Harbor:Main

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

Admin Updates


OLD TOPICS

  • 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.


  • 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

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

[Radiology Directory]

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 tope of screen

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)


Transportation Needs

Social EM resources

Admission

Admission Guidelines

Interqual Criteria Tips

Interqual Override Notes

Right level of care

OBS & CORE


Dialysis in the ED

Other Disposition

Transferring a patient

Documentation

Disaster & Surge

Resident Education

See Also