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Admitting

Page history last edited by Mary Lacy 2 months, 2 weeks ago

ADMITTING

  • Please submit a bed request form ASAP as soon as you know a patient's desired level of care.  Don't wait to write orders to submit your bed request as this will delay the flow of patients out of the ER.
  • The ED is expected to have established:
    • that the patient needs to be admitted 
    • that IM is the appropriate service (ie the pt is not FP & not surgical, ect)
    • the appropriate level of care (MICU, step down, floor)
    • that the labs and imaging necessary to determine the above have been completed
    • that initial stabilizing interventions are done (abx started, BIPAP initiated, etc.) 

 

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Comments (2)

Kendall Rogers said

at 2:39 pm on Jan 26, 2010

Jay/Dana: 2 Areas to Clarify that were brought up today (delete this comment when it has been explained above):
Scenario 1: night call resident does a consult on a patient and at the end it is decided the patient needs to be transfered to a medicine service - which team should take the patient, night call resident or the day call? I think this should go to night call, they have done the work and it will count towards their cap for that night. If we do make it day call, then they are split between ER and upstairs. I think all requests for transfer should be seen by night call resident as a consult to decide how the patient will be best treated, this should not matter to the team as the work will be the same if the patient is followed as a consult each day or as a patient on the team.
Scenario 2: PALS transfer arrives before noon - Gold Medicine or day call team. I do not know what to do here, should we consider it similar to a MICU transfer? The gold team is in ER doing triage so maybe difficult to split between the two areas, but we should discuss and decide this as well.

dkdavis@salud.unm.edu said

at 2:28 pm on Jan 27, 2010

Consults in the ER vs floor.
Consults in the ER should be done by Night Float and admitted to the night call team if admission is warranted.
Consults on the floor are supposed to be seen by OCD. If it seems that transfer of service is needed I would prefer that OCD manage them for the night and then they are transferred to one of the day teams (Day call would seem most appropriate).
PALS transfers before noon should go to the day call team.

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