Harbor:VA MICU rotation - Revision history

Mholtz: Text replacement - "-->" to "→"

2017-11-17T15:28:23Z

Text replacement - "-->" to "→"

← Revisión anterior		Revisión del 15:28 17 nov 2017
Línea 52:		Línea 52:
	*Call the Bed Control/Nursing Supervisor 53568 or page 2920 to find out if patient has been assigned a bed.		*Call the Bed Control/Nursing Supervisor 53568 or page 2920 to find out if patient has been assigned a bed.
	*Once the patient has been assigned a bed, page GMED admitting resident pager 89082 to sign out your patient. '''Remember to ask their team info to update the transfer order.'''		*Once the patient has been assigned a bed, page GMED admitting resident pager 89082 to sign out your patient. '''Remember to ask their team info to update the transfer order.'''
	*The cap for ~~ICU-->GMED~~ transfers is 4 patients per receiving team. The ICU residents should discuss amongst themselves and prioritize the transfers with most ongoing hospital needs.		*The cap for ICU→GMED transfers is 4 patients per receiving team. The ICU residents should discuss amongst themselves and prioritize the transfers with most ongoing hospital needs.
	*Transfers from ICU to GMED occurring after 5pm should be discussed with the MOD to ensure appropriateness of transfer.		*Transfers from ICU to GMED occurring after 5pm should be discussed with the MOD to ensure appropriateness of transfer.
	*In the circumstances where the ICU is in need of beds at any time, the patient can be transferred out of the unit overnight and still be cared for by ICU team, then transferred to GMED in the morning.		*In the circumstances where the ICU is in need of beds at any time, the patient can be transferred out of the unit overnight and still be cared for by ICU team, then transferred to GMED in the morning.

PoppyCat: /* Pre Day-1 */

2017-08-18T22:22:35Z

Pre Day-1

Show changes

PoppyCat: /* Background */

2017-07-20T02:46:14Z

Background

← Revisión anterior		Revisión del 02:46 20 jul 2017
Línea 1:		Línea 1:
	==Background==		==Background==
	*~~VA Coordinator~~ is ~~Christine Seydel.~~ 310-268-~~3034~~. ~~Email christine~~.~~seydel~~@va.gov. ~~She works from Monday-Thursday~~.		*Badge/CPRS coordinator is Kerri Frasca Mapu: (310) 268-3002/Kerri.Frasca@va.gov/Office Main Hospital 3220
	*Call schedule at the website: ~~www.~~amion.com~~. The~~ login ~~is cedarsim~~		*Schedule contacts are Kelsey Anderson (Kelsey.Anderson2@va.gov), Ian Cowan (ICowan@mednet.ucla.edu), and UCLA chiefs (CurrentChiefs@mednet.ucla.edu)
			*Call schedule at the website:to amion.com, use the login code “ucla im”

	==Pre Day-1==		==Pre Day-1==
Línea 24:		Línea 25:
	*Telemetry (cards) is in 5 South B		*Telemetry (cards) is in 5 South B

