Harbor:Diversion for ALS and BLS - Revision history

Andreawu at 00:37, 28 December 2021

2021-12-28T00:37:31Z

← Revisión anterior		Revisión del 00:37 28 dic 2021
Línea 20:		Línea 20:
	'''BLS Diversion'''		'''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” 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).		*“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.		*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		*Requires hospital administration approval
Línea 27:		Línea 27:
	'''Guidelines for BLS Diversion triggers''': Requires hospital administration approval		'''Guidelines for BLS Diversion triggers''': Requires hospital administration approval
	*Above ALS diversion triggers AND		*Above ALS diversion triggers AND
	*3 patients in ambulance triage waiting >30 min AND one of the following:		*'''3 patients in ambulance triage waiting >60 min''' AND one of the following:
	**At least 2 #ESI 2’s in waiting room		**At least 2 #ESI 2’s in waiting room
	**WR #s = 50-60		**WR #s = 50-60

Andreawu at 00:34, 28 December 2021

2021-12-28T00:34:26Z

← Revisión anterior		Revisión del 00:34 28 dic 2021
Línea 27:		Línea 27:
	'''Guidelines for BLS Diversion triggers''': Requires hospital administration approval		'''Guidelines for BLS Diversion triggers''': Requires hospital administration approval
	*Above ALS diversion triggers AND		*Above ALS diversion triggers AND
	*3 patients in ambulance triage ~~and at~~ least 2 #ESI 2’s in waiting room ~~= total 5-8~~		*3 patients in ambulance triage waiting >30 min AND one of the following:
	*WR #s = 50-60		**At least 2 #ESI 2’s in waiting room
	*WR LOS = >12hrs		**WR #s = 50-60
	*No trauma bays open		**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.		*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		*Request is made by phone to the MAC on behalf of the CMO. Cannot be done via ReddiNet

Andreawu at 00:32, 28 December 2021

2021-12-28T00:32:44Z

← Revisión anterior		Revisión del 00:32 28 dic 2021
Línea 27:		Línea 27:
	'''Guidelines for BLS Diversion triggers''': Requires hospital administration approval		'''Guidelines for BLS Diversion triggers''': Requires hospital administration approval
	*Above ALS diversion triggers AND		*Above ALS diversion triggers AND
	* ~~Number of~~ ambulance triage and #ESI 2’s in waiting room = 5-8		*3 patients in ambulance triage and at least 2 #ESI 2’s in waiting room = total 5-8
	*WR #s = 50-60		*WR #s = 50-60
	*WR LOS = >12hrs		*WR LOS = >12hrs

Andreawu at 17:01, 26 October 2021

2021-10-26T17:01:31Z

← Revisión anterior		Revisión del 17:01 26 oct 2021
Línea 1:		Línea 1:
	~~<big>Diversion decisions made by MICN, Overall Charge RN and Area Charge RNs, and Attending huddle q4 hours prn</big>~~

	'''ALS Diversion'''		'''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.		*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.
Línea 10:		Línea 8:
	**Allowing staff time to move patients within or through the ED to free up space/staff resources.		**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.		**Allowing the ED time to prepare for next round of sick patients.


	'''Guidelines for ALS Diversion triggers''':		'''Guidelines for ALS Diversion triggers''':
Línea 17:		Línea 16:
	*Diversion decisions made by joint agreement of MICN, OCN, AED Charge, and Attending		*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		*OCN & Attending names are recorded in the ReddiNet as the Authorizing personnel


	'''BLS Diversion'''		'''BLS Diversion'''

