For immediate clinical management see "Replantation"
- Obtain Urgent Hand Call Consult
- If potential replantation candidate per Hand Call initiate transfer to USC through MAC (USC should NOT decline do to "closed status" - see below)
- State to MAC "We are requesting a Higher Level of Care Urgent/Emergent transfer to USC per DHS Policy 373.3" (this makes the request a priority and should get transfer approved within 60 minutes)
- TRANSFERS FOR POTENTIAL REPLANTATION WILL PROCEED REGARDLESS OF WHETHER USC HAS AVAILABLE BEDS. (Even if closed to transfers for that reason per CMO Spellberg at USC)
Dealing with Disagreements Regarding Transfer
- If there is disagreement between HUCLA Hand Call and USC Replantation service about proceeding with replantation - HUCLA Hand Call Service should directly talk with USC replantation service.
- If there is still disagreement - HUCLA Hand Call attending must talk to USC replantation attending.
- If there continues to be disagreement - the patient WILL be accepted by USC for an in-person evaluation by the replantation service (per CMO's at USC and HUCLA) - please involve both Trauma Attending and Director of Operations for the ED (Peterson) or Chair, Emergency Department if this occurs.
- If the patient is transferred to USC and after evaluation it is decided that replantation is not indicated - HUCLA WILL accept the patient back in transfer.
- Peterson 2/2019