Difference between revisions of "Harbor:Screening EMS Patients"

(ALS & BLS Direct to triage (2/5/18))
(Senior Resident)
 
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*Respond to screen ASAP to get EMS report
 
*Respond to screen ASAP to get EMS report
 
*Release ALS personnel (BLS may have to stay until patient in room)
 
*Release ALS personnel (BLS may have to stay until patient in room)
*If on wall and appears stable for triage/WR, discuss with attending
+
*If on wall and appears '''stable for triage/WR''', discuss with attending
**If attending agrees use .edambutriage note but do NOT click the "MSE"
+
**If attending agrees use '''.edambutriage''' note but do NOT click the "MSE"
**Revised .edambutriage :  This patient was brought in by EMS for ___.  I initiated the medical screening exam and feel the patient is stable to go to triage at this time.  The patient is ambulatory, vital signs are stable, and they will have their MSE continued by the provider in triage.  I discussed the case with Dr. ____ who agrees with this plan. 
 
 
**Write "Triage" in the RN Comments column
 
**Write "Triage" in the RN Comments column
 
**These patients will then go to team triage
 
**These patients will then go to team triage
* If need to stay in the ED, do brief MSE note and will be assigned to a team by Charge RN based on geography
+
* '''If the patient needs to stay in the ED, do a brief MSE note'''
  
 
===MICN===
 
===MICN===

Latest revision as of 19:15, 4 June 2019

ALS & BLS Direct to triage (2/5/18)

  • ALS or BLS patients with the following:
    • Stable Vital Signs
      • T 36-38C
      • HR 60-100
      • SBP 100-210, DBP 60-120
      • RR 12-20
    • Ambulatory
    • Cleared by Charge RN
    • If your patient meets all 3 criteria, take them directly to the physician in triage (or NP if physician is unavailable)
  • Charge RN must:
    • Quick-register the patient AND
    • Use the Pre-Hospital template to enter:
      • VS
      • EMS unit
      • Brief statement about patient being stable and ambulatory to triage

Patients not meeting "Direct to Triage" criteria

AED Charge

  • Quick-register patient
    • If clearly needs to stay AED
      • Room Available
        • Place in room
        • Assign purple/green based on room
      • No room available - Assign by alternating purple/green
    • Notify Senior Resident via Spectra - "EMS is waiting"
    • Hold EMS until physician arrives (30 min max)
    • If no room, after screened by senior resident:
      • If assigned "AED" by screening MD, place in next available room (stays with same team regardless of room)
      • If assigned "Triage" by screening MD, to triage for physician/NP in triage to perform MSE

Senior Resident

  • If you notice EMS patient has been waiting > 30 min for team assignment - call Charge RN
  • Respond to screen ASAP to get EMS report
  • Release ALS personnel (BLS may have to stay until patient in room)
  • If on wall and appears stable for triage/WR, discuss with attending
    • If attending agrees use .edambutriage note but do NOT click the "MSE"
    • Write "Triage" in the RN Comments column
    • These patients will then go to team triage
  • If the patient needs to stay in the ED, do a brief MSE note

MICN

  • ALS Arrivals ONLY
    • Download and print 2 copies of ePCR (aka EMS Report Form)
    • Place stickers on them
    • Leave 1st copy with patient’s RN
  • Give 2nd copy to clerk

ED ATTENDING

  • If you notice EMS patient has been waiting > 30 min for team assignment - call Charge RN

See Also

References

Chappell 1/31/18 rev Peterson 1/2019