Andreawu at 17:00, 26 October 2021

2021-10-26T17:00:42Z

← Revisión anterior		Revisión del 17:00 26 oct 2021
Línea 3:		Línea 3:
	'''ALS Diversion'''		'''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.		*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.
	**ED ~~Saturation~~ does NOT redirect BLS arrivals or patients arriving to Harbor ~~as a specialty center~~ (e.g. Trauma, STEMI, Perinatal).		**“ALS ED Sat” does NOT redirect BLS arrivals or specialty center patients arriving to Harbor (e.g. Trauma, STEMI, Perinatal)..
	*~~Up to~~ two hours ~~at a time~~. At the end of the two-hour diversion, ReddiNet will automatically re-open the hospital to ~~all 9-1-1 traffic~~.		*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 ~~two~~ alternative ~~EDs are~~ also noted as ~~“ED Saturation”~~, ALS ambulances will be directed to the closest ED, regardless of “ED Sat” status on ReddiNet. (~~everyone is open~~)		*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.
	*'''Goal''' of ~~ED Saturation~~ is to ensure safety of current ED patients and of patients being transported by EMS~~. Diversion facilitates this~~ by:		*“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)
	**Allowing staff ~~the~~ time to move patients within or through the ED to free up space/staff resources ~~to care for additional patients, without pressure of incoming patients~~.		*'''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.		**Allowing the ED time to prepare for next round of sick patients.

	'''Guidelines for ALS Diversion triggers''':		'''Guidelines for ALS Diversion triggers''':
	*~~Not~~ enough space to care for the next critical patient coming by ambulance		*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 treatment spaces despite decompress patients to other beds/hallway
	**Not enough staff (RN, RT, provider, etc.) or supplies (vents, blood, etc.)		**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		'''Guidelines for BLS Diversion triggers''': Requires hospital administration approval
	*Very serious decision given consequences to community
	*Above ALS diversion triggers AND		*Above ALS diversion triggers AND
	* Number of ambulance triage and #ESI 2’s in waiting room = 5-8		* Number of ambulance triage and #ESI 2’s in waiting room = 5-8
Línea 23:		Línea 31:
	*WR LOS = >12hrs		*WR LOS = >12hrs
	*No trauma bays open		*No trauma bays open
	*~~OCN to notify~~ Clinical Nursing Director ~~or designee +~~ Attending ~~to notify [[Harbor:DEM_Admin_on_Duty_(AOD)\|DEM AOD]] --> Approval~~ by CMO/CEO or designee		*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



	[[Category:Admin]]		[[Category:Admin]]

Andreawu at 19:14, 25 October 2021

2021-10-25T19:14:57Z

← Revisión anterior		Revisión del 19:14 25 oct 2021
Línea 14:		Línea 14:
	**Not enough treatment spaces despite decompress patients to other beds/hallway		**Not enough treatment spaces despite decompress patients to other beds/hallway
	**Not enough staff (RN, RT, provider, etc.) or supplies (vents, blood, etc.)		**Not enough staff (RN, RT, provider, etc.) or supplies (vents, blood, etc.)


	'''Guidelines for BLS Diversion triggers''': Requires hospital administration approval		'''Guidelines for BLS Diversion triggers''': Requires hospital administration approval
			*Very serious decision given consequences to community
	*Above ALS diversion triggers AND		*Above ALS diversion triggers AND
	* Number of ambulance triage and #ESI 2’s in waiting room = 5-8		* Number of ambulance triage and #ESI 2’s in waiting room = 5-8
Línea 21:		Línea 23:
	*WR LOS = >12hrs		*WR LOS = >12hrs
	*No trauma bays open		*No trauma bays open
	*OCN to notify Clinical Nursing Director or designee + Attending to notify DEM AOD --> Approval by CMO/CEO or designee		*OCN to notify Clinical Nursing Director or designee + Attending to notify [[Harbor:DEM_Admin_on_Duty_(AOD)\|DEM AOD]] --> Approval by CMO/CEO or designee


	[[Category:Admin]]		[[Category:Admin]]

Andreawu at 19:09, 25 October 2021

2021-10-25T19:09:20Z

Andreawu at 19:04, 25 October 2021

2021-10-25T19:04:59Z

@@ Línea 1: / Línea 1: @@
-Guidelines for BLS Diversion triggers:
+Diversion decisions made by MICN, Overall Charge RN and Area Charge RNs, and Attending huddle q4 hours prn
-**# ESI 2’s – 5-8
-**WR #s – 50-60
+ALS Diversion
-**WR LOS – >12hrs
+*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.
-**No trauma bays open
+**ED Saturation does NOT redirect BLS arrivals or patients arriving to Harbor as a specialty center (e.g. Trauma, STEMI, Perinatal).
-**OCN to notify Joy LaGrone + Attending to notify DEM AOD --> Approval by CMO/CEO or designee
+*Up to two hours at a time. At the end of the two-hour diversion, ReddiNet will automatically re-open the hospital to all 9-1-1 traffic.