	*The ICU is broken into 3 teams that consist of an intern and a resident. Call is usually q3. Call is from ~~8 AM~~-~~6AM~~. Any patient you admit before ~~6 AM~~ the following day goes to your team. Similarly, the previous day's call team may give you an admission if it arrived to them after ~~6 AM~~ on the morning you are starting call.		*The ICU is broken into 4 teams that consist of an intern and a resident. Call is usually q4. Call is from 7am -11am (but admit until 6am). Any patient you admit before 6am the following day goes to your team. Similarly, the previous day's call team may give you an admission if it arrived to them after 6am on the morning you are starting call. You carry the code pager when you are on call. On a call day your intern stays until 7pm. A night float intern arrives at 7pm (who does all the floor work and is not usually responsible for new admissions).
			*Code/RRT pager always goes off at 8am, 2pm, and 8pm for test. If you are carrying the code pager you will need to sign in at 8am and 8pm at the main nurse station binder.
			*On a non-call day you and your intern can sign out to the call team as soon as your work in done, usually somewhere between noon to 5pm
	*You admit any medical patient who needs any sort of monitoring. Even neuro stroke patients watch overnight and rarely surgery patients as well.		*You admit any medical patient who needs any sort of monitoring. Even neuro stroke patients watch overnight and rarely surgery patients as well.
	*You transfer patients to and receive patients from the ward		*You transfer patients to and receive patients from the ward
	*The nursing care at the wards at the VA is like our 6W ward. That is poorly monitored. So do not hastily transfer to ward to diurese your service. You will likely run a code in the ward- when someone has already been dead for a few hours.		*The nursing care at the wards at the VA is like our 6W ward. That is poorly monitored. So do not hastily transfer to ward to diurese your service. You will likely run a code in the ward- when someone has already been dead for a few hours.
	*Rounds usually begin around 8:30. However, if you have any CCU patients on your service, the CCU fellow and attending round at 7:30 and you must be present. Also, if you are on call for the day and there are any CCU patients on the entire MICU service (even if they’re not yours), you must be present for the 7:30 rounds.		*Rounds usually begin around 8:30. However, if you have any CCU patients on your service, the CCU fellow and attending round at 7:30 and you must be present. Also, if you are on call for the day and there are any CCU patients on the entire MICU service (even if they’re not yours), you must be present for the 7:30 rounds.
	*The docs rely on you to assume care for admitted patients once they ~~talk~~ to you, so see your patients soon after getting the admission.		*The docs rely on you to assume care for admitted patients once they verbally signed out to you, so see your patients soon after getting the admission.
	*Code pager always goes off at 9 am for test.		*To page people in the VA, VA pager dial star 11 first. Cedars pager dial star 19 first. UCLA pager 1-800-BEEP-231 first.
	*You carry the code pager and the "rapid response" pager. Do not ignore these pages- but you will likely get many false alarms.		*To sign out/cover a pager, call UCLA pager operator (310)206-6766
	*To page people in the VA, VA pager dial 11 first. Cedars pager dial 19 first. UCLA pager 1-800-BEEP-231 first.

	==Admission==		==Admission==
	*You can get 2 types of admits: From the ED and transfers from other services and the general medicine floor. For the floor transfers, go see the patient before accepting the transfer. You are able to block the transfer if you think it is not acceptable, however, it can be easier just to take the patient. If you accept the transfer, the primary team needs to write a transfer summary note as well as delayed orders to your service. The intern caps officially at 10 patients and then you see the remainder of the admits on your own.		*You can get 2 types of admits: From the ED and transfers from other services and the general medicine floor. For the floor transfers, go see the patient before accepting the transfer. You are able to block the transfer if you think it is not acceptable, however, it can be easier just to take the patient. If you accept the transfer, the primary team needs to write a transfer summary note as well as delayed orders to your service. The intern caps officially at 10 patients and then you see the remainder of the admits on your own.
	*At night, if you get an admit, ask the MICU if they have room for the patient prior to transfer, the nurses greatly appreciate this.		*At night, if you get an admit, ask the MICU if they have room for the patient prior to transfer, the nurses greatly appreciate this.
	*To consult a service, you call the service as well as place a consult in the computer. Overnight, any surgical consult including neurosurgery is a general surgery intern.		*To consult a service, you call the service as well as place a consult in the computer. Overnight, any surgical consult including neurosurgery is a general surgery intern. The surgery intern will deliver an updated sheet of consult pager numbers to the MICU workroom in the evening.
	*Procedures: it depends on the fellow but procedures on your own are ok if you feel comfortable. The fellow can also help.		*Procedures: It depends on the fellow but procedures on your own are ok if you feel comfortable. The fellow can also help. The MICU is responsible for putting in Quinton catheters for dialysis.
	*Intubations: if you are comfortable, you can intubate patients yourself without anesthesia. However, [[RSI]] drugs are not necessarily readily available and you may have to push the drugs yourself. If the fellow is around he can help you out. Anesthesia (usually a CRNA) will likely always steal your tube. Even if you are the one running a code. But you can always ask to do the intubation.		*Intubations: if you are comfortable, you can intubate patients yourself without anesthesia. However, [[RSI]] drugs are not necessarily readily available and you may have to push the drugs yourself. If the fellow is around he can help you out. Anesthesia (usually a CRNA) will likely always steal your tube. Even if you are the one running a code. But you can always ask to do the intubation.
	*Signout — the interns sign out to each other. Usually the residents would just heads-up each other if they felt a patient was unstable, etc.		*Signout — In the morning the interns sign out to each other. Usually the residents would just heads-up each other if they felt a patient was unstable, etc. In the afternoon usually you and your intern sign out together to the on call resident and intern. You need to update/print out the sign out sheet in CPRS.

