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)
- 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.
- 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)