Harbor:Main

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

Admin Updates

• Harbor's COVID page Coronavirus (COVID-19) Info
  • Paxlovid, Remdesivir, etc ... COVID Treatment Options

• QR Code Resources
  • For Staff (QI forms and equipment issue links)
  • For Patients

• Interqual criteria Interqual Criteria Tips

• Contrast
  • 6/8 - OK to resume typical ordering practices with thoughtful attention to H&P and recent studies

• Monkeypox
  • See Monkeypox for medical information & Harbor Monkeypox Plan
    • Consider in patients with travel history
    • Rash typically preceded by fever, lymphadenopathy, malaise, HA, and muscle aches
      • Prodrome 5-13 days after exposure
      • Rash 1-4 days after prodrome
    • Vesicular or pustular rash, well-circumscribed, may be umbilicated or become confluent and progress over time to scabs
    • Higher likelihood in MSM patients, presenting with lesions in the genital area
  • Move directly to a negative-pressure room; airborne (N-95) and contact precautions
  • Call IPC x66532 and Micro x66289 and get a monkeypox collection kit from Microbiology
    • Call LAC Acute Communicable Disease Control (weekdays 8:30A-5P 213-240-7941, after hours 213-974-1234 and ask for the physician on call) LA County 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
  • 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

Administrative duties

• • Administrative resident directions
  • Receiving Phone Calls
    • Critical Result Callback
  • EKG Screening
  • Pre-shift: 5S
  • Airway Bag [Airway management team]

RME & triage

• • Harbor:Direct Admission after Hours
  • Core Measures
  • Crown Checks in PED

Managing your Patient

General

Paging consultants

• Harbor:Ophtho abbreviation dictionary

Tests & Orders

• Labs

Radiology

• Ultrasound
  • Ordering a Formal Ultrasound
  • Formal & ED Ultrasounds
  • Endocavitary Probes
• Enter Prelim Rads Read
• Example text for a discrepancy e-mail
• CT
  • Ordering a CT
  • CT Specs
• Oral contrast
• Contrast Extravasation:
  • Hyaluronidase for IV Contrast Extravasation order Form

Radiology Hours

[Radiology Directory]

STAT MRI

• 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

Antibiogram

• • Harbor antibiotics in sepsis
    • Sepsis core measures

Finding Equipment/DME

• Equipment (AED/RME)
• Equipment (peds)
• Durable Medical Equipment (DME)

Procedures

• Consenting a patient
• Procedure Videos

Special patient types

Code Activations

• Involuntary Holds
• Airway Management Team
• Code Stroke
• STEMI Activation
• Trauma Activations

Sepsis

• Harbor antibiotics in sepsis

Occupational Exposure

• Industrial or On-the-Job Accidents (IA)

Infectious Disease Threats

• COVID
• Suspected Ebola protocol

Patient Disposition

Discharge

ED Follow-Up Options

• Prescribing

DC with meds in ED

• Eye drops (vanco & tobra) and STI prophylaxis for home
• HIV prophylaxis for sexual assault patients (raltegravir and Truvada)

• Paper Forms

• Coumadin clinic
• Expedited workup clinic
• Law Enforcement Discharge Escort
• Home Health
• Harbor:Home hospice from ED

Admission

Admission Guidelines

• Admitting a patient
• Who Goes to Family Medicine

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

• Observation placement
• CORE placement

Other Disposition

• Death Packet Checklist
• Deceased patients

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
• Transfer to Comprehensive Stroke Center
• XRT transfers

Documentation

• PC Cheat Sheet
  • Macros and Autotext
• Attending Documentation
• Resident documentation
• Consenting a Patient
  • File:Harbor-Photo-Consent.pdf

Disaster & Surge

• Disaster plan
• Surge plan
• Harbor:Diversion for ALS and BLS
• ORCHID Downtime
• Infectious Disease Threats
  • Suspected Ebola protocol

Resident Education

• Teaching Rounds Topics
• VA MICU rotation
• How to get started in research at Harbor
• Jeopardy Policy

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