Harbor:Main: Difference between revisions
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===Admission=== | ===Admission=== | ||
====[[Harbor:Admission and consultation guidelines|Admission | ====[[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]] |
Revision as of 23:56, 24 April 2020
This is the main page for Harbor-UCLA emergency department; See Pediatric ED for the main Harbor pediatric page.
Admin Updates
- Coronavirus (COVID-19) Info: https://www.wikem.org/wiki/Harbor:Infectious_Disease_Threats#Wuhan_Coronavirus_.28nCoV-2019.29
- 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)
- please use the EC7 as needed (Na, K, iCa, H/H, pH, CO2, pO2, HCO3, base excess)
- 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
- 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
On shift (PC) Cheat Sheet
Paging consultants
Phone numbers
Radiology directory
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
- 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
- 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
E supplies A-Z
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)
- PE Response Team
- Psych Patients (Exodus)
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
- Home Health
Admission
Admission 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