Harbor:Screening EMS Patients

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