Andreawu: Created page with "Guidelines for BLS Diversion triggers: # ESI 2’s – 5-8 WR #s – 50-60 WR LOS – >12hrs No trauma bays open **OCN to notify Joy LaGrone + Attending to notify DE..."

2021-10-25T18:55:29Z

Created page with "Guidelines for BLS Diversion triggers: **# ESI 2’s – 5-8 **WR #s – 50-60 **WR LOS – >12hrs **No trauma bays open **OCN to notify Joy LaGrone + Attending to notify DE..."

Página nueva

Guidelines for BLS Diversion triggers:
**# ESI 2’s – 5-8
**WR #s – 50-60
**WR LOS – >12hrs
**No trauma bays open
**OCN to notify Joy LaGrone + Attending to notify DEM AOD --> Approval by CMO/CEO or designee

← Revisión anterior		Revisión del 19:09 25 oct 2021
Línea 1:		Línea 1:
	Diversion decisions made by MICN, Overall Charge RN and Area Charge RNs, and Attending huddle q4 hours prn		<big>Diversion decisions made by MICN, Overall Charge RN and Area Charge RNs, and Attending huddle q4 hours prn</big>

	ALS Diversion		'''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.		*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.
	**ED Saturation does NOT redirect BLS arrivals or patients arriving to Harbor as a specialty center (e.g. Trauma, STEMI, Perinatal).		**ED Saturation does NOT redirect BLS arrivals or patients arriving to Harbor as a specialty center (e.g. Trauma, STEMI, Perinatal).
	*Up to two hours at a time. At the end of the two-hour diversion, ReddiNet will automatically re-open the hospital to all 9-1-1 traffic.		*Up to two hours at a time. At the end of the two-hour diversion, ReddiNet will automatically re-open the hospital to all 9-1-1 traffic.
	*If the nearest two alternative EDs are also noted as “ED Saturation”, ALS ambulances will be directed to the closest ED, regardless of “ED Sat” status on ReddiNet. (everyone is open)		*If the nearest two alternative EDs are also noted as “ED Saturation”, ALS ambulances will be directed to the closest ED, regardless of “ED Sat” status on ReddiNet. (everyone is open)
	*Goal of ED Saturation is to ensure safety of current ED patients and of patients being transported by EMS. Diversion facilitates this by:		*'''Goal''' of ED Saturation is to ensure safety of current ED patients and of patients being transported by EMS. Diversion facilitates this by:
	**Allowing staff the time to move patients within or through the ED to free up space/staff resources to care for additional patients, without pressure of incoming patients.		**Allowing staff the time to move patients within or through the ED to free up space/staff resources to care for additional patients, without pressure of incoming patients.
	**Allowing the ED time to prepare for next round of sick patients.		**Allowing the ED time to prepare for next round of sick patients.

	Guidelines for ALS Diversion triggers:		'''Guidelines for ALS Diversion triggers''':
	*Not enough space to care for the next critical patient coming by ambulance		*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 treatment spaces despite decompress patients to other beds/hallway
	**Not enough staff (RN, RT, provider, etc.) or supplies (vents, blood, etc.)		**Not enough staff (RN, RT, provider, etc.) or supplies (vents, blood, etc.)

	Guidelines for BLS Diversion triggers:		'''Guidelines for BLS Diversion triggers''': Requires hospital administration approval
	*Above ALS diversion triggers AND		*Above ALS diversion triggers AND
	* Number of ambulance triage and #ESI 2’s in waiting room = 5-8		* Number of ambulance triage and #ESI 2’s in waiting room = 5-8
Línea 21:		Línea 21:
	*WR LOS = >12hrs		*WR LOS = >12hrs
	*No trauma bays open		*No trauma bays open
	*OCN to notify ~~Joy LaGrone~~ + Attending to notify DEM AOD --> Approval by CMO/CEO or designee		*OCN to notify Clinical Nursing Director or designee + Attending to notify DEM AOD --> Approval by CMO/CEO or designee


			[[Category:Admin]]