Ver el código de «Harbor:Diversion for ALS and BLS»

'''ALS Diversion'''
*ED Saturation (aka Diversion) is a process of marking the ED in the countywide ReddiNet system as “closed” to adult Advanced Life Support (ALS) arrivals. 
**“ALS ED Sat” does NOT redirect BLS arrivals or specialty center patients arriving to Harbor (e.g. Trauma, STEMI, Perinatal).. 
*ALS ED Sat” lasts for two hours but can be ended earlier. At the end of the two-hour diversion, ReddiNet will automatically re-open the hospital to ALS. 
*If the nearest alternative ED is also noted as “ALS ED Sat”, ALS ambulances will be directed to the closest ED, regardless of “ED Sat” status on ReddiNet. 
*“ALS ED Sat” is not a command, but a suggestion. EMS can still bring the patient to the MAR if it is considered to be the safest decision (e.g. patients in extremis) 
*'''Goal''' of Diversion is to ensure safety of current ED patients and of patients being transported by EMS by::
**Allowing staff time to move patients within or through the ED to free up space/staff resources. 
**Allowing the ED time to prepare for next round of sick patients.


'''Guidelines for ALS Diversion triggers''': 
*Consider when not enough space to care for the next critical patient coming by ambulance
**Not enough treatment spaces despite decompress patients to other beds/hallway
**Not enough staff (RN, RT, provider, etc.) or supplies (vents, blood, etc.)
*Diversion decisions made by joint agreement of MICN, OCN, AED Charge, and Attending
*OCN & Attending names are recorded in the ReddiNet as the Authorizing personnel


'''BLS Diversion'''
*“BLS ED Sat” is added to ALS ED Sat and marks the ED in the countywide ReddiNet system as “closed” to all ALS and BLS arrivals.
*“BLS ED Sat” does NOT redirect specialty center patients arriving to Harbor (e.g. Trauma, STEMI, Perinatal).
*Very serious decision given consequences to community. Only to be used when situation in ED is felt to be truly unsafe for patients. 
*Requires hospital administration approval


'''Guidelines for BLS Diversion triggers''': Requires hospital administration approval
*Above ALS diversion triggers AND 
*'''3 patients in ambulance triage waiting >60 min''' AND one of the following:
**At least 2 #ESI 2’s in waiting room 
**WR #s = 50-60
**WR LOS = >12hrs
**No trauma bays open
*ED request for “BLS ED Sat” must come from the Clinical Nursing Director and ED AOD via the OCN and Attending. Hospital approval by CMO/CEO or designee. 
*Request is made by phone to the MAC on behalf of the CMO. Cannot be done via ReddiNet



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