SCVMC:ED

Santa Clara Valley Medical Center: Emergency Department

Administrative

• Accepting transfers
  • "Red Box Trauma" - accept all
  • Pediatric Ortho from Regional Medical Center - accept
  • STEMI from SLH - transferring physician speaks to interventional cardiologist first
  • Valley Health Plan - transferring physician speaks with transfer line
  • Other Transfers - transferring physician need specialty accepting physician, not ED
• Department Phone List & Door Codes
• QI Case Review Form

Patient Care

General

• Departmental Dot Phrases
• Chest Pain: HS-Troponin Chest Pain Algorithm
  • Outpatient Stress Test: call Gold hospitalist to coordinate
• Stroke: (Extended) Stroke Criteria pg. 4-5
• Sepsis: SEP-1 Sepsis Core Measures
  • Adult Antibiogram 2019 | Pediatric Antibiogram 2019
    • VMC Antimicrobial Stewardship Webpage
• COVID-19: COVID-19 VEP Guidance
• Protocol advanced imaging with radiology (x57625) for:
  • CT scans with IV contrast
  • MRI
  • Ultrasound - Friday 10pm - Sunday 10pm & holidays
• Ordering and Fitting (DME) Durable Medical Equipment From ED: Pacific Medical (available 24/7)
  • Using on-site stocked DME
• Suboxone Induction Protocol (CA Bridge) | SCVMC Algorithm
  • Business Hours Process:
    • Induce patient per protocol
    • Contact Jill Lassettre, our Substance Use Navigator (SUN), 669-236-1564
      • She will arrange followup care with Substance Use Treatment Services (SUTS)
  • After Hours Process:
    • Induce patient per protocol
    • Fill out a Treatment Appointment Form
      • Located on a clipboard hanging on the wall by the nursing stations in RME or XC
      • Every business day, an 8am appointment at the Central Valley Clinic (CVC) is kept open for ED-induced patients
    • Send Jill Lassettre a message via EMR with MRN and expected appointment date
  • COVID-19 Clinic Follow-Up Note
  • Buprenorphine Home Induction
  • Free Online DEA-X Waiver Training (Cat 1 CME: MD 8hr, PA 24hr) is available
• Occupational Exposure of HHS Healthcare Workers
  • M-F 8AM-430PM: Refer to Employee Health 408-793-2658 - 751 S. Bascom Avenue, Suite 160 (Valley Specialty Center)
  • After hours: ED/EXC evaluation
    • Exposed employee should notify their supervisor regarding source patient. Source patient's attending to order source testing panel
    • Do not order tests on exposed employee.
    • Have patient fill out Post-Exposure Form. Fax one copy, give another copy to exposed employee
    • Determine HIV PEP need:
      • If source patient is HIV negative: no HIV PEP needed.
      • If source patient is HIV positive: highly recommend HIV PEP
      • If source patient HIV status unknown: per CDC reasonable to provide HIV PEP until source testing is confirmed, give patient HIV PEP first dose in ED and prescribe enough until Employee Health follow up date
    • Exposed employee follows up next business day at Employee Health
• PrEP and PEP Valley PACE Clinic Info
  • PrEP: CDC FAQs
  • PEP: Valley Non-Occupational Exposure

Interdepartmental: Admissions & Consultations

• ED Admission Grid Guidelines & Femur Fracture Protocol
  • Hand Algorithm: Ortho (odd days), Plastics (even days)
  • Face: Otolaryngology (odd days), Plastics (even days)
  • Reimplant/Revascularization: Stanford
  • Type A Thoracic Dissection: Stanford (typically)
  • Pediatric Neurosurgery: Lucile Packard Children's Hospital
  • Breast: General Surgery
  • SICU: speak with Trauma Attending
  • CCU: speak with Cardiology Attending
  • MICU: speak with MICU Resident

• Contacting Consultants
  • STEMI: MUC to page
  • Stroke: MUC to page
  • Trauma Activation (Criteria): MUC to page
    • All hospital admissions with a traumatic injury (unless isolated ortho) require a trauma attending consult
  • Emergent Consult: MUC to page
  • Anesthesia: Use AMION to call phone
  • All other consults: Use Secure Chat

• Criteria to defer NSGY consultation in traumatic injury overnight

• OBGYN MSE to BOUC Clinic Workflow (M-F 830-1600)
  • Valley New Pregnancy Algorithm

• Kaiser patient on a 5150 hold needing medical admission: Admit to Medicine at VMC with Inpatient Psych Consult (get EPRP approval)
• Kaiser patient on a 5150 hold who is medically cleared: Discharge to EPS (EPRP will pass case along to Kaiser Behavioral Health Team)
  • Kaiser patient under 18 years-old on a 5585 hold who is medically cleared: Transfer to EMQ/Uplift

Follow-Up & Discharge

• Request a PCP for a patient
  • Send a new message to 'P HHS Panel Management [10907]' for the request
  • Save as a QuickAction for next time
• Subspecialist referral: place order in "Dispo" tab
  • Okay to write "follow up of ED consult" for reason if patient seen by consultant in ED
  • If EMR prevents you from placing referral (typically for VHP insurance patients), refer to PMD or any county UC (not EXC) for referral to be placed.
• Quality RN
  • Can help out with:
    • Filing DMV loss of consciousness form
    • Additional ED lab / follow up requests
  • Send a new message to 'P ED Quality Call Back Pool (Non-Urgent) [16010929]'
  • Save as a QuickAction for next time
• Sobering Center: Mission Street 408-648-4411
  • Must be an adult and able to walk or do own wheelchair transfers
• Mental Health Urgent Care
  • Don Lowe Pavilion - blue door at corner of Enborg Lane & Enborg Court
  • 408-885-7855
• STI/HIV & TB Clinic Follow Up
  • Look up "Crain STI" or "VHC Lenzen TB" clinics in Dispo
  • 976 Lenzen Ave, San Jose 95126
• Dental Clinics | Additional Dental Services
• Partner Community Health Centers
• Create a Personal Follow Up List Instructions

Hospital Protocols

• VMC Policies & Procedures Webpage
• Pharmacy Protocols

See Also

• SCVMC Main Page
• SCVMC Express Care
• SCVMC Custody Care

References

Singh 4/2020 Bergersen 3/2020