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''Ronald Regan DEM administrative portal''

== RR ED Phone Numbers ==

=== ED numbers ===

Main attending 78447<br />
U3 attending 78448<br />
Senior res 78449<br />
Junior res 78450<br />
U3 res 78451<br />
Intern 78393<br />
Triage hospitalist 79873<br />

=== Radiology ===

Radiology operator 78700<br />
CT PM reading 78737<br />
GI/ABD reading 78737<br />
Neuro reading 78729<br />
Chest reading 78704<br />
CT tech 78786<br />
Xray tech 78703<br />
MRI 78745<br />
US 78796<br />

=== Ancillary ===

RR operator 66766<br />
CWA 78407<br />
Bed control 56922<br />
Blood Bank 78150<br />
RR Lab 78100<br />
ED LAB 78159<br />
Pharm ER 77219<br />
Pharm RR 77621<br />
Social Work 79805<br />
CM 797639<br />
RT 78912<br />

=== Consults ===

==== Medicine ====

CCU p90080 <br />

J (liquid onc) p90050 <br />

MICU p90090 <br />

Neuro Gen p89114 <br />

Neuro Stroke p90130 <br />

Renal non transplant p96110 <br />

Renal transplant p96220 <br />

Psych p95722 <br />

==== Surgical ====

C (onc) p90021 <br />

ENT p89060 <br />

Face: even days ENT; Odd days plastics <br />

Gyn p90595 <br />

Liver p89190 <br />

Neurosurg p94320 <br />

OB p95944 <br />

Optho p33887 <br />

Ortho p88003 <br />

Plastics p89074 <br />

Spine: even days neurosurgery; odd days ortho <br />

Trauma R1 76453/p95549 <br />

Trauma R3 76454 / p95550 <br />

U (colorectal ) p90022 <br />

Urology p89045 <br />

Vascular p90065 <br />



== Medicine Admission Criteria ==

=== Cardiac ===

Arrhythmias: known a.fib & stable, medicine; new onset or unstable, CCU<br />

Rule out MI: low risk, OBS; low risk not obs appropriate, Medicine; high risk, CCU<br />

Syncope: low risk, OBS; moderate risk, Medicine; high risk, CCU<br />

s/p Heart Transplant: CCU<br />

HTN Emergency: CCU<br />

CHF: mild, medicine; new onset or severe, CCU<br />

=== Pulm ===

Asthma: mild, OBS; moderate, Medicine; severe, MICU<br />

CAP: mild, OBS; moderate, medicine; severe, MICU<br />

Pulm HTN: mild-moderate, Medicine; severe, MICU<br />

s/p Lung transplant: mild-moderate, Medicine; severe, MICU<br />

Pulm Fibrosis: mild-moderate, Medicien; severe, MICU<br />

=== GI ===

Gastroenteritis: mild, OBS; mod-severe, Medicine<br />

PO Intolerance: mild or known cause, OBS; unknown cause or severe, Medicine<br />

ERCP: Medicine<br />

Upper/Lower GI Bleed: Stable with HGB >/= 7, Medicine; Active or HGB <7, MICU<br />

=== Hem/Onc ===

Sx Anemia: known dx or admit for tx only, OBS; new dx, Medicine<br />

Neutropenia/Fever: J patient, J service; not a J patient, Medicine<br />

ALL: J service,<br />

AML: J service,<br />

s/p BMT: J service, <br />

Solid Tumors: SMH; unless not a Solid One Patient or Patient refused transfer, Medicine <br />

=== Renal ===

Hyponatremia: Na >/= 120, Medicine; Na <120, MICU<br />

Hypernatremia: Na </= 160, Medicine; Na > 160, MICU<br />

Hypokalemia: K>/= 2.5, Medicine; K<2.5, MICU<br />

Hyperkalemia: K</= 6, Medicine, K>6, MICU<br />

s/p Renal Transplant: stable, Medicine<br />

=== Endo ===

DKA: MICU<br />

Myxedema Coma: MICU<br />

Thyroid Storm: MICU<br />

=== ID ===

Cellulitis: stable, OBS; if DM, PVD, immunocompromised or involving hand, Medicine<br />

=== Other ===

EtOH Withdrawal: mild&uncomplicated, OBS; moderate, Medicine; Severe, MICU<br />

Neuro Checks: >q2h, Medicine; </= q2h, MICU<br />

Frequent Labs: <q4h, MICU<br />

Suctioning: >q1h, Medicine; </=q1h, MICU<br />

== Medicine Bed Requests / Sign-Outs / Transfers / Misc ==

=== Bed Requests ===

24 hours a day, place bed request prior to calling hospitalist. <br/>

5pm to 7am: call hospitalist; If hospitalist does not agree with bed request they change the bed request.<br/>

7am to 5pm: do not call hospitalist unless OBS admission or dispo questions; if medicine team disagrees with dispo they change the bed request.<br/>

=== Sign Outs ===

5pm to 7am: place bed request, call hospitalist. give a one line sign-out. medicine team will then call you for full sign out. <br/>

7am to 5pm: place bed request, a medicine team will call you; unless OBS, call hospitalist.<br/>

at all times, if team disagrees with bed request, that team will change bed request and sign out to team they think is most appropriate, ED not responsible for changing bed request or re-signing out to another team, this includes OBS sign-outs<br/>

=== Capped Services ===

5pm to 7am: All medicine admissions should be through triage hospitalist who will redirect admissions based on capped services.<br/>

7am to 5pm: if CCU, MICU or J service are capped, they will let hospitalist know, hospitalist will inform CWA who will let ED know to follow the below changes in bed requests.<br/>

If Capped:<br/>

COU admissions to be changed to Medicine with Cardiology c/s<br/>

CCU admissions to change to MICU or next available ICU bed <br/>

MICU admissions to next available ICU bed<br/>

J service admissions to change to Medicine <br/>

=== Santa Monica Transfers ===

If ED states “Not appropriate for transfer” but hospitalist or case manager disagree, hospitalist will change this designation. If CM disagrees with ED decision on appropriateness of transfer, they are to call hospitalist, not ED team to discuss.

=== Next Day Follow-Up ===
Evaluation and Treatment Center in Santa Monica: <br/>
1245 16th Street Suite 125 <br/>
Direct Line : 310-899-7440 <br/>
What is it? Urgent Care Type Center with expanded resources)<br/>
<br/>
How to be seen there?<br/> 
Scheduling a patient to be assessed by an MD the following day after an ED Visit can be accomplished by calling the Direct Line above.<br/>
1)Patients will be provided an appointment time Monday through Friday from 8:00AM to 5:00PM <br/>
2) Patients may also “walk in”  to the evaluation without an appointment Monday through Friday 5:00PM to 9:00PM; Saturday, Sunday and Holidays walk in patients are seen 9:00AM to 5:00PM <br/>                                                                                                                            
3) MD orders are not required for these appointments as the evaluating MD would assess the patient for ongoing medical needs <br/>
<br/>
Nurses Service ONLY Appointments <br/>
1)      Patients who require care that a registered nurse can provide may be scheduled for RN Services only <br/>
2)      These appointments are also scheduled at the number above, however would require orders from a treating physician <br/>
a)      Care such as IV hydration<br/>
b)      IV Antibiotics<br/>
<br/>

==See Also==
*[[University of California Los Angeles (Ronald Reagan + Olive View Medical Centers)]]


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