	==Discharge/Transfer==		==Discharge/Transfer==
Línea 52:		Línea 54:
	*Call room is on 6th floor East, follow signs for resident quarters.		*Call room is on 6th floor East, follow signs for resident quarters.
	**Door code is 5-2-3-1.		**Door code is 5-2-3-1.
	*Remember to bring food and drinks. Cafeteria closes at 3 pm. There is NO food in the hospital on the weekends. There is free lunch in the 3East conference room on Mondays, Wednesdays, Thursdays, and Fridays, usually sandwiches or pizzas. There is a fridge in the call room for you to store your food.		*Remember to bring food and drinks. Cafeteria closes at 3 pm but re-opens at 12:30 am. There is NO food in the hospital on the weekends. There is free lunch in the 3East conference room on Mondays, Wednesdays, Thursdays, and Fridays, usually sandwiches or pizzas. There is a fridge in the call room for you to store your food.

	==References==		==References==
Línea 60:		Línea 62:
	7/6/09 Jonie Hsiao<br>		7/6/09 Jonie Hsiao<br>
	7/18/09 Tina Nguyen		7/18/09 Tina Nguyen
			7/2017 Diane Hsu

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

Rossdonaldson1: Text replacement - "RSI " to "RSI "

2017-01-05T03:41:45Z

Text replacement - "RSI " to "RSI "

← Revisión anterior		Revisión del 03:41 5 ene 2017
Línea 39:		Línea 39:
	*To consult a service, you call the service as well as place a consult in the computer. Overnight, any surgical consult including neurosurgery is a general surgery intern.		*To consult a service, you call the service as well as place a consult in the computer. Overnight, any surgical consult including neurosurgery is a general surgery intern.
	*Procedures: it depends on the fellow but procedures on your own are ok if you feel comfortable. The fellow can also help.		*Procedures: it depends on the fellow but procedures on your own are ok if you feel comfortable. The fellow can also help.
	*Intubations: if you are comfortable, you can intubate patients yourself without anesthesia. However, RSI drugs are not necessarily readily available and you may have to push the drugs yourself. If the fellow is around he can help you out. Anesthesia (usually a CRNA) will likely always steal your tube. Even if you are the one running a code. But you can always ask to do the intubation.		*Intubations: if you are comfortable, you can intubate patients yourself without anesthesia. However, [[RSI]] drugs are not necessarily readily available and you may have to push the drugs yourself. If the fellow is around he can help you out. Anesthesia (usually a CRNA) will likely always steal your tube. Even if you are the one running a code. But you can always ask to do the intubation.
	*Signout — the interns sign out to each other. Usually the residents would just heads-up each other if they felt a patient was unstable, etc.		*Signout — the interns sign out to each other. Usually the residents would just heads-up each other if they felt a patient was unstable, etc.

Mholtz at 02:53, 30 December 2016

2016-12-30T02:53:43Z

← Revisión anterior		Revisión del 02:53 30 dic 2016
Línea 56:		Línea 56:
	==References==		==References==
	<references/>		<references/>
	9/11/05 Dorcas Atkinson, Lisa Dabby, Chirag Shah		9/11/05 Dorcas Atkinson, Lisa Dabby, Chirag Shah<br>
	7/10/08 Rachelle Sohren's Guide to the VA Rotation		7/10/08 Rachelle Sohren's Guide to the VA Rotation<br>
	7/6/09 Jonie Hsiao		7/6/09 Jonie Hsiao<br>
	7/18/09 Tina Nguyen		7/18/09 Tina Nguyen

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

Mholtz at 02:53, 30 December 2016

2016-12-30T02:53:17Z

Show changes

Neil.m.young: Text replacement - " ==" to "=="

2016-07-06T14:11:14Z

Text replacement - " ==" to "=="

← Revisión anterior		Revisión del 14:11 6 jul 2016
Línea 1:		Línea 1:
	==Background ==		==Background==
	VA Coordinator is Christine Seydel. 310-268-3034. Email christine.seydel@va.gov. She works from Monday-Thursday.		VA Coordinator is Christine Seydel. 310-268-3034. Email christine.seydel@va.gov. She works from Monday-Thursday.

	Call schedule at the website: www.amion.com. The login is cedarsim		Call schedule at the website: www.amion.com. The login is cedarsim

	==Pre Day-1 ==		==Pre Day-1==
	#Complete online training		#Complete online training
	#www.ees-learning.net		#www.ees-learning.net
Línea 28:		Línea 28:
	At that time, ask Chris (coordinator) for your meal voucher = money for each night you are on call. $7 each weekday and $13 on the weekend calls. Make sure you log onto Amion and print out your call schedule, as the form for reimbursement requires it.		At that time, ask Chris (coordinator) for your meal voucher = money for each night you are on call. $7 each weekday and $13 on the weekend calls. Make sure you log onto Amion and print out your call schedule, as the form for reimbursement requires it.

	==Basics ==		==Basics==
	#MICU/CCU/SICU is in 5 West.		#MICU/CCU/SICU is in 5 West.
	#pCU 5 South C		#pCU 5 South C
Línea 51:		Línea 51:
	--To page people in the VA, VA pager dial 11 first. Cedars pager dial 19 first. UCLA pager 1-800-BEEP-231 first.		--To page people in the VA, VA pager dial 11 first. Cedars pager dial 19 first. UCLA pager 1-800-BEEP-231 first.

	==Admission ==		==Admission==
	--You can get 2 types of admits: From the ED and transfers from other services and the general medicine floor. For the floor transfers, go see the patient before accepting the transfer. You are able to block the transfer if you think it is not acceptable, however, it can be easier just to take the patient. If you accept the transfer, the primary team needs to write a transfer summary note as well as delayed orders to your service. The intern caps officially at 10 patients and then you see the remainder of the admits on your own.		--You can get 2 types of admits: From the ED and transfers from other services and the general medicine floor. For the floor transfers, go see the patient before accepting the transfer. You are able to block the transfer if you think it is not acceptable, however, it can be easier just to take the patient. If you accept the transfer, the primary team needs to write a transfer summary note as well as delayed orders to your service. The intern caps officially at 10 patients and then you see the remainder of the admits on your own.

Línea 64:		Línea 64:
	--Signout—the interns sign out to each other. Usually the residents would just heads-up each other if they felt a patient was unstable, etc.		--Signout—the interns sign out to each other. Usually the residents would just heads-up each other if they felt a patient was unstable, etc.

	==Discharge/Transfer ==		==Discharge/Transfer==
	--To transfer someone, you usually will call general medicine and transfer the patient to the medicine ward.		--To transfer someone, you usually will call general medicine and transfer the patient to the medicine ward.

Línea 75:		Línea 75:
	--If you discharge somebody directly from the MICU, you must write a discharge summary in the computer. The same goes for death notes.		--If you discharge somebody directly from the MICU, you must write a discharge summary in the computer. The same goes for death notes.

	==Call Room ==		==Call Room==
	#Call room is on 6th floor East, follow signs for resident quarters.		#Call room is on 6th floor East, follow signs for resident quarters.
	#Door code is 5-2-3-1.		#Door code is 5-2-3-1.

Neil.m.young: Text replacement - "== " to "=="

2016-07-05T15:37:00Z

Text replacement - "== " to "=="

← Revisión anterior		Revisión del 15:37 5 jul 2016
Línea 1:		Línea 1:
	== Background ==		==Background ==
	VA Coordinator is Christine Seydel. 310-268-3034. Email christine.seydel@va.gov. She works from Monday-Thursday.		VA Coordinator is Christine Seydel. 310-268-3034. Email christine.seydel@va.gov. She works from Monday-Thursday.

	Call schedule at the website: www.amion.com. The login is cedarsim		Call schedule at the website: www.amion.com. The login is cedarsim

	== Pre Day-1 ==		==Pre Day-1 ==
	#Complete online training		#Complete online training
	#www.ees-learning.net		#www.ees-learning.net
Línea 28:		Línea 28:
	At that time, ask Chris (coordinator) for your meal voucher = money for each night you are on call. $7 each weekday and $13 on the weekend calls. Make sure you log onto Amion and print out your call schedule, as the form for reimbursement requires it.		At that time, ask Chris (coordinator) for your meal voucher = money for each night you are on call. $7 each weekday and $13 on the weekend calls. Make sure you log onto Amion and print out your call schedule, as the form for reimbursement requires it.

	== Basics ==		==Basics ==
	#MICU/CCU/SICU is in 5 West.		#MICU/CCU/SICU is in 5 West.
	#pCU 5 South C		#pCU 5 South C
Línea 51:		Línea 51:
	--To page people in the VA, VA pager dial 11 first. Cedars pager dial 19 first. UCLA pager 1-800-BEEP-231 first.		--To page people in the VA, VA pager dial 11 first. Cedars pager dial 19 first. UCLA pager 1-800-BEEP-231 first.

	== Admission ==		==Admission ==
	--You can get 2 types of admits: From the ED and transfers from other services and the general medicine floor. For the floor transfers, go see the patient before accepting the transfer. You are able to block the transfer if you think it is not acceptable, however, it can be easier just to take the patient. If you accept the transfer, the primary team needs to write a transfer summary note as well as delayed orders to your service. The intern caps officially at 10 patients and then you see the remainder of the admits on your own.		--You can get 2 types of admits: From the ED and transfers from other services and the general medicine floor. For the floor transfers, go see the patient before accepting the transfer. You are able to block the transfer if you think it is not acceptable, however, it can be easier just to take the patient. If you accept the transfer, the primary team needs to write a transfer summary note as well as delayed orders to your service. The intern caps officially at 10 patients and then you see the remainder of the admits on your own.

Línea 64:		Línea 64:
	--Signout—the interns sign out to each other. Usually the residents would just heads-up each other if they felt a patient was unstable, etc.		--Signout—the interns sign out to each other. Usually the residents would just heads-up each other if they felt a patient was unstable, etc.

	== Discharge/Transfer ==		==Discharge/Transfer ==
	--To transfer someone, you usually will call general medicine and transfer the patient to the medicine ward.		--To transfer someone, you usually will call general medicine and transfer the patient to the medicine ward.

Línea 75:		Línea 75:
	--If you discharge somebody directly from the MICU, you must write a discharge summary in the computer. The same goes for death notes.		--If you discharge somebody directly from the MICU, you must write a discharge summary in the computer. The same goes for death notes.

	== Call Room ==		==Call Room ==
	#Call room is on 6th floor East, follow signs for resident quarters.		#Call room is on 6th floor East, follow signs for resident quarters.
	#Door code is 5-2-3-1.		#Door code is 5-2-3-1.

Neil.m.young: Text replacement - "== Source ==" to "==References== "

2016-06-27T23:31:17Z

Text replacement - "== Source ==" to "==References== <references/>"

← Revisión anterior		Revisión del 23:31 27 jun 2016
Línea 81:		Línea 81:
	--Remember to bring food and drinks. Cafeteria closes at 3 pm. There is NO food in the hospital on the weekends. There is free lunch in the 3East conference room on Mondays, Wednesdays, Thursdays, and Fridays, usually sandwiches or pizzas. There is a fridge in the call room for you to store your food.		--Remember to bring food and drinks. Cafeteria closes at 3 pm. There is NO food in the hospital on the weekends. There is free lunch in the 3East conference room on Mondays, Wednesdays, Thursdays, and Fridays, usually sandwiches or pizzas. There is a fridge in the call room for you to store your food.

	== ~~Source~~ ==		==References==
			<references/>
	9/11/05 Dorcas Atkinson, Lisa Dabby, Chirag Shah		9/11/05 Dorcas Atkinson, Lisa Dabby, Chirag Shah

Hacharya: /* Basics */

2016-04-19T21:56:25Z

Basics

← Revisión anterior		Revisión del 21:56 19 abr 2016
Línea 33:		Línea 33:
	#Telemetry (cards) 5 South B		#Telemetry (cards) 5 South B

	--The ICU is broken into 3 teams that consist of an intern and a resident. Call is usually q3. Call is from 8 AM-~~8PM~~. Any patient you admit before ~~7 PM~~ goes to your team. ~~Any patient you admit after 7 PM goes to the next day’s team. The night float resident comes in at 8 PM and then is responsible for the overnight admissions~~, ~~which goes to~~ the ~~next day’s~~ team~~. Please be aware that~~ you ~~may come in~~ the ~~next~~ morning ~~with brand new patients on your list~~.		--The ICU is broken into 3 teams that consist of an intern and a resident. Call is usually q3. Call is from 8 AM-6AM. Any patient you admit before 6 AM the following day goes to your team. Similarly, the previous day's call team may give you an admission if it arrived to them after 6 AM on the morning you are starting call.

	--You admit any medical patient who needs any sort of monitoring. Even neuro stroke patients watch overnight and rarely surgery patients as well.		--You admit any medical patient who needs any sort of monitoring. Even neuro stroke patients watch overnight and rarely surgery patients as well.