- Harbor:Observation placement
- Harbor:Occupational exposure
- Harbor:Occupational exposure (dot-phrases)
- Harbor:Opiate Withdrawal/MAT/BUP
- Harbor:Options for follow-up (peds)
- Harbor:Oral contrast
- Harbor:Ordering Blood Products
- Harbor:Ordering a CT
- Harbor:Ordering a Formal Ultrasound
- Harbor:PC Cheat Sheet
- Harbor:PED psych patients
- Harbor:PE Response Team
- Harbor:Paging
- Harbor:Patient wants to switch to Harbor
- Harbor:Pediatric:Subspecialties
- Harbor:Pediatric ED (main)
- Harbor:Pediatric admission guidelines
- Harbor:Pediatric antibiotics
- Harbor:Pediatrics CCS Follow up
- Harbor:Peds
- Harbor:Peds ED follow-up track information
- Harbor:Peds ED schedule and sick backup plans
- Harbor:Peds results/symptom phone follow up
- Harbor:Phone numbers
- Harbor:Placement patients
- Harbor:Post-admission management
- Harbor:Prescribing
- Harbor:Primary Care
- Harbor:Procedures Videos
- Harbor:Psych patients
- Harbor:QR for Patients
- Harbor:QR for Staff
- Harbor:RME & TRIAGE
- Harbor:RME Manual
- Harbor:Radiology Hours
- Harbor:Radiology directory
- Harbor:Receiving phone calls
- Harbor:Replantation Patients
- Harbor:Resident Documentation
- Harbor:Resident documentation
- Harbor:Resident responsibilities and transitions of responsibility
- Harbor:Respiratory isolation
- Harbor:Right level of care
- Harbor:Rules for Performing ED Ultrasounds
- Harbor:SB 1152 - 2019 California homeless patient discharge planning law
- Harbor:STAT MRI
- Harbor:STEMI 911 Inter-Facility Transfer (IFT)
- Harbor:Same/Next Day Specialty Clinic Follow up
- Harbor:Sandbox
- Harbor:Scheduled dialysis patients in ED
- Harbor:Screening EMS Patients
- Harbor:Sepsis antibiotics
- Harbor:Sepsis core measures
- Harbor:Sexual assault
- Harbor:Social EM resources
- Harbor:Social work
- Harbor:Stimulant Use Disorder Treatment
- Harbor:Stress Testing
- Harbor:Substance Use Disorder
- Harbor:Surge plan
- Harbor:Teaching Rounds Topics
- Harbor:Transfer/Discharge to Specialty Clinic
- Harbor:Transfer to Comprehensive Stroke Center
- Harbor:Transfer to L&D
- Harbor:Transferring a patient
- Harbor:Transferring to psych ER
- Harbor:Transportation Needs
- Harbor:Trauma activations
- Harbor:Ultrasound approval list
- Harbor:Ultrasound reference card
- Harbor:Urgent Outpatient IR
- Harbor:Urgent Specialty Follow-up for DHS or MHLA Patients
- Harbor:VA MICU rotation
- Harbor:Wellness
- Harbor:Who goes to family medicine
- Harbor:Whole person care
- Harbor:XRT
- Harbor: Base Hospital Resource for Physicians and MICNs
- Harbor: Bullet Removal Guidelines
- Harbor: ED Bedside Ultrasound Policy and Procedure Guidelines
- Harbor: Hyperbaric Transfers
- Harbor: Identifying Jane/John Doe, finding next of kin tips
- Harbor: Macros and Autotext
- Harbor: Reporting to DCFS
- Harbor: Social Resources
- Harbor: Thoraco lumbar sacral orthosis
- HarborUCLA:5S
- HarborUCLA:Administrative resident
- HarborUCLA:EKG screening
- HarborUCLA:Main
- HarborUCLA:Pediatric ED (main)
- HarborUCLA:Receiving phone calls
- HarborUCLA:Triaging ambulance runs
- Harbor Macros: AMA
- Harbor Macros: Abdominal Pain
- Harbor Macros: Abdominal Pain(Female)
- Harbor Macros: Back Pain
- Harbor Macros: Chest Pain
- Harbor Macros: EKG
- Harbor Macros: Pediatrics
- Harbor Macros: Syncope
- Harbor UCLA - CIR