• If you are citizen of an European Union member nation, you may not use this service unless you are at least 16 years old.

  • Stop wasting time looking for files and revisions. Connect your Gmail, DriveDropbox, and Slack accounts and in less than 2 minutes, Dokkio will automatically organize all your file attachments. Learn more and claim your free account.

View
 

Medicine consults during covid outbreak

Page history last edited by Seth Scott 6 months ago

Hospital Medicine PALS Call Consult Redirect Guidelines

Draft: 3/22/20

 

In response to the creation of the COVID (Zinc Medicine) inpatient service and the temporary suspension of the Internal Medicine Consult team (effective 3/23/20 at 0700), the PALS IM attending will serve to assist in redirecting primary services to the following services if there is questions regarding the most appropriate consulting team. Consults traditionally performed by IM will now be performed by disease-specific consult services (e.g. diabetes -> Endocrinology)

 

Process: if primary team is unsure of appropriate consult, the IM PALS attending may be contacted by the primary service.  PALS attending will take the patient’s name, MRN and clinical information and provide the caller with a recommendation for appropriate service (guidance on disease-specific consultations below).  As able, the PALS attending should connect the caller with the appropriate consult service via TigerConnect to help facilitate the communication and transfer of services.

 

For cases in which there is no apparent appropriate service and Internal Medicine is likely the most appropriate consult service, the PALS attending should reach out to the Gold, Copper and Silver attendings via TigerConnect to find a person to perform the consult.  For similar overnight consult requests, the IM PALS attending should contact the night float residents via TigerConnect to facilitate the consult.  Overnight consults will be staffed with the Gold attending the following morning in this circumstance.

 

Cardiology:

Persistent sinus tach 

A fib or other arrhythmia

Hypertension uncontrolled

Concern for heart failure

Hypotension (or ICU if pt unstable)

Preoperative risk stratification for a pt undergoing non-elective surgery

 

Pulmonology:

Dyspnea

Hypoxia

Pneumonia

Pleural effusion

COPD

Concern for PE

 

Heme/Onc:

Anticoagulation recommendations

Anemia

 

GI

Cirrhosis

Ascites

 

Nephrology:

Hyponatremia

Hyperkalemia

Other electrolyte disturbances

AKI

Acid base problem

Hypertension uncontrolled

 

ID:

Concern for any infection

Fevers 

 

Endocrinology:

Diabetes and glycemic control issues

Thyroid issues

 

 

Neurology: 

Acute mental status changes (or other AMS)

Seizure

Stroke

 

Psych:

Delirium 


 

Comments (0)

You don't have permission to comment on